Congress Investigates Long Term Care Insurers

The New York Times (free registration) reports that Congress is putting the long term care insurance industry “under scrutiny.” The House Committee on Energy and Commerce is investigating long term care insurers Conseco and the Penn Treaty American Corporation.
It seems that certain long term care insurers are making policyholders jump through hoops to have their [...]

Provider Letter: Clarifications on National Provider Identifiers

The Texas Department of Aging and Disability Services (DADS) issued a letter dated May 25 to home and community-based services (HCS) and Texas Home Living providers (TxHmL) clarifying issues about National Provider Identifiers (NPI) that apply only to them.
By June 1, 2007, DADS must have NPI numbers for all HCS and TxHmL providers, which means [...]

Bush Proposes Medicare Reimbursement Cuts to Fund Proposals

The Bush administration seeks to cut Medicare reimbursements to hospitals, home health agencies, and skilled nursing facilities in an effort to save as much as $100 billion to fund health care proposals. (Kaiser Network)
Last week, the House Ways and Means Health Subcommittee, chaired by Democrat Pete Stark, held a hearing to consider a proposal from [...]

Texas Register Update: NorthSTAR Program Waiver

The Texas Register published a notice about the Texas Health and Human Services Commission’s intent to submit the state’s application for renewal of the NorthSTAR Program §1915(b) waiver to the Texas State Plan for Medical Assistance under Title XIX of the Social Security Act.
The current waiver expires on September 30, 2007.
If you have [...]

Provider Letters: R&S Report, Foster Care/Adoption Subsidy Medicaid

The Texas Department of Aging and Disability Services (DADS) informed DADS Long Term Care Services and Supports Providers of the “importance and usefulness” of the Remittance and Status (R&S) Report Information in a letter dated May 18. To avoid incorrect and inaccurate billing, providers must make sure information is accurate.
DADS reminded providers that a new [...]

Provider Letters: ‘Clarifying the Myths in Assisted Living Facilities,’ Cost of Living Adjustments

In a letter dated May 14, the Texas Department of Aging and Disability Services (DADS) notified assisted living providers, provider organizations, and surveyors about a conference called, “Clarifying the Myths in Assisted Living Facilities.” The conference will be held on July 19, 24, and 31.
Topics to be presented include aging in place, emergency preparedness, [...]

Texas Register Updates: Ambulance Services and Reimbursement Rates

The Texas Health and Human Services Commission (HHSC) proposed a series of rule changes that would align Medicaid rules with the requirement to acquire prior authorization for non-emergency ambulance transport. The rule changes would include terminology updates.
A public hearing will be held on May 24, 2007, from 9:00 a.m. to 10:00 a.m. in the HHSC [...]

U.S. SUPREME COURT HEARS ARGUMENT ON HOME HEALTH WORKER EXEMPTION UNDER WAGE AND HOUR LAWS.

Long Island Care at Home vs. Coke, a federal case concerning home health worker compensation, got its second hearing before the U.S. Supreme Court on April 16, 2007. Before the justices: the validity of a longstanding Department of Labor regulation regarding “companionship services” provided by third parties (read: home health agencies) “to the care of [...]

DADS Mandates Employer Implemented Policies Addressing Fraud and False Claims Laws, Including Whistleblower Protections

DADS issued Information Letter 07-50 on May 10, 2007, requiring all Home and Community-Based (HCS) and Texas Home Living (TxHmL) Providers educate employees, contractors, and agents about federal and state fraud and false claims laws, and the whistleblower protections available under those laws. The mandate comes from the employee educational requirements under Section 6032 of [...]

Cooperation Key to Nursing Home Quality Improvements

Mary Ousley, past chair of the American Health Care Association, which represents long term care providers, testified before a congressional committee last week about the long term care profession’s experience with the Omnibus Budget Reconciliation Act of 1987 (OBRA ‘87).
OBRA ‘87 is considered landmark legislation because it established many nursing home oversight rules in [...]

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