Tex.
Gov't Code Section 536.152
Reimbursement Adjustments
(a)
Subject to Subsection (b), using the data collected under Section 536.151 (Collection and Reporting of Certain Information) and the diagnosis-related groups (DRG) methodology implemented under Section 536.005 (Conversion of Payment Methodology), if applicable, the commission shall to the extent feasible adjust child health plan and Medicaid reimbursements to hospitals, including payments made under the disproportionate share hospitals and upper payment limit supplemental payment programs, based on the hospital’s performance with respect to exceeding, or failing to achieve, outcome and process measures developed under Section 536.003 (Development of Quality-based Outcome and Process Measures) that address the rates of potentially preventable readmissions and potentially preventable complications.(b)
The commission must provide the report required under Section 536.151 (Collection and Reporting of Certain Information)(b) to a hospital at least one year before the commission adjusts child health plan and Medicaid reimbursements to the hospital under this section.
Source:
Section 536.152 — Reimbursement Adjustments, https://statutes.capitol.texas.gov/Docs/GV/htm/GV.536.htm#536.152 (accessed Apr. 29, 2024).
