DADS released three information and two provider letters:
CBA and HCSSA (revised letter):
DADS case managers will add a dental buffer up to a maximum of $400 to each CBA initial ISP and annual reassessment, unless the amount of the buffer will cause the ISP to exceed the cost limit, effective April 19. (Letter)
AFC, ALF, CBA, CLASS, CMPAS, DBMD, HDM, MDCP, PACE, TAS, and other providers:
An excerpt on how to check for LTC claim payment information:
Personal Needs Allowance (PNA)
Call the Department of Aging and Disability Services (DADS) Personal Needs Hotline at 1-512-438-2200, Option 2.Billing, Remittance and Status (R&S) Reports
Call the Texas Medicaid & Healthcare Partnership (TMHP) Call Center/Help Desk at 1-800-626-4117 or 1-800-727-5436.
Service Authorization
Call the DADS Provider Claims Services (PCS) Hotline at 1-512-438-2200:
• Option 1 – Nursing Facilities; Hospices; Intermediate Care Facilities
• Option 5 – Texas Home Living (TxHmL) Waiver Program; Home and Community-based Services (HCS)
• Option 6 – Rehabilitative Services
All ICFs/ID with Capacity of 13 or Fewer Beds:
DADS issued the letter to include all ICFs/ID that have 13 or fewer beds and to update the frequently asked question (FAQ) attachment to include FAQs received from the “Implementing Nursing Services Related to Senate Bill (SB) 1857, 82nd Texas Legislature, Regular Session, 2011 in the ICF program” training. (Letter)
ICF/ID:
An ICF/ID exempt from licensure must conduct a DFPS investigation if:
- DFPS does not investigate an ANE allegation that was reported by an employee of the ICF/ID because it does not meet DFPS’ definition of ANE in Texas Administrative Code (TAC), Title 40, Part 19, Chapter 711, Investigations in DADS Mental Retardation and DSHS Mental Health Facilities and Related Programs (as described in §711.5);
- DFPS does not investigate a complaint that was reported by a person who is not affiliated with the ICF/ID because it does not meet DFPS’ definitions in 40 TAC §711.5 of Chapter 711 (when DFPS receives a complaint that is listed in 40 TAC §711.7, DFPS will not investigate the complaint, but will forward the complaint to the ICF/ID that the complaint pertains to); or
- DFPS Adult Protective Services (APS) conducts an in-home investigation related to an individual of the ICF/ID who was allegedly abused, neglected or exploited by a family member, or a person with an ongoing relationship with the individual, who is not an employee of the ICF/ID where the individual resides, and the facility was not responsible for supervision at the time the ANE was alleged.
CCAD RC, CBA AL/RC, and CBA PCSP providers:
HHSC approved rate changes for these providers, effective February 1, 2012. The facility cost area rates are decreased by $0.79 per day of service to reflect the most recent increase in SSI payments. (Letter)