In 2014 the State of Texas established the Nursing Facility Minimum Payment Amounts Program (MPAP) to allow participating skilled nursing facilities with a source of Intergovernmental Transfers to receive additional funds equal to the difference between Medicare Part A and the amount they would have received under Medicaid.  MPAP became effective on March 1, 2015, but was intended to be a short term program lasting not later than September 1, 2016 when Texas is to have developed a performance based program.  Last year Texas enacted legislation instructing the Texas Health and Human Services Commission to transition from MPAP to a Quality Incentive Payment Program (QIPP) for all nursing facilities receiving public funds for the non-federal share.  HHSC prepared a Concept Paper on December 9, 2015 describing the QIPP program requirements and explaining that QIPP is designed to incentivize SNFs to incentivize and improve innovation in providing nursing services.   On February 8, 2016, HHCS received feedback from CMS on the Concept Paper stating that CMS would not approve certain portions of the Concept Paper.  Since then CMS and HHSC have been negotiating with CMS over terms in the Concept Paper leading to a very real possibility that HHSC will not be able to implement QIPP on September 1, 2016 as required.  There is a self imposed March 11, 2016 deadline for resolution on the open items.

3/14 Update: HHSC announced on March 11, 2015 that implementation of the Quality Incentive Payment Program will be delayed by six months, if agreement with CMS can be reached prior.  The Minimum Payment Amounts Program (MPAP) will be extended for six months through February 28, 2017 for existing MPAP participants only.