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Funding Impact of the 1115 Transformation Waiver

Funding Impact of the 1115 Transformation Waiver. RHP 14 Learning Collaborative July 18 , 2014. Kevin Nolting Consulting. Current Status of UCC Funding. Recent Information on DY 3 UCC Funding Activities:

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Funding Impact of the 1115 Transformation Waiver

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  1. Funding Impact of the 1115 Transformation Waiver RHP 14 Learning Collaborative July 18, 2014 Kevin Nolting Consulting

  2. Current Status of UCC Funding Recent Information on DY 3 UCC Funding Activities: • HHSC has developed the Texas Hospital Uncompensated Care (TXHUC) application, a combined DSH and UC application for FFY 2014 (DY 3) • This application will serve two purposes • HHSC will be using information in the application to conduct the interim reconciliation for all providers that received a FFY 2011 Demonstration Year (DY 1) UC payment as required under the CMS UC Waiver Claiming Protocol. • All providers that wish to participate in the FFY 2014 DSH and/or in the DY 3 UC program have to complete and submit the application. • Providers wanting to participate in the FFY 2014 DSH program and/or the DY 3 UC program must complete the TXHUC to be eligible. • Providers who received DY 1 UC payments must complete the form or will be subject to recoupment of all DY 1 UC payments • HHSC deadline for requesting a copy of the TXHUC is July 23, 2014. • A hospital that fails to request a TXHUC by the deadline will not be eligible to participate in the 2014 DSH and DY 3 UC programs or to appeal HHSC's non-qualification decisions. • No published estimate of future program funding dates.

  3. Current Status of UCC Funding Recent Information on DY 2 UCC Funding Activities: • HHSC distributed $3.9 Billion in DY 2 UCC payments (total allocation) • Statewide committed IGT would have paid $4.9 Billion • Resulted in a 21.7% haircut to remain within DY 2 UCC Pool allocation • Total UCC costs reported was $5.9 Billion

  4. Funding Implications The following are funding questions that need to be addressed collaboratively between HHSC and the Waiver participants: • Allocation of dwindling UC Pool. • Future impact on indigent care affiliations due to reduced UC Pool and future “haircuts”. • Impact of the outcome of HHSC Rider 86. • Impact of future changes related to the Affordable Care Act. • Status of DSH funding for future years. • Prepare for negotiations on Waiver renewal and strategies for successful outcomes.

  5. Allocation of Dwindling UC Pool Current Waiver Pool Allocations

  6. Allocation of Dwindling UC Pool Historical UPL Expenditures Projected

  7. Impact on IGT of Haircut Impact on IGT of Haircut Scenarios on Impacts on IGT resulting from a Haircut

  8. Questions and Answers Kevin Nolting knolting@noltingconsulting.com

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