Information and Provider Letters: Medicaid Emergency Dental Services and Provider Conference

The Texas Department of Aging and Disability Services (DADS) issued an information letter to nursing facilities to clarify Medicaid-certified nursing facility emergency dental services. According to DADS, the current rule applies when an emergency dental procedure, which does not require prior authorization, is required. For more information, download the letter here. DADS issued a provider [...]

Information Letters: Rate Change and Cost Ceiling Adjustments

The Texas Department of Aging and Disability Services (DADS) informed Medically Dependent Children Program Camp Providers that the Texas Health and Human Services Commission (HHSC) has developed a camp provider rate change. The new payment ceiling rate, effective June 1, 2007, is $9.68/hour. Contact Lori Roberts at (512) 438-5391 or lori.roberts@dads.state.tx.us if you have questions. [...]

No Chemo Medicaid Coverage for Illegal Aliens

In what’s sure to be a hotly debated decision, the Centers for Medicare and Medicaid Services (CMS) informed the New York Medicaid Program last month that it can’t cover chemotherapy treatment for illegal aliens. (Kaiser Network) CMS allows Medicaid coverage for illegal aliens for emergency services, but chemotherapy is not considered an emergency procedure. Richard [...]

Texas Register Updates: Proposed Rule and Open Meeting

Proposed Rule The Texas Health and Human Services Commission (HHSC) has proposed an amendment that will clarify that HHSC is responsible for setting the personal needs allowance for Medicaid recipients who live in long-term care facilities. For more information, see the relevant section of the September 14 Texas Register. Correction, Open Meeting, and Pre-Application Orientation [...]

Provider and Information Letters: New Payment Rates, Life Safety Code

The Texas Department of Aging and Disability Services (DADS) issued a letter to Community Based Alternatives and Assisted Living/Residential Care Providers to inform them about Personal Care 3 Reimbursement Rates. These rates became effective on September 1, 2007. For more details, download the letter here. DADS informed the Medically Dependent Children Program and Home and [...]

Provider and Information Letters: CHOW Requirements and New Convictions Barring Employment

In a letter to Nursing Facilities, the Texas Department of Aging and Disability Services (DADS) alerted these providers to changes in the code required by Senate Bill 344, passed by the 80th Legislature, Regular Session, 2007. Changes to Section 242.0336, Temporary Change of Ownership (CHOW) License, include: The Department of Aging and Disability Services (DADS) [...]

Provider and Information Letters: Minimum Wage, Medicaid Reimbursement Rate Increases, Etc.

The Texas Department of Aging and Disability Services (DADS) notified Community Based Alternatives (CBA), Home and Community Support Services Agencies, CBA Assisted Living/Residential Care Providers, Consolidated Waiver Program Providers, Deaf-Blind with Multiple Disabilities Waiver Providers, Medically Dependent Children’s Program Providers, Primary Home Care Providers, and Day Activity and Health Services Providers that the Texas Health [...]

Texas Register Updates: Payment Rates Adoption and Notices

The Texas Department of Health and Human Services (HHSC) has notified providers about new per diem payment rates for the nursing facilities program operated by the Texas Department of Aging and Disability Services. The new payment rates were effective on September 1, 2007. For more information, see the relevant section of the August 31 Texas [...]

Update On Texas Medical Board Decision

I wrote here about a decision by the Texas Medical Board to reject an ALJ’s proposal-for-decision.The case involves the Board’s rejection of the ALJ’s Proposal that the case against the physician be dismissed. The physician had committed a one time error by responding to a patient’s request for medical records with a bill based on [...]

GAO Says CMS Failed to Properly Audit Private Insurance Companies

According to a new Government Accountability Office (GAO) report, the Centers for Medicare and Medicaid Services (CMS) failed to properly audit private insurance companies for overpayments or to recover the excess payments. (Kaiser Network) Medicare-participating private insurers kept “tens of millions of dollars” that could have been passed on to beneficiaries or returned to the [...]

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