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Texas Temporary COVID Medicaid Rate Increase

Tiffany Karlin

June 22, 2020

Texas Health and Human Services approved a temporary rate increase of $19.63 per day for Medicaid residents in Texas nursing facilities. Read the complete update here.

Bullet points provided by the TX Health Care Association.

Updates include:

  • The rate add-on will be retroactive to April 1, 2020.
  • Rate is valid through the “COVID pandemic”.
  • Items such as MCO Administrative fees and premium taxes will be paid on top of the provider rate increase, and not taken out of the $19.63.
  • Providers should expect to see higher payments in the next TMHP funding distributions.
  • HHSC is working with the MCOs to automate processing payments moving forward effective July 1, 2020.  As for reprocessing of previously paid claims (retro to 4/1/20), they will be giving MCOs up to 60 days to adjudicate the claims. 
  • PLEASE NOTE: this increase is to be used on “expenditures related to COVID” only.
  • Clarification on staffing costs: defined as the use of “increased staff compensation through reimbursement of overtime or lump sum bonuses, including bonuses for hazard pay, or other methodologies that will not result in future reductions in hourly wages when the temporary rate increases are discontinued”. 
  • Like the HHS Provider Relief Payments, Texas providers will need to sign an Attestation form on the use of funds. You will have 90 days to sign the form, and failure to do so may result in recoupment of funds, and halt payment of the add-on for those providers.

Rate increase information is available here.

NOTE: Full terms and conditions and use of funds have not been posted in writing to date. Once we are in receipt we will keep you apprised.

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