Texas Health and Human Services Commission

Texas Article IX Hospital Charity Care and Transparency Report

Pursuant to the Texas General Appropriations Act (GAA) 88th (R.S.) H.B. 1 (2023), Article IX Section 17.34, Texas Health and Human Services Commission (HHSC) has contracted with Myers and Stauffer LC (Myers and Stauffer) to assist in collecting various financial and utilization data from Texas hospitals and other sources, performing analyses over and reporting on the data obtained.

HHSC provided email notification to hospitals regarding this engagement from txhhs@public.govdelivery.com on Thursday, March 21, 2024. The content of this notification has also been posted on HHSC’s Provider Finance Department – Hospital Services website: https://pfd.hhs.texas.gov/hospitals-clinic/hospital-services.

For more information:

Email: TXArticleIX@mslc.com

HHSC Contact information:

Christina Nip
upplemental Payments Program Manager
Hospital Finance – Provider Finance Department
Texas Health and Human Services Commission
Email: Christina.Nip@hhs.texas.gov

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Myers and Stauffer Contractor Responsibilities

Each item below must be included in the final report, which must include data, at a minimum, for years 2021 and 2022:

  1. All deliverables listed below shall be compiled into one comprehensive final report and submitted to HHSC no later than October 31, 2024.
  2. The report should identify recommendations on ways to improve hospital reporting and transparency, including recommendations on improving hospital reporting on the Annual Statements of Community Benefits Standards and to reduce duplication of reporting requirements to the state.
  3. The report should identify a summary of all revenue streams and their value, including patient revenue from private and government sources, all supplemental state or federal funding sources, research grants, medical debt accounts sold to collectors, and locally generated tax revenue when applicable, by facility and hospital system.
  4. The report should identify the value of charity care, bad debt expense, and unreimbursed cost of health services by facility and hospital system.
  5. The report should identify expenses for Graduate Medical Education as well as charity care program details, including number of clients enrolled in the charity care program, number of rejected charity care applications, and the number of medical debt accounts related to a client that applied for charity care but was not enrolled in the charity care program sold to debt collectors by a hospital.
  6. The report should identify all “nonprofit medical exempt” properties in the state belonging to hospitals, along with the market value of the property, taxable value of the property, and value of each hospital’s tax exemption benefit.
  7. The report should identify a statewide analysis contrasting hospitals’ percentage of operating costs in relation to hospital service area household adjusted gross income range. This analysis should also address the type and volume of community benefit hospitals offer in relation to the type of communities they are servicing. Additionally, the analysis should account for all hospitals’ financial assistance criteria, including income eligibility, application industry standards in asset evaluation, and the time it takes for hospitals to accept or reject a charity care application.
  8. The report should identify an assessment of hospital compliance and efficacy with required disclosures under Health and Safety Code, Secs. 311.031 and 311.046(d).

Engagement Timeline

Project Schedule Date
Project Kick-Off February 1, 2024
Draft Report Due to HHSC July 31, 2024
Final Draft due to HHSC September 30, 2024
Completion of Report in Coordination with HHSC October 31, 2024
Findings Published and Provided to Texas State Legislature December 1, 2024

Frequently Asked Questions

  1. What will the data Myers and Stauffer collects be used for?
    The data we collect will be used to satisfy our responsibilities as HHSC’s contracted vendor, as noted in the Contractor Responsibilities section above.
  1. Will deadline extensions be available to hospitals for requests made by Myers and Stauffer?
    Due to the very short timelines we are contracted to meet, as indicated in the Timeline section above, we will be unable to offer many extensions. Hospitals are encouraged to allocate adequate resources to respond to all requests and inquiries made by the communicated deadlines.
  1. Will hospitals be able to view results ahead of the final report?
    Any advance release of results would go through HHSC, and any requests of this nature should be directed to HHSC.
  1. How do I submit a question to Myers and Stauffer regarding this engagement?
    We have established a dedicated mailbox that will both send and receive correspondence related to this project: TXArticleIX@mslc.com. We will respond to all inquiries within five business days, but likely sooner if the inquiry is not complex. Please do not send confidential or sensitive information, protected health information or personally identifiable information through email. We will establish secure channels for submissions of such data.