Information Letter and Alerts: ICF/MR, HCS, NFs

DADS release one information letter and several news alerts: ICF/MR: DADS informed these providers about process changes for how allowable related-party hours for Medicaid cost reporting are determined; and new fully-funded model wage rates that apply to direct services providers, effective September 1. (Letter) Recent news alerts: DADS posted an invitation to a webinar about [...]

Are Doctors Dropping Medicare Patients?

In the past month, we’ve blogged about the travails of doctors, especially primary care physicians. As doctors reduce patient loads and medical students opt to specialize to earn more money, the primary care physicians shortage will only grow. The American Academy of Family Physicians said there will be 40,000 fewer such doctors in 10 years. [...]

Texas Register Updates: Medicaid Payment Rates

The following information was obtained from the October 23 issue of the Texas Register: HHSC will hold a public hearing on November 3, 2009, at 1:30 p.m., in the Lone Star Conference Room of HHSC, Braker Center, Building H, located at 11209 Metric Boulevard, Austin, Texas, to discuss Medicaid payment rates for: Sleep Studies HHSC [...]

Provider and Information Letters: HCS, TxHmL, CDSAs

DADS released one provider and three information letters: HCSSAs: All Medicare-approved home health agencies or those seeking approval under Medicare must comply with Outcome and Assessment Information Set (OASIS)-C requirements. Download the patient classification table here and the letter here. HCS, TxHmL, and CDSAs: HHSC approved new payment rates for these programs, effective September 1, [...]

Texas Register Updates: ICF/MR, DBMD, CLASS, Etc.

The following public notices were obtained from the October 16 issue of the Texas Register: HHSC adopted the following per diem reimbursement rates: Per Diem Rates for Large, State-Operated ICF/MR Services Large State-Operated ICF/MR Facilities-Medicaid Only clients Adopted interim daily rate: $469.88 Large State-Operated ICF/MR Facilities – Dual-eligible Medicaid/Medicare clients Adopted interim daily rate: $450.30 [...]

SCHIP Expansion in Health Care Reform

President George Bush twice vetoed versions of a bill that would have expanded the State Children’s Health Insurance Program (SCHIP) amid concerns that parents who could afford private insurance would seek coverage under the program, depriving low-income children of coverage. Republicans who voted against the bill also were concerned the bill would expand coverage to [...]

Information Letters: HCS, TxHmL, CDSAs, HCSSAs

DADS released three information letters: CBA, HCSSAs, CDSAs: On November 1, DADS will expand the Overnight Companion Services (OCS) to the remaining fee-for-service counties in Region 11 (Brooks, Duval, Jim Hogg, Kennedy, Live Oak, McMullen, Starr, Webb, and Zapata) and all of the counties in Region 4. DADS held an “expansion event” on Tuesday to [...]

Texas Register Updates: Automatic Medicaid Enrollment for Newborns

HHSC intends to submit an amendment to the Texas State Plan for Medical Assistance, which would allow automatic one-year enrollment in Medicaid for babies born to women covered by Medicaid, whether the newborn lives with the mother or whether the mother remains eligible for Medicaid. For more information or to request a copy of the [...]

Primary Care Physician Shortage Bills ‘Anemic’

According to the Kaiser Network, congressional bills set to extend health insurance to the presently uninsured don’t address how primary care physicians will deal with the heavy load of new patients. The American Academy of Family Physicians said there will be 40,000 fewer such doctors in 10 years. The group predicts 160,000 fewer primary care [...]

Recession and Nursing Facilities

How is the recession affecting nursing facilities? According to the Associated Press, the Centers for Medicare and Medicaid Services cut Medicare rates to nursing facilities (NFs) by $16 billion over 10 years. These facilities can expect more cuts if President Barack Obama’s health care reform bill becomes law. American Health Care Association (AHCA) president and [...]

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