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)
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
| 11/14/2024: CMS released the revised Texas Contract Amendments (04/01/2024 and CY 2025). 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 (DOCX)
- 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:
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