Provider Letters: Minimizing Claim Rejections, Life Safety Code, Etc.

May 1 The Texas Department of Aging and Disability Services (DADS) sent an informational letter to long term care providers about what they can do to minimize claim rejections. Attached to the two-page letter is a two-page chart titled, “Common Reasons Claims Deny.” Download the letter and chart here. May 7 All home and community-based [...]

Provider Letters: National Provider Identifier and Criminal History Checks

April 27 The Texas Department of Aging and Disability Services (DADS) informed nursing facilities, community services, ICF/MR, and therapy providers about the National Provider Identifier (NPI) reporting process. An NPI is a 10-digit number used to identify health care providers. To prevent delays in billing, all providers that contract with DADS are required to report [...]

Texas Register: MCOs, SHARS, Reimbursement, and PCS

The Texas Health and Human Services Commission (HHSC) proposed a new rule that would require Medicaid Managed Care Organizations (MCO) disease management care programs to have performance measures that are comparable to the Medicaid fee-for-service/Primary Care Case Management disease management program. Additionally, MCOs must demonstrate an ability to manage complex diseases among Medicaid recipients. A [...]

STAR+PLUS Clients Letter and Fire Authority Memo

In a letter dated April 26, the Texas Department of Aging and Disability Services informed nursing facility providers new to the STAR+PLUS program about the program’s enrollment procedures and assured them that effective January 1, 2007, the STAR+PLUS enrollment will not impact the nursing facility process. For more information, download the letter here. The Centers [...]

Long Term Care Providers Face More Medicare Reimbursement Cuts

Providers receiving Medicare reimbursements could see more reductions in reimbursements by 2011, the Kaiser Network reports. Under the 2005 Tax Increase Prevention and Reconciliation Act, which President Bush signed into law in 2006, the federal government will be required to withhold three percent of payments to business that pay taxes and contract with the government. [...]

Medicare Prescription Drug Negotiation Bill Stalls in Senate

Earlier this month, the U.S. House of Representatives passed a bill that would require the government to negotiate Medicare Part D prescription drug prices with drug companies. (See Congress Debates Medicare Part D Drug Price Negotiating) Last week, the measure failed to receive enough for votes for a floor debate in the Senate. (Medical News [...]

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