Balancing Incentive Program

What is the Balancing Incentive Program?

Federal law established the Balancing Incentive Program (BIP) which increases the Federal Matching Assistance Percentage to participating states through September 2015 in exchange for states making certain structural reforms to increase access to Medicaid community based long-term services and supports (LTSS).

These required structural reforms include

  • implementing a "no wrong door" eligibility and enrollment system;
  • developing core standardized assessment instruments; and
  • ensuring case management activities are conflict free.

The Texas Health and Human Services Commission (HHSC) and the Texas Department of Aging and Disability Services (DADS) submitted an application to the federal Centers for Medicare and Medicaid Services (CMS) to participate in the BIP (PDF format). On September 4, 2012, CMS approved the state's BIP application.

Texas must implement the required structural changes and achieve a 50 percent benchmark of Medicaid community-based LTSS expenditures by October 2015. Click here to access the CMS BIP website. This website provides additional information about the BIP goals and requirements for states to receive BIP enhanced funding.

HHSC has delegated coordination of BIP activities to DADS. DADS will hold ongoing stakeholder meetings through the remainder of calendar year 2012 to solicit your input on how to design the program. Questions about the BIP may be sent to Please send your recommendations on how the state could meet the BIP requirements using the template on this page to the same address. Click here for a list of all stakeholder recommendations DADS has received (PDF format).

Balancing Incentive Program Workplan

The BIP workplan (PDF format) outlines how DADS will implement the Balancing Incentive Program to include deliverables such as:

  • Standardized eligibility and enrollment information
  • A case management system
  • Website
  • Toll-free phone number
  • Data collection and reporting

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Updated: February 11, 2015