Welcome to RHP 9 – Transforming Healthcare Now 

Waiver Information

  • Medicaid 1115 Waiver renewed October 1, 2017 – September 30, 2022. Information on the existing waiver details and transition plans can be found at the Texas Health & Human Services Waiver Renewal.
  •  Click here to reivew the updated RHP 9 Plan for demonstration years DY9-10. 
  • Aligns with the Triple Aim of the Centers for Medicare and Medicaid Services (CMS): Improve the experience of care, Improve the health of populations, and Reduce the per capita costs of healthcare without compromising quality.
  • Creation of Regional Healthcare Partnerships (RHP) that support coordinated, efficient delivery of quality care, and a plan for system transformation that is driven by the needs of the community.
  • Provides incentive payments for quality improvement and healthcare delivery system reform

Quick Facts on RHP 9:      

  • 3 Counties: Dallas, Denton, & Kaufman
  • 2,530 square miles
  • Population of 3.1 million
  • 40% are low income
  • 22 providers participating in Delivery System Reform Incentive Payment (DSRIP) projects
  • Needs assessment: Gaps in access, behavioral health, and overall care coordination.

Upcoming Events:


To Be Announced



There are currently no upcoming events. Please check back later.






Making a Difference

  • CMS and HHSC are still in negotiations for the CHIRP, TIPPS, & RAPPS DPPs.  They are at a standstill on the source of the non-federal share of the funding and the use of LPPFs with concerns around “hold harmless” agreements.
  • The OAG (Office of Attorney General) has submitted the attached notice withdrawing the request for an oral hearing on the 1115 Waiver so that the Court may make an expediated decision on their pending Motion to Enforce the Preliminary Injunction. 
  • HHSC has not submitted the DY11 DSRIP DY11 Extension Amendment request – it is currently on hold, although HHSC guidance is to continue on as we are currently with both the possibility of an DSRIP Extension and/or the DPPs as sometime in the future.  They are currently exploring the options – see notes below.
  • Friday, January 14, 2022, 11:59 pm:  Due date for providers to submit responses to HHSC request for additional information (NMI requests)
  • Wednesday, January 19, 2022 – October reporting DY10 DSRIP payments processed for transferring hospitals.
  • Friday, January 28, 2022 – October reporting DY9 DSRIP payments for all providers and DY10 DSRIP payments processed for providers that were not paid on January 19, 2022. There are separate transactions for each DY.
  • Tuesday, February 25, 2022 - HHSC and CMS will approve or deny the additional information submitted in response to HHSC comments on October reported milestone/metric achievement.
DSRIP One-year Extension
  • The DSRIP extension amendment request for demonstration year (DY11 – October 1, 2022 – September 30, 2022) is currently on hold. 
  • HHSC is reviewing the impact of the November 15th letter from CMS on the DSRIP Extension amendment.
  • The DSRIP team has drafted the waiver amendment, PFM, and MBP changes required to implement the extension, find this information posted on HHSC Waiver Overview page under November 1, 2021 Proposed Amendment for One-Year DSRIP Extension (DY11).
  • Webinar video from the NOV 3, 2021 on the proposed changes to the PFM and MBP is located here.   
  • HHSC is still moving forward with rule development for the program extension in the event they do decide to submit.
Compliance Monitoring
  • MSLC continues working on CAT C R4 reviews
  • The timeline for this review is SEP 21 – FEB 22
  • Audit-specific questions should be sent to:  MSLC and copy the HHSC Compliance Mailbox.
DSRIP Transition

Public Hearings for DPP Year Quality Measures and Requirements

  • HHSC will conduct public hearings next week to receive public comment on proposed quality measures and reporting requirements for year 2 of the directed payment programs (DPPs).
  • Quality measures and Requirements will be posted to each of the DPP web pages by Monday, 1/10/22. Additional information is available on the HHS Events pages linked below. The hearings schedule is as follows:
  • I highly encourage all providers to review the Y1 and Y2 quality measures for the DPPs so that you are sure you are ready to report when the anticipated DPPs are approved, although the measures in many cases are similar, there may be nuances that are slightly different than current measures.  Please review so you are not caught off guard. 
  • Written comments regarding the proposed measures and reporting requirements may be submitted electronically beginning 1/10/22 using each of the links on the HHS Events pages until 11:59 p.m. on January 31, 2022.


Proposed Directed Payment Programs (DPPs)

  • We do not have any final or formal decisions on Comprehensive Hospital Increased Reimbursement Program (CHIRP), Rural Access to Primary and Preventive Services (RAPPS) or Texas Incentives for Physicians and Professional Services (TIPPS).
  • CMS has indicated the primary concern is regarding financing of the non-federal share – specifically regarding LPPFs. All communication between HHSC and CMS is posted at https://www.hhs.texas.gov/providers/medicaid-supplemental-payment-directed-payment-programs/directed-payment-programs (scroll to the bottom of the page).
  • Based on ongoing discussions with CMS, provider reporting originally scheduled for October was delayed. In a GovDelivery notification posted on 11/19/21, HHSC communicated that DPP reporting would commence 35 calendar days after a CMS approval of the program.
  • Reminder: sign up/update GovDelivery Notices for the applicable DPP here: https://service.govdelivery.com/accounts/TXHHSC/subscriber/new.
HHSC Contacts
  • Continue sending question related to DPP measures, performance requirements, specifications, and reporting to DPPQuality@hhs.texas.gov
  • For financial questions or other questions on the DPPS:  See attached HHSC Anchor Call Notes for DPP Contact pages and Website links.