LBB Rate Increase Attestation
The Health and Human Services Commission (HHSC) is requiring an attestation from all providers who receive additional funds through increased Medicaid reimbursement rates approved as a result of the COVID-19 federal emergency declaration. Providers shall attest that no portion of those additional funds will be used to increase hourly wages for any staff.
For additional information, please see the
NF Information Letter
HCS Information Letter
sent by HHSC and/or posted on the
For questions regarding the completion of this attestation, please email: NF or HCS program:
Long-Term Support and Services
For questions regarding DME, Physician, or Other program:
For technical questions or issues, please email
Web Applications and Innovation Services
September 30, 2020 at 11:59 PM
HHSC requires the attestation to be submitted as soon as possible, but no later than September 30, 2020. Failure to attest will result in recoupment of the additional funds paid during the emergency temporary rate increase period, from April 1, 2020 through the HHSC’s termination of the emergency temporary rate increases.
Complete all fields below as appropriate for the provider/program type. Read the attestations and check the boxes to agree to the attestations. Click the Submit button when completed. Note: NF and HCS providers – please enter all contract number(s) and/or component code(s) being included in this attestation.
This attestation is submitted for:
Provider Doing Business As (DBA) Name
Enrolled Medicaid Provider
Nursing Facility (NF)
Home and Community Based Services (HCS)
Durable Medical Equipment (DME)
National Provider Identifier (NPI)
Texas Provider Identification (TPI)
I attest that the provider will limit their use of the funds to comply with the requirements imposed by the Legislative Budget Board, who require that rate increase funding be limited, when used for staff compensation, to increase staff compensation through reimbursement of overtime or lump sum bonuses, including bonuses for hazard pay, or other methodologies that will not result in future reductions in hourly wages when the temporary rate increases are discontinued.
I attest that I am a person legally authorized to sign for this provider and that the information entered above is correct to the best of my knowledge and belief. After submission of this attestation, if I become aware of a change in the information that is relevant to this attestation, I will notify HHSC.