Rulings Favor California Providers
June 29, 2009 by Jerri Lynn Ward, J.D.
Filed under Funding Issues, Medicaid
California is attempted to solve a budget deficit by cutting programs, and in-home care workers would have received a $2 hourly wage cut beginning July 1. A federal judge blocked the wage cut. In-home care workers in California will maintain their present wage level. (Source) The salary cut would have saved the state $98 million [...]
Child Health Program Bills Introduced
June 29, 2009 by Jerri Lynn Ward, J.D.
Filed under Funding Issues, Texas: 81st Legislative Session
The Texas House and Senate introduced bills related to the child health plan program: Senate Bill 6 and House Bill 11. Among other things, the bills would change family income eligibility levels. Earlier this month, we reported that the Texas Senate had approved a bill to increase enrollment in the State Children’s Health Insurance Program, [...]
Texas Register Updates: Medicaid Rates, Texas Medical Board Changes
June 29, 2009 by Jerri Lynn Ward, J.D.
Filed under Medicaid, Physicans, Texas Medical Board
The following information was obtained from the June 19 issue of the Texas Register: Public Hearings and Notices The Texas Health and Human Services Commission (HHSC) will hold a public hearing on July 15, 2009, at 1:30 p.m., to receive comment on proposed Medicaid payment rates for Early and Periodic Screening, Diagnosis, and Treatment Personal [...]
Obtacles to Keeping the Medically Fragile at Home
June 23, 2009 by Jerri Lynn Ward, J.D.
Filed under Home Health
The State claims that it does not force those who age out of the children’s health care plan into institutional care. It looks to me that the State certainly does do that and in a recent case, it appears that a young man died because of it. AUSTIN – Toby Simmons’ disabilities were so severe [...]
Medical Homes in Texas
June 23, 2009 by Jerri Lynn Ward, J.D.
Filed under Physicans
The Houston Chronicle published a feature story about medical homes, which provide “personal and coordinated care” for seniors. Personal doctors coordinate the care seniors receive and manage it from a central location, and patients have more access to doctors and medical records. Medical home coordinator Dr. Trevor Rabie said, “Many patients feel that if they [...]
Pharmaceutical Industry Agrees to Cut Drug Costs
June 23, 2009 by Jerri Lynn Ward, J.D.
Filed under Medicare, Medicare Part D
The Wall Street Journal reports that the pharmaceutical industry has agreed to cut the cost of Medicare drugs to prevent larger cuts President Barack Obama may impose to fund his health care reform plan. Under the cost-cutting plan, the drug industry would pay for half the Medicare drug’s price when it’s not covered by the [...]
Information Letters: R&S Report Updates, Form 2032, Etc.
June 22, 2009 by Jerri Lynn Ward, J.D.
Filed under HCS, ICF-MRs, Medicaid, Nursing Homes
The Texas Department of Aging and Disability Services (DADS) issued six information letters: TMHP Remittance and Status (R&S) Report Information In a letter to DADS Long Term Care Services and Supports providers, DADS emphasized the importance and usefulness of the TMHP (R&S) Report: “Providers that do not reconcile their R&S Reports may be billing incorrectly, [...]
Inappropriately Placed Residents and Adminstrative Penalties
June 18, 2009 by Pam Peters, J.D.
Filed under Assisted Living
Following a survey, DADS assessed an administrative penalty against an assisted living facility for “having three inappropriately placed residents.†Our firm appealed this holding on behalf of the facility under the premise that the regulations forbid the Department from assessing administrative penalties for “inappropriate placement.†We filed a Motion for Summary Disposition asking the ALJ [...]
Mental Health Parity Act Effective Date Delayed Until January 2010
June 17, 2009 by Dana Stripling, J.D., Of Counsel
Filed under Benefits, Employment Issues, Other Posts
New requirements for employee health care plans originally scheduled to go into effect next month now have been delayed for at least a few more months. Congress has deferred the effective date of the Mental Health Parity and Addiction Equity Act (MHPA) until January 2010. The MHPA does not require health insurance plans to provide [...]
Texas Register Updates: Changes to Physicians Assistants Section, Etc.
June 16, 2009 by Jerri Lynn Ward, J.D.
Filed under Medicaid, Medicare, Texas Medical Board
The following information was obtained from the June 12 issue of the Texas Register: Public Hearings The Texas Health and Human Services Commission (HHSC) will hold a public hearing on July 1, 2009, at 9 a.m. to receive public comment on rate increases for the Community Based Alternatives waiver program, the Community Living Assistance and [...]
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