1 Tex. Admin. Code § 354.1649 - Certain Requirements for the Planned Transition Year and their Exceptions
(a) To be eligible
for the MLIU QPI milestone payment, beginning in the transition year,
performers must report for each DSRIP project the MLIU individuals served or
encounters provided at the individual or encounter level as opposed to the
percentage of total QPI.
(b) There
are limited exceptions to this requirement. Performers may request an exception
to this requirement by a date to be determined by HHSC. DSRIP projects eligible
for an exception include:
(1) a DSRIP project
for which the performer did not assess the DSRIP project participants' health
insurance coverage or financial status prior to September 30, 2015, and instead
used a proxy to estimate the MLIU population served in their October DY4 QPI
Reporting Template, and:
(A) utilizes an
intervention site that is a school, non-medical social service office (i.e.,
shelter), or community health fair;
(B) is in Project Area 1.6 (Enhance Urgent
Medical Advice), 2.6 (Implement Evidence-based Health Promotion), or 2.7
(Implement Evidence-based Disease Prevention Programs); or
(C) the performer is a Local Health
Department that does not bill Medicaid for the types of services provided
through the DSRIP project; or
(2) any other DSRIP project that HHSC
determines has a strong justification for an exception.
Notes
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