Texas Capitated Financial Alignment Model Demonstration (Texas Dual Eligible Integrated Care Demonstration Project)
Guidance for Texas Capitated Financial Alignment Model Demonstration (Texas Dual Eligible Integrated Care Demonstration Project)
Final
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: August 31, 2020
Texas Capitated Financial Alignment Model Demonstration (Texas Dual Eligible Integrated Care Demonstration Project)
SPOTLIGHT & RELEASES
| 04/23/2024: CMS released the Texas Medicare-Medicaid Plan Quality Withhold Analysis Results for Demonstration Year 7. More information is available below. |
Key Dates
May 23, 2014 - CMS and Texas sign MOU
November 25, 2014 - CMS, Texas, and participating plans execute three-way contract
March 1, 2015 - Scheduled start of opt-in enrollment
April 1, 2015 - Scheduled start of passive enrollment
December 31, 2015 - CMS, Texas, and participating plans execute updated three-way contract
November 1, 2020 – CMS, Texas, and participating plans execute three-way contract amendment extending the demonstration
December 1, 2021 – CMS, Texas, and participating plans execute a three-way contract amendment
December 1, 2022 – CMS, Texas, and participating plans execute a three-way contract amendment
Texas Dual Eligible Integrated Care Demonstration Project Model
On May 23, 2014, the Centers for Medicare & Medicaid Services (CMS) announced that the State of Texas partnered with CMS to test a new model for providing Medicare-Medicaid enrollees with a more coordinated, person-centered care experience. Under the demonstration, also called "Texas Dual Eligible Integrated Care Demonstration Project," Texas and CMS contracted with Medicare-Medicaid plans to coordinate the delivery of, and be accountable for, covered Medicare and Medicaid services for participating Medicare-Medicaid enrollees.
More Information from CMS:
- Fact Sheet
- Three-Way Contract (PDF)
- MOU (PDF)
- Amendment to State Proposal (PDF)
- State Proposal (PDF)
- Preliminary Third Evaluation Report for the Texas capitated model demonstration under the Medicare-Medicaid Financial Alignment Initiative (12/20/2023)
- Preliminary Second Evaluation Report for the Texas capitated model demonstration under the Medicare-Medicaid Financial Alignment Initiative (06/01/2022)
- First Evaluation Report for the Texas capitated model demonstration under the Medicare-Medicaid Financial Alignment Initiative (05/24/2019)
- Readiness Review Tool (PDF)
- Texas Evaluation Design Plan (PDF)
- Letter of Intent to Extend Scheduled End Date (PDF)
- Texas Medicare-Medicaid Plan Quality Withhold Analysis Results for Demonstration Year 1 (PDF)
- Texas Medicare-Medicaid Plan Quality Withhold Analysis Results for Demonstration Year 2 (PDF)
- Texas Medicare-Medicaid Plan Quality Withhold Analysis Results for Demonstration Year 3 (PDF)
- Texas Medicare-Medicaid Plan Quality Withhold Analysis Results for Demonstration Year 4 (PDF)
- Texas Medicare-Medicaid Plan Quality Withhold Analysis Results for Demonstration Year 5 (PDF)
- Texas Medicare-Medicaid Plan Quality Withhold Analysis Results for Demonstration Year 6 (PDF)
- Texas Medicare-Medicaid Plan Quality Withhold Analysis Results for Demonstration Year 7 (PDF)
Information for Plans:
- All state-specific information and guidance for plans is available on the Information and Guidance for Plans page.
Information for Beneficiaries and Providers:
- Texas Dual Eligible Integrated Care Project Continuity of Care Provisions (PDF)
- Texas Health and Human Services Commission's (HHSC) Office of the Ombudsman
- Texas Dual Eligible Integrated Care Project Provider Frequently Asked Questions (FAQs) (PDF)
- Texas Dual Eligible Integrated Care Project Home Health Provider FAQs (PDF)
Information from the State of Texas:
Funding Support:
Want regular email updates? Sign up by visiting this link.
We’re always looking for ways to improve the experience and usability of our webpages. If you’ve Feedback or issues to report, please contact us at MMCOWeb@cms.hhs.gov.
HHS is committed to making its websites and documents accessible to the widest possible audience, including individuals with disabilities. We are in the process of retroactively making some documents accessible. If you need assistance accessing an accessible version of this document, please reach out to the guidance@hhs.gov.
DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.