Texas Register Updates: RFP, Nursing, Reimbursement Changes
The following information was obtained from the August 13 issue of the Texas Register: Public Notices HHSC intends to submit to CMS a waiver amendment for the State of Texas Access Reform Program, a Managed Care waiver program under the authority of §1915(b) of the Social Security Act. The amendment would add new benefits for the proposed substance use disorder treatment services, including those provided in residential settings. HHSC is anticipating expanding the STAR+PLUS 1915(b) and two 1915(c) waivers to the area currently part of Integrated Care Management 1915(c) waiver services. HHSC is submitting ICM 1915(c) waiver renewals in the unlikely event STAR+PLUS ...
Information Letters: NFs, ICFs/MR, CLASS, and DBMD
DADS released three new information letters: Per diem payment rates NFs and hospice directors, effective September 1, 2010, can be found here. Per diem payment rates for ICFs/MR, effective September 1, 2010, can be found here. CLASS and DBMD providers: DADS informed these providers that effective September 1, 2010, it will not allow providers to be paid for more than 24 hours of service in a 24-hour day. Claims submitted for more than 24-hour units in a 24-hour day will be denied payment. (Letter)
Information Letters: Hospice and Nursing Facilities
DADS released three information letters: Hospice: Hospice providers are responsible for know the Medicare and Medicaid eligibility for a hospice client. An excerpt: The DADS rule for Medicaid Hospice Payments and Limitations at 40 TAC §30.60(h) states: (h) Third-party resources. Medicaid pays only after all third-party resources have been used. In accordance with 40 TAC §30.60(h), it is the responsibility of the hospice provider to be aware of a client’s eligibility for Medicare Part A when a client elects hospice. Additionally the hospice provider is responsible for being aware of any Medicare Part A eligibility for the client through the entire hospice period of care ...
Texas Register Updates: ICFs/MR and Nursing
The following information was obtained from the August 20 issue of the Texas Register: Public Notices HHSC proposes new Medicaid per diem reimbursement rates for the Truman W. Smith Children's Care Center ($219.69 ) and DADS-operated/state-operated ICFs/MR (small $603.64; large Medicaid-only: $537.41; large dual-eligible Medicaid/Medicare: $516.23). See the Texas Register for more information. HHSC intends to submit Transmittal Number 10-050, Amendment Number 943, to the Texas State Plan for Medical Assistance, which would add concurrent hospice care and treatment services for individuals younger than 21. HHSC intends to submit an amendment to SCHIP, which would add concurrent hospice care and treatment services for SCHIP members. Finally, ...
Information Letter: For Nursing Facilities
Two updates for NFs: The definition of "licensed health professional" has been moved to 40 TAC §19.101(56), from 40 TAC §19.101(57); The DADS Paid Feeding Assistant Training curriculum is available on the Regulatory Services Credentialing web page at the following url: http://www.dads.state.tx.us/providers/NF/credentialing/NATCEP/feedingassistant.pdf (98-page PDF)
DADS Alerts: MDS Training Materials, LTSS, HSC
The Minimum Data Set 3.0 training materials is posted online here. HHSC and DADS will host LTSS provider meetings in the Dallas and Tarrant service areas, which will allow HHSC, DADS, and five selected STAR+PLUS health maintenance organizations to present information for successful implementation of the STAR+PLUS program expansion. See the alert page for dates and times. News alert for HCS providers: Concerns have been raised by stakeholders over issues surrounding IPCs in the CARE system and the 7-day time period a MR authority service coordinator has to review an IPC in the CARE system for their agreement or disagreement. Specifically: Issues around entire ...
Solo Primary Care Physicians
The Houston Chronicle reported that in the last two years, about 350 Texas doctors have dropped the Medicare program. In 2008, 62 percent of those doctors were primary care physicians. Something similar is happening with Medicaid, the government health insurance program for low-income individuals and families. In the age of lower reimbursement rates, specializing may be a more attractive option for medical students than going into primary care. Would a solo practice trend encourage more medical students to enter into the field and hang out their own shingles? NPR is running a three-part series on primary care physicians going solo. An excerpt ...
Licensed Health Providers
Provider and Information Letters: ICF/MR, HCSSA, NFs, Assisted LivingDADS released seven new provider letters and one information letter. DADS informed...
NPR’s Primary Care Physician Series
Last week, we pointed you to the first part of NPR’s article series on primary...
Texas Register: Boarding Home Facilities, ICFs/MR, HSSCAs, Etc.
The following information was obtained from the August 27 issue of the Texas Register: Public...
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Employment
President Obama Urges Action on Paycheck Fairness ActPresident Obama is urging the Senate to pass the Paycheck Fairness Act, which died...
Look Back: 111th Congress has Taken Active Role in Shaping Employer Actions
In a few weeks, the United States Congress will take a late-summer recess before...
Employers, Are You in the Safe Harbor?
In the past year, the U.S. Department of Labor, the Equal Employment Opportunity...
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Business
The Return of Debtor’s PrisonsAs this article states, Debtors Prisons were abolished in America in the 1800′s. Collection companies are now using courts as their personal debt collection agencies by having debtors thrown in jail based on contempt charges for missing hearings. The rub? The collection companies are effecting this by failing to give debtors notice of the hearings! The... [Read more of this review]
Court’s Texting Decision Shows Importance of Updated Policies
The United States Supreme Court considered an employer’s policies on e-mail and texting use in a decision issued on June 17. As reported previously in this blog, City of Ontario v. Quon raised the issue of whether a governmental employer who reviewed the content of text messages sent using an employer-provided pager had committed an unlawful search... [Read more of this review]
Healthcare Providers and the “Red Flags” Rule: A Reprieve?
McKnights Long-Term Care News is reporting that a “stipulation in principle” has been reached with the FTC to temporarily exempt healthcare providers from the rule. In an earlier article, McKnights noted that the FTC has moved the compliance date of the rule to January 2, 2010. The stipulation may arise from the fact that medical groups... [Read more of this review]
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