IL and News Alerts: 6/21, 7/23 Meetings
June 18, 2013 by Jerri Lynn Ward, J.D.
Filed under Assisted Living, Home Health, Hospice, Licensed Health Providers, Medicaid, Nurses
AFC, AL/RC, CBA HCSSA, DAHS, FMS, HDM, MDCP, Out-of-Home Respite ADC and AL/RC, PHC, and TAS: DADS notified contracted providers of changes to contract and fiscal compliance monitoring protocol in relation to negative billing. (Letter) – (Published on the DADS site today, 6/18) DADS will hold the quarterly HCSSA stakeholder meeting this Friday, June 21, 2013, [...]
TX Register Updates: Notice Correction, THTQIP Waiver
June 17, 2013 by Jerri Lynn Ward, J.D.
Filed under ICF-MRs, Licensed Health Providers, Medicaid, Nurses, Physical Therapists, Physicans
The following information was obtained from the June 14 issue of the Texas Register. Public Notices and Correction HHSC corrected a notice published in the May 31, 2013, issue in reference to the intent to submit a request to amend the CLASS Medicaid waiver. An excerpt: In addition to the changes previously described in the [...]
From McKnight’s: CMS Crackdown, NF Management Agreements
June 13, 2013 by Jerri Lynn Ward, J.D.
Filed under Medicaid, Nursing Homes, Patient Protection and Affordable Care Act
– “A compliance expert cautioned long-term care providers about CMS’ new Fraud Prevention System in a recent McKnight’s Super Tuesday webcast. While technology can catch bad actors, it’s also a crucial way to maintain compliance, advised Alliance Training Center Executive Director Leah Klusch, RN, BSN, FACHCA. She advocated for programs that electronically compare Minimum Data Set and billing data [...]
CHARTING BY EXCEPTION–THE FAST TRACK TO RUG ERRORS?
June 12, 2013 by Jerri Lynn Ward, J.D.
Filed under Business, Licensed Health Providers, Medicare, Nursing Homes
Charting by exception is the single most problematic form of nursing charting. Charting by exception is a tool used for residents who require little to no nursing intervention or care. This type of charting, if not done correctly, will leave the facility subject to allegations of RUG review errors. Reviewers scrutinize nurse charting to [...]
TX Register Updates: THTQIP, Hospital Waiver Payments
June 11, 2013 by Jerri Lynn Ward, J.D.
Filed under Hospitals, Medicaid, Physicans
The following information was obtained from the June 7 issue of the Texas Register. Public Notice HHSC intends to submit to CMS a request to amend the Texas Healthcare Transformation Quality Improvement Program waiver program. An excerpt: Effective September 1, 2013, the expenditures for STAR+PLUS enrollees for elimination of the 30-day spell of illness limitation [...]
IL and News Alerts: RN Assessment, Workshop Registration
June 10, 2013 by Jerri Lynn Ward, J.D.
Filed under Medicaid, Nurses, Nursing Homes
DADS released one information letter. TxHmL and Local Authority Service Coordinators: DADS informed TxHmL program providers of the requirement to complete a RN nursing assessment for all individuals in their program before a nurse or an unlicensed service provider can perform nursing tasks. (Letter) – DADS contracted with the NACES Plus Foundation Inc. to collect [...]
DRILLING DOWN TO ADL MDS ERRORS: THE HOW AND WHY MONEY IS WALKING OUT YOUR DOOR
June 7, 2013 by Jerri Lynn Ward, J.D.
Filed under General Counsel, Licensed Health Providers
As discussed last week, ADL’s are the major target for HHSC-OIG. ADL’s are the source for most errors resulting in RUG write downs. Not only did the facility lose money on incorrectly charted ADL’s they will also face large penalties after a RUG review. Charting ADL’s For most MDS nurses, ADLS are pieces [...]
IL/PLs: CMS Survey & Clarification
June 6, 2013 by Jerri Lynn Ward, J.D.
Filed under ICF-MRs, Medicaid, Nursing Homes
DADS released one PL and one IL/PL. All ICF/IID: DADS clarified the CMS Survey & Clarification Letter 13-11-ICF/IID, No Longer Certified Under Time-Limited Agreements, issued on February 8, 2013. An excerpt: CMS eliminated the requirement for TLAs on May 16, 2012. Since the ACC was tied to the TLA, the ACC has also been eliminated. [...]
TX Register Update: CLASS Medicaid Waiver
June 4, 2013 by Jerri Lynn Ward, J.D.
Filed under Medicaid
The following information was obtained from the May 31 issue of the Texas Register. HHSC intends to submit to CMS a request to amend the CLASS Medicaid waiver to add the CDA services option for supported employment and a revision to the service definition of supported employment to clarify assistance available and specify integrated, competitive [...]
DADS News Alerts: 6/14 HDM Waiver Deadline, 7/11 Webinar
June 3, 2013 by Jerri Lynn Ward, J.D.
Filed under Medicaid
– DADS will host a webinar on Thursday, July 11, 2013, Implementing Consistent Assignment in a Long-Term Care Setting Using Evidence Based Strategies. You may reserve your seat now at: https://www1.gotomeeting.com/register/181006081 – On May 29, 2013, CMS re-posted the RAI Manual V1.10. Effective May 20, the new version omits six sections: Chapter 3 Section F; [...]
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