Medicaid Around the Country

Texas Medicaid enrollment interactive. “Use this interactive to compare the number of Texans enrolled in Medicaid, the Children’s Health Insurance Program and the Women’s Health Program. By clicking on the legend, you can remove or add a category from view in order to more clearly compare how enrollment has changed for different groups of people.” [...]

TX Register Updates: TANF Changes

The following information was obtained from the February 3 issue of the Texas Register: HHSC proposed amendments to §355.101, Introduction, and §355.107, Notification of Exclusions and Adjustments. The changes would create a formal definition for the term “line item” and eliminate a reference to auditors. HHSC also proposed to amend §372.107, persons excluded from TANF [...]

IL and PLs: Adverse Licensing, Crime Reporting

DADS released one information and two provider letters. CLASS CSA, CLASS, DSA, HCS, TxHmL, CDA, and Local Authorities: DADS is expanding utilization management and review activities for its Medicaid community entitlement and waiver programs, effective January 1, 2012. (Letter) ADC, ALF, HCSSA, ICF/ID, and NF: Beginning March 1, 2012, if the name of an applicant [...]

TX Register Update: Specialty Drugs

The following information was obtained from the January 27 issue of the Texas Register. HHSC proposed new §354.1853, Specialty Drugs, which provides a definition and criteria for specialty drugs. An excerpt: Section 1.02(d), Senate Bill 7, 82nd Legislature, First Called Session, 2011, amends Texas Government Code §533.005(a) by adding paragraph (23)(G) to require Medicaid managed [...]

ILs: Nursing Changes

DADS released three information letters. HCS and TxHmL: These providers must be in compliance with nursing changes by January 1, 2012, with the following requirements: HCS and TxHmL program providers must be in compliance by January 1, 2012 with the following requirements: • All licensed vocational nurses (LVNs) must be clinically supervised by a registered [...]

TX Register Updates: Feb. 15 Hearing, Emergency Rules

The following information was obtained from the January 20 issue of the Texas Register. Public Notices HHSC will hold a public hearing on February 15, 2012, at 1:30 p.m., to receive comment on proposed Medicaid payment rates for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies; payment rates for annual Healthcare Common Procedure Coding System; and [...]

IL and PLs: Inappropriately Placed Residents

DADS released one information and two provider letters. Assistant Living Facilities: The legislature has made changes to the process of removing an inappropriately placed resident. An excerpt: An inappropriately placed resident is a resident who was appropriate when admitted to the ALF, but whose condition has changed. All residents must be appropriate for the ALF [...]

Medicare/Medicaid News Around the Web

MedPAC, a group that advises Congress on Medicare, recommends an overhaul in the way skilled nursing homes are reimbursed. “Congress also should direct HHS to cut payments to skilled nursing facilities with relatively high risk-adjusted rehospitalization rates for their Medicare-covered skilled nursing facility stays.” – McKnight’s Raising the age of Medicare eligibility. “Medicare provides health [...]

Three Year Old Denied Kidney Transplant because She is Special Needs

So this is what they think of the clients of providers of care for the developmentally disabled. Does it all come back to this?

TX Register Updates: Military Spouses, Denying Licenses

The following information appeared in the January 13 issue of the Texas Register. Public Notices HHSC adopted a new per diem payment rate for the Tyler state-owned veterans nursing facility: $237.00. HHSC intends to submit to CMS a request to amend the Youth Empowerment Services waiver to expand the geographical area of the waiver to [...]

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