U.S. flag

An official website of the United States government

Texas Healthcare Transformation and Quality Improvement Program

State: Texas
Waiver Authority:
1115
Status: Approved

Waiver Dates

Approval: 12/12/2011
Effective: 12/12/2011
Expiration: 09/30/2030

Supporting Documents

Approved Application(s) and Related Documents

Date Title
09/24/2024 Demonstration Approval – PHP-CCP Limits, Attachment H and UC Tool, and Technical Corrections (PDF, 8.14 MB)
01/01/2018 Fact Sheet (PDF, 65.48 KB)

Administrative Record

Date Title
04/04/2024 State Withdrawal of Postpartum Coverage Amendment (PDF, 127.96 KB)
02/28/2024 Quarterly Monitoring Report - 10/1/2023 - 12/31/2023 (PDF, 8.21 MB)
12/28/2023 Quarter 4 & Annual Monitoring Report – 10/1/2022 – 9/30/2023 (PDF, 18.31 MB)
12/15/2023 State Acceptance Letter (PDF, 273.42 KB)
11/16/2023 Demonstration Approval (PDF, 8.16 MB)
10/18/2023 CMS Approval - UC Pool Reassessment Data Source (PDF, 311.61 KB)
09/06/2023 State Withdrawal of STAR Kids Preferred Drug List Amendment (PDF, 193.88 KB)
08/29/2023 Quarterly Monitoring Report – April - June 2023 (PDF, 7.35 MB)
08/29/2023 State Letter on UC Pool Reassessment Data Source and Withdrawal of Amendment (PDF, 232.5 KB)
06/26/2023 Demonstration Approval – Technical Correction (PDF, 8.22 MB)
05/23/2023 Quarterly Monitoring Report – 1/1/2023 – 3/31/2023 (PDF, 8.99 MB)
05/16/2023 CMS Completeness Letter (PDF, 294.81 KB)
05/09/2023 CMS Attachment K Approval (PDF, 347.13 KB)
05/01/2023 Modification to Second Reassessment of UC Pool Amendment (PDF, 736.15 KB) View Comments
02/28/2023 Quarter 1 Monitoring Report – 10/1/2022 – 12/31/2022 (PDF, 23.4 MB)
01/26/2023 CMS Approved Technical Corrections (PDF, 7.99 MB)
12/29/2022 Quarter 4 & Annual Monitoring Report – October 2021 – September 2022 (PDF, 13.69 MB)
09/08/2022 Quarterly Monitoring Report – 1/1/2022 – 3/31/2022 (PDF, 6.19 MB)
08/29/2022 Quarterly Monitoring Report – 4/1/2022 – 6/30/2022 (PDF, 3.02 MB)
06/16/2022 Quarterly Monitoring Report – 10/1/2021 – 12/31/2021 (PDF, 22.43 MB)
06/09/2022 CMS Complete Letter (PDF, 326.04 KB)
06/08/2022 CMS Approved Technical Corrections (PDF, 8.32 MB)
05/26/2022 CMS Approved Evaluation Design (PDF, 2.91 MB)
05/25/2022 Postpartum Coverage Amendment Application (PDF, 704.48 KB) View Comments
05/13/2022 CMS Complete Letter (PDF, 288.08 KB)
05/04/2022 Case Management Amendment Application (PDF, 492.4 KB) View Comments
04/22/2022 CMS Letter to State (PDF, 178.52 KB)
03/16/2022 CMS Approved Evaluation Design (PDF, 2.34 MB)
02/03/2022 State Withdrawal of Applied Behavioral Analysis Amendment (PDF, 297.78 KB)
12/22/2021 CMS Approval – PHP-CCP Payment Protocol (PDF, 916 KB)
12/22/2021 Quarter 4 & Annual Monitoring Report – 10/1/2020 – 9/30/2021 (PDF, 26.77 MB)
11/29/2021 State Letter to CMS (PDF, 191.9 KB)
11/22/2021 Quarterly Budget Neutrality Report July 1, 2021 – September 30, 2021 (XLSX, 418.35 KB)
11/18/2021 CMS Complete Letter (PDF, 281.66 KB)
11/15/2021 CMS Letter to State (PDF, 260.44 KB)
11/05/2021 STAR Kids Preferred Drug List Amendment (PDF, 707.15 KB) View Comments
10/14/2021 CMS Complete Letter (PDF, 287.47 KB)
10/01/2021 Applied Behavioral Analysis Amendment (PDF, 605.54 KB) View Comments
09/14/2021 CMS Approved Interim Evaluation Report (PDF, 4.87 MB)
09/07/2021 Letter from the State (PDF, 305.45 KB)
08/27/2021 Quarterly Monitoring Report – 4/1/2021 – 6/30/2021 (PDF, 20.13 MB)
08/25/2021 Quarterly Budget Neutrality Report April 1, 2021 to June 30, 2021 (XLSM, 426.66 KB)
08/25/2021 Quarterly Budget Neutrality Report – April 2021 - June 2021 (XLSM, 453.23 KB)
08/16/2021 Letter from State (PDF, 129.15 KB)
08/13/2021 CMS Letter to State (PDF, 228.98 KB)
07/28/2021 CMS Complete Letter (PDF, 301.41 KB)
07/14/2021 State Extension Application (ZIP, 14.98 MB) View Comments
07/08/2021 Semi-Annual Monitoring Report – July 2021 (PDF, 22.71 MB)
07/06/2021 State Acceptance Letter - Amendment 17 (PDF, 144.31 KB)
06/08/2021 CMS Amendment Approval (PDF, 6.32 MB)
05/27/2021 Quarterly Budget Neutrality Report – January 2021 - March 2021 (XLSM, 453.69 KB)
05/25/2021 Quarterly Budget Neutrality Report January 1, 2021 – March 31, 2021 (XLSX, 418.34 KB)
04/19/2021 CMS Attachment K Approval (PDF, 448.07 KB)
04/16/2021 CMS Letter to State (PDF, 5.77 MB)
04/01/2021 Annual Budget Neutrality Report January 22, 2020 to December 31, 2020 (XLSM, 426.46 KB)
03/24/2021 CMS Complete Letter (PDF, 195.57 KB)
03/24/2021 CMS Complete Letter (PDF, 195.53 KB)
03/01/2021 Annual Monitoring Report – March 2021 (PDF, 5.86 MB)
02/22/2021 Medically Fragile Amendment Application (PDF, 464.93 KB) View Comments
02/12/2021 CMS Letter to State (PDF, 39.08 KB)
01/20/2021 NEMT Amendment 17 (PDF, 401.28 KB) View Comments
01/15/2021 CMS Approval (PDF, 4.74 MB)
01/15/2021 State Acceptance Letter (PDF, 195.22 KB)
12/15/2020 CMS Complete Letter and State PHE Application (PDF, 3.54 MB)
11/24/2020 Quarterly Budget Neutrality Report July 1, 2020 – September 30, 2020 (XLSX, 419.95 KB)
10/13/2020 CMS Technical Corrections (PDF, 630.99 KB)
10/08/2020 Annual Budget Neutrality Monitoring Report - October 2019 - September 2020 (XLSM, 124.78 KB)
09/16/2020 Medically Fragile Amendment Incomplete Letter (PDF, 195.44 KB)
09/08/2020 CMS Approval - Texas Amendment 16 (PDF, 679.27 KB)
09/08/2020 CMS Approval - Texas COVID-19 Amendment (PDF, 646.4 KB)
09/02/2020 CMS Approved DSRIP Transition Plan (PDF, 665.04 KB)
08/26/2020 Quarterly Budget Neutrality Report April 1, 2020 to June 30, 2020 (XLSM, 426.66 KB)
08/14/2020 Annual Report October 2019 - September 2020 (PDF, 528.41 KB)
08/07/2020 CMS STC Update Approval (PDF, 605.62 KB)
06/08/2020 CMS Complete Letter (PDF, 66.08 KB)
06/02/2020 State Amendment 16 Application (PDF, 779.18 KB) View Comments
05/27/2020 Quarterly Budget Neutrality Report January 22, 2020 to March 31, 2020 (XLSM, 426.62 KB)
05/19/2020 CMS Technical Corrections (PDF, 5.11 MB)
05/11/2020 CMS Approved Health Information Technology Strategic Plan (PDF, 540.05 KB)
05/05/2020 CMS Approved Program Funding and Mechanics Protocol (PDF, 607.29 KB)
03/31/2020 Annual Report September 2018 – October 2019 (PDF, 561.13 KB)
03/31/2020 Texas-submitted Health Information Technology Plan (PDF, 508.47 KB)
03/26/2020 DSRIP Payments September 2018 – October 2019 (XLSX, 2.17 MB)
09/30/2019 Draft DSRIP Transition Plan (PDF, 691.47 KB)
09/26/2019 CMS Approval of Texas Uncompensated Care Pool Resizing (PDF, 1.42 MB)
09/17/2019 CMS Approved Texas Measure Bundle and Program Funding and Mechanics Protocols (PDF, 1.65 MB)
09/16/2019 Semi-Annual Demonstration Report 2019 (PDF, 344.78 KB)
06/13/2019 CMS Approved UC Application Tools (PDF, 1.61 MB)
05/31/2019 Waiver Payments and State Share Source January-March 2019 (XLSX, 20.01 MB)
05/17/2019 DSRIP Payments October-September 2018 (XLSX, 1.52 MB)
05/17/2019 Quarterly Caseload Reporting January-March 2019 (XLSX, 14.72 KB)
05/17/2019 Quarterly Cost Reporting January-March 2019 (XLSX, 94.1 KB)
04/09/2019 Amendment 4 Application and Decision Letter (PDF, 686.37 KB)
03/29/2019 Draft Texas-Submitted DY9-10 Program Funding and Mechanics (PFM) Protocol (PDF, 775.88 KB)
03/14/2019 Annual Report October-September 2018 (PDF, 2.85 MB)
02/26/2019 2019 DY8 Q1 1115 Waiver Quarterly Payments with State Share Source (XLSX, 960.8 KB)
12/31/2018 DY7 Estimated UC Payments (XLSX, 12.11 MB)
12/29/2018 DY7 Actual UC Payments (XLSX, 12.1 MB)
11/30/2018 2018 DY7 Q4 1115 Waiver Quarterly Payments with State Share Source (XLSX, 22.55 MB)
11/29/2018 2018 Q4 Quarterly Caseload Report (XLSX, 13.42 KB)
11/29/2018 2018 Q4 Quarterly Cost Report (XLSX, 135.66 KB)
10/01/2018 Texas 2018 Budget Neutrality Assurance (PDF, 302.96 KB)
08/30/2018 Quarterly Budget Neutrality Report – DY7 Q3 (PDF, 309.67 KB)
08/28/2018 2018 Q3 Quarterly Caseload Report (XLSX, 15.26 KB)
08/28/2018 2018 Q3 Quarterly Cost Report (XLSX, 88.45 KB)
08/02/2018 CMS Approved Texas Section 1115 Demonstration Evaluation Design (PDF, 1.83 MB)
07/26/2018 Texas Attachment H Approval Letter (PDF, 744.54 KB)
05/31/2018 Quarterly Budget Neutrality Report – DY7 Q2 (PDF, 146.64 KB)
05/30/2018 Combined DY6 Annual, DY6 Q4, and DY7 Q1 Report (PDF, 3.73 MB)
05/30/2018 DSRIP Project Summary October DY6 (XLSX, 1.53 MB)
05/30/2018 DSRIP Reporting Data DY6 (XLSX, 156.93 KB)
05/29/2018 2018 Q2 Quarterly Caseload Report (PDF, 113.6 KB)
05/25/2018 2018 Q2 Quarterly Cost Report (PDF, 66.73 KB)
05/24/2018 CMS approved Protocols J and R technical corrections (PDF, 2.01 MB)
05/18/2018 Amendment 10 – State Withdrawal Request (PDF, 49.62 KB)
05/18/2018 Amendment 5 – State Withdrawal Request (PDF, 53.25 KB)
03/29/2018 Quarterly Budget Neutrality Report – DY7 Q1 (PDF, 65.41 KB)
02/14/2018 CMS Approval of Attachments J and R (PDF, 4.23 MB)
12/21/2017 CMS Demonstration Extension – December 2017 (PDF, 3.15 MB)
12/21/2017 State Acceptance Letter (12/21/17) (PDF, 55.76 KB)
12/20/2017 October 2017 Enrollment Broker Report (PDF, 406.18 KB)
11/20/2017 September 2017 Enrollment Broker Report (PDF, 367.78 KB)
10/20/2017 August 2017 Enrollment Broker Report (PDF, 368.31 KB)
10/13/2017 Managed Care Report DY6 Q3 (PDF, 1.91 MB)
08/24/2017 Special Terms and Conditions (08/24/17) (PDF, 3.75 MB)
08/20/2017 June 2017 Enrollment Broker Report (PDF, 368.53 KB)
08/14/2017 Managed Care Report DY6 Q2 (PDF, 2.55 MB)
05/30/2017 CMS Approved Final Evaluation of the 1115(a) Texas Demonstration (5/30/2017) (PDF, 8.03 MB)
05/20/2017 April 2017 Enrollment Broker Report (PDF, 368.28 KB)
05/20/2017 March 2017 Enrollment Broker Report (PDF, 368.26 KB)
05/15/2017 Amendment 13 Spell of Illness Request Withdrawal By Texas (5/15/2017) (PDF, 43.38 KB)
04/20/2017 February 2017 Enrollment Broker Report (PDF, 368.26 KB)
04/12/2017 Managed Care Report DY6 Q1 (PDF, 3.91 MB)
03/20/2017 January 2017 Enrollment Broker Report (PDF, 367.88 KB)
03/16/2017 CMS Completeness Determination (3/16/2017) (PDF, 73.37 KB)
03/06/2017 Texas Amendment 14 Application (PDF, 20.71 MB) View Comments
02/28/2017 Managed Care Report DY5 Q3 (PDF, 3.36 MB)
02/17/2017 Managed Care Report DY5 Combined Annual/Q4 (PDF, 526.3 KB)
02/15/2017 December 2016 Enrollment Broker Report (PDF, 367.79 KB)
01/26/2017 Texas Request for 21-month Temp Extension (1/26/2017) (PDF, 71.71 KB)
01/15/2017 November 2016 Enrollment Broker Report (PDF, 368.69 KB)
12/31/2016 Estimated UC Payments 2016 (PDF, 203.83 KB)
12/29/2016 Actual UC Payments and any Reconciliation 2016 (PDF, 276.08 KB)
12/22/2016 Amendment 12 – State Withdrawal Request (12/22/2016) (PDF, 580.17 KB)
12/22/2016 CMS Approval - Texas Amendment 13 (PDF, 2.31 MB)
12/22/2016 State Application - Amendment 13 (12/22/2016) (PDF, 5.2 MB)
12/15/2016 October 2016 Enrollment Broker Report (PDF, 372.46 KB)
11/29/2016 DY6 Q4 Payment Report (PDF, 526.3 KB)
11/15/2016 September 2016 Enrollment Broker Report (PDF, 365.3 KB)
10/15/2016 August 2016 Enrollment Broker Report (PDF, 363.23 KB)
10/11/2016 Non-Managed Care Items Report DY5 Q3 (PDF, 349.88 KB)
10/11/2016 Texas DY5 Q3 DSRIP Payment Summary (XLSX, 40.37 KB)
10/11/2016 Texas DY5 Q3 DSRIP Project Summary (XLSX, 1.35 MB)
10/11/2016 Texas DY5 Q3 Demonstration Expenditures (XLSX, 63.47 KB)
09/27/2016 Managed Care Report DY5 Q2 (PDF, 4.36 MB)
09/16/2016 Uncompensated Care Evaluation Report – September 2016 Update (09/16/2016) (PDF, 3.12 MB)
09/15/2016 July 2016 Enrollment Broker Report (PDF, 362.83 KB)
08/31/2016 Uncompensated Care Evaluation Report (08/31/2016) (PDF, 2.71 MB)
08/29/2016 DY6 Q3 Payment Report (PDF, 348.14 KB)
08/15/2016 June 2016 Enrollment Broker Report (PDF, 362.23 KB)
06/15/2016 April 2016 Enrollment Broker Report (PDF, 363.05 KB)
06/13/2016 Non-Managed Care Items Report DY5 Q2 (PDF, 426.52 KB)
05/15/2016 March 2016 Enrollment Broker Report (PDF, 398.17 KB)
05/13/2016 State Acceptance Letter (05/13/2016) (PDF, 45.8 KB)
05/02/2016 CMS Temporary Extension Approval - May 2016 (PDF, 2.86 MB)
04/07/2016 State 15-month Extension Request (04/07/16) (PDF, 64.88 KB)
12/08/2015 CMS Completeness Letter (12/08/2015) (PDF, 67.11 KB)
11/20/2015 CMS Uncompensated Care Pool Letter (11/20/15) (PDF, 57.19 KB)
10/14/2015 CMS Application Complete Letter (10/14/2015) (PDF, 70.68 KB)
10/01/2015 CMS Amendment Approval-October 2015 (10/01/2015) (PDF, 2.04 MB)
09/30/2015 TX Interim Evaluation Report (09/30/2015) (PDF, 15.33 MB)
09/29/2015 Extension Application THTQIP (09/29/15) (PDF, 3 MB) View Comments
06/16/2015 Amendment 11 - Spell of Illness (06/16/2015) (PDF, 125.43 KB) View Comments
06/11/2015 CMS Completeness Letter (06/11/2015) (PDF, 91.31 KB)
05/29/2015 HTQIP Quarterly Report Jan-Mar 2015 (05/29/205) (PDF, 358.36 KB)
05/27/2015 TX DSRIP Midpoint Assessment (05/27/2015) (PDF, 2.68 MB)
02/27/2015 HTQIP Quarterly Report Oct-Dec 2015 (02/27/2015) (PDF, 337.73 KB)
02/26/2015 Current Approval - TX Dual Eligibles Integrated Care Amendment Approval (02/26/2015) (PDF, 1.65 MB)
01/28/2015 HTQIP Annual Report 2014 (01/28/2015) (PDF, 788.78 KB)
12/10/2014 Amendment Ten (PDF, 154.73 KB) View Comments
12/10/2014 Preliminary Review Letter (12/10/2014) (PDF, 90.95 KB)
12/04/2014 HCBS Compliance Letter (12/04/2014) (PDF, 74.61 KB)
11/19/2014 Pending Application - Amendment Eight (11/19/14) (PDF, 24.38 KB) View Comments
11/19/2014 Texas Amendment 9 – Withdrawn by State (PDF, 125.77 KB) View Comments
11/05/2014 Amendment Eight Completeness Letter 11/05/2014 (PDF, 91.13 KB)
11/05/2014 Amendment Nine Completeness Letter 11/05/2014 (PDF, 91.01 KB)
10/24/2014 Approval Letter (10/24/2014) (PDF, 100.51 KB)
05/21/2014 Revisions Approval (05/21/2014) (PDF, 190.7 KB)
04/30/2014 TX DSRIP Midpoint Assessment (04/30/2014) (PDF, 2.68 MB)
10/21/2013 Concept Paper (PDF, 110.04 KB)
10/15/2013 Letter of Receival (10/15/13) (PDF, 747.59 KB)
09/06/2013 Amendment Proposal (12/12/2011-09/30/2016) (PDF, 7.1 MB)
09/06/2013 Approval to Amend Letter (09/06/13) (PDF, 731.02 KB)
06/21/2013 Amendment Request Letter (PDF, 125.76 KB)
06/21/2013 Amendment – DSRIP DY 2 Funding Reallocation (PDF, 115.43 KB)
06/21/2013 Amendment – UC/DSRIP Pool Funding Reallocation (PDF, 133.23 KB)
06/19/2013 Amendment Request Letter (PDF, 142.84 KB)
02/07/2013 Approval of Technical Corrections Letter (02/07/13) (PDF, 748.57 KB)
08/31/2012 Acceptance of Approval Letter (08/31/12) (PDF, 674.93 KB)
08/31/2012 Thank You Letter (08/31/12) (PDF, 673.31 KB)
08/30/2012 Texas DSRIP Program Funding and Mechanics Protocol (08/30/12) (PDF, 963.87 KB)
05/03/2012 Amendment Request Letter (05/03/12) (PDF, 671.39 KB)
01/10/2012 Texas Demonstration Approval Acceptance Letter (PDF, 174.24 KB)
12/12/2011 Approval to Amend Letter (12/12/11) (PDF, 675.63 KB)
12/12/2011 Expenditure Authority (12/12/11-09/30/16) (PDF, 678.07 KB)
12/12/2011 Special Terms and Conditions (12/12/11-09/30/16) (PDF, 1.22 MB)
12/12/2011 Special Terms and Conditions (12/12/11-09/30/16) (PDF, 1.28 MB)
12/12/2011 Waiver List (12/12/11-09/30/16) (PDF, 663.72 KB)
12/11/2011 Special Terms and Conditions (12/11/11-09/30/16) (PDF, 4 MB)
Texas 2014 Transition Plan (PDF, 772.2 KB)
Return to State Waivers List