Texas Register Upate: Internet Posting of Sanctions Imposed for Contractual Violations

The Texas Health and Human Services Commission (HHSC) adopted a rule regarding Internet Posting of Sanctions Imposed for Contractual Violations. HHSC is authorized to impose sanctions against a Medicaid managed care organization for failing to comply with contract terms. During the 30-day comment period, HHSC received one comment: Comment: HHSC received a comment from DSHS, [...]

Provider Letter: HCSSA Houston Roundtable Q&A

The Texas Department of Aging and Disability Services has released HCSSA Houston Roundtable Questions and Answers, a table of questions and answers that resulted from two Regulatory Services staff meetings in Houston, Texas, last year. Topics include Licensing, Training, Coordination of Care, Survey Questions, Administrative Issues, OASIS, and General Questions. For more information, download the [...]

Payment Reforms for Inpatient Hospital Services

In an effort to improve the accuracy of payment under the acute care hospital inpatient prospective payment system and give hospitals incentives to improve quality, the Centers for Medicare and Medicaid Services (CMS) proposed a new rule. From the press release: Medicare’s inpatient rates for operating expenses will increase by 3.3 percent in FY 2008 [...]

States To Share $30 Million For Health Insurance Counseling

All 50 states, the District of Columbia, Puerto Rico, Guam, the Virgin Islands will share $30 million in grant money to provide health insurance counseling services to Medicare beneficiaries, according to the Centers for Medicare and Medicaid Services. The State Health Insurance Assistance Programs, or SHIPs, will help beneficiaries figure out which insurance coverage is [...]

CMS Publishes Physician-Related Updates

The Centers for Medicare and Medicaid Services (CMS) has provided incentives for physicians to report quality data. As the process may be too expensive for smaller practices, CMS implemented a three-year pilot program that will pay 800 small- or medium-sized practices in Arkansas, California, Massachusetts, and Utah to report quality care data for Medicare patients [...]

Texas Register: CCAD Age Requirement, ICM Program

The Texas Health and Human Services Commission (HHSC) has proposed a rule that will impose an age requirement for Community Care for Aged and Disabled (CCAD) services. Currently, there is no age requirement. In response to the settlement agreement in a case titled, Alberto N., et al, vs. Albert Hawkins and James Hine (PDF), HHSC [...]

Congress Debates Medicare Part D Drug Price Negotiating

Congressional discussions about the government negotiating Medicare Part D drug prices is ongoing. Although President George W. Bush has threatened to veto legislation allowing the government to negotiate prescription drug prices, lawmakers are moving forward. The House of Representatives passed a measure that would require the secretary of the Department of Health and Human Services [...]

Medicare Advantage Payment Rates To Increase

The Centers for Medicare and Medicaid Services (CMS) announced that payment rates for Medicare Advantage plans will increase by 3.5 percent in 2008. (CQ Health Beat News) Medicare Advantage plans offer beneficiaries the traditional fee-for-service program with the option to receive Medicare through private insurance plans like health maintenance organizations and preferred provider plans. CMS [...]

Provider Letters: STAR+PLUS, Monthly Service Fees Updates, Etc.

In a March 29 letter to Primary Home Care and Day Activity and Health Services providers, the Texas Department of Aging and Disability Services (DADS) wanted to make sure these providers were aware that they can bill DADS for PHC or DAHS services provided to consumers in counties covered by the STAR+PLUS program in rare [...]

Funds for Kidney Patients Under Medicare Part D

Medicare Part D recipients who are qualified kidney dialysis patients will have extra assistance getting bone disease Medicare Part D prescription drugs. (Medical News Today) The American Kidney Fund (AKF) may give eligible patients up to $2,000 a year in drug assistance funds. These grants will help cover “donut hole” costs for recipients caught in [...]

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