Rising Costs Affect Medicaid Expansion and Primary Care Physicians

The question in the health care reform debate is not whether Medicaid and providers will be affected by changes, but rather how they will be affected. The goal of Barack Obama’s health care reform plan is to reduce the number of uninsured Americans. Doing so will cost money. The News-Leader reports that under the president’s [...]

Provider and Information Letters: ICFs/MR, HSC, TxHml

According to the code, the examining physician determines the severity of injuries in ICF/MR facilities. In a provider letter, DADS informed ICFs/MR that an examining PA and APN may also determine severity of injuries if delegated by an examining physician. Download the letter here. DADS is removing the cost limitation for Augmentative Communication Devices (ACDs) [...]

Texas Register Updates: Contract Award, Reimbursement Rate Changes

The following information was obtained from the August 21 issue of Texas Register: Public Notices and Hearings DADS awarded a contract (total value $227,599) to Bailit Health Purchasing, Inc., to provide the procurement, implementation, and evaluation of the health home pilot project for children on Medicaid. For a list of per diem reimbursement rates DADS [...]

Provider and Information Letters: NFs, ICF/MRs, Assisted Living, and Others

DADS sent a 12-page letter with recommendations for infection control and prevention in long term care facilities to nursing and assisted living facilities and ICF/MRs. Among the recommendations are (Letter): An active, effective, facility-wide infection control program should be established. The purpose of the program is to help prevent the development and spread of infectious [...]

News from CMS

>> CMS recently announced that a 60-day supplier bidding period for the Round One Rebid of the Medicare Competitive Bidding Program for durable medical equipment, prosthetics, orthotics, and supplies will begin at the end of October. (Source) CMS’s Jonathan Blum said, “Competitive bidding is an essential tool to help Medicare pay appropriately for health care—important [...]

Texas Register Updates: HSC, TxHmL, CWP, Nursing

The Texas Register‘s web pages are down as of this posting. You may download the following information, obtained from the August 14 issue of the Texas Register, in the PDF files linked in the post: Public Hearing HHSC will hold a public hearing on September 1, 2009, at 9 a.m. to receive public comment on [...]

Long Term Care Providers and Health Care Form

How will President Barack Obama’s massive health care reform proposal affect long term care providers? With a bill of over 1,000 pages and a budget in the trillions, the shift is bound to have a big impact. According to a story in Kaiser Health News, despite worries to the contrary, providers would benefit over the [...]

Provider and Information Letters: HCS, ICF/MR, TxHml, Etc.

DADS reminded providers about FY 2009 cut-off dates for miscellaneous claims and year-end close-out processing. You may download letters for the following providers: ICF/MR Group 5 ICF/MR Group 6 HCS and TxHml Community Services, Nursing Facility, and Therapy Providers DADS informed community-based ICF/MR providers of the initiation of adverse actions that may be taken by [...]

Texas Register Updates: ICF/MRs and Nursing Facilities

The following information was obtained from the August 7 issue of the Texas Register: Public Hearings and Notices The Texas Health and Human Services Commission (HHSC) will hold a public hearing on August 27, 2009, at 1 p.m. to receive public comment on the proposed interim per diem Medicaid reimbursement rates for small and large [...]

Proposed 2010-11 ICR/MR Rates – comment through 8/7/09

As a result HHSC’s delay in issuing the proposed rates, the public commet period has been extended through Friday, August 7, 2009 at 5:00 p.m. Take advantage of this opportunity to have your voice heard by emailing Pam McDonald with HHSC at pam.mcdonald@hhsc.state.tx.us by 5:00 p.m. on Friday, August 7, 2009. • The proposed rates [...]

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