Texas Comptroller To Lawmakers: End Accenture Contract

Carole Keeton Strayhorn, Texas Comptroller, chastised the Texas Health and Human Services Commission for its $800 million contract with Accenture, a group that administers Medicaid enrollment and other social services. Citing mismanagement, Stayhorn says the contract “must be ended.”
According to the Houston Chronicle, Accenture’s call centers experience computer glitches and lost and backlogged applications. [...]

Hearing on Proposed Provider Reimbursement Rates

The Texas Health and Human Services Commission (HHSC) announced in the October 20 Texas Register that there will be a public hearing for comments on proposed interim Medicaid reimbursement rates that will apply to large, state-operated Intermediate Care Facilities for Persons with Mental Retardation. Included are state schools operated by the Texas Department of Aging [...]

The False Claims Act–A Significant Hammer!

For an example of how whistleblowers and the False Claims Act interact, read this article, Home Health Care Industry Reels from Medicare Scandal. Whistleblowers can bring qui tam lawsuits against providers and benefit hugely. In this particular case, the whistleblower benefits as follows:
The False Claims Act permits individuals to file qui tam lawsuits [...]

Provider Letter: HCSSA Presurvey

The Texas Department of Aging and Disability Services issued a provider letter that replaces PL #05-25, effective June 1, 2006.
The revised letter reflects changes in presurvey requirements, pursuant to 40 Texas Administrative Code Chapter 97 amendment. From the letter:

The administrator, alternate administrator, supervising nurse (if applicable), and alternate supervising nurse (if applicable) of a HCSSA [...]

Geriatric Doctors In Short Supply

The long term care insurance industry is not the only one that will feel the aging baby boomer surge. Geriatric physicians are in short supply, an imbalance that will become more obvious as baby boomers retire and require specialized treatment. (New York Times – free registration required)
Geriatrics is not a popular specialty in medical schools, [...]

More Money for Doctors Reporting Quality of Care Data

Physicians who provide care to Medicare patients with chronic conditions will have an incentive to do more paperwork. The Kaiser Network reports that the Centers for Medicare and Medicaid Services will begin a three-year pilot program that will pay physicians to report quality of care data. An excerpt:

The three-year program will begin next year in [...]

CMS Offers Online Tools to Help Medicare Part D Beneficiaries

Medicare Part D beneficiaries with questions about the prescription drug program can now access more information online.
At the Centers for Medicare and Medicaid Services (CMS) web site, a tool called the “Drug Plan Finder” should contain information about all available drug plans, according to the Kaiser Network. Users can compare plans across states and learn [...]

CMS Computer System Leaves Medical Records At Risk

According to a new Government Accountability Office (GAO) report, the computer system at the Centers for Medicare and Medicaid Services (CMS)has weaknesses that could result in unauthorized disclosures of medical records. (Source)
Former CMS administrator Mark McClellan, who left his position last weekend, told the Associated Press that the GAO didn’t find evidence of compromised records, [...]

Provider Letters: Desk Review and NPI Collection Process

In a letter to Home and Community Support Services Agencies, the Texas Department of Aging and Disability Services (DADS) reminds these providers of the requirement to report allegations of abuse, neglect, or exploitation of clients to DADS and the Department of Family and Protective Services (DFPS).
These incidents previously were investigated by on-site visits. In [...]

Over 41,000 Qualified Nursing School Applicants Rejected in 2005

Nursing schools had to turn away over 41,000 qualified applicants in 2005 because there weren’t enough faculty to teach. This is an unfortunate trend because of the overall nursing shortage nationwide.
According to USA Today, 7.9 percent of faculty positions at nursing schools remain unfilled, and the Department of Health and Human Service reports that the [...]

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