Last year I blogged about a group of Texas pharmacists (independent operators) lobbying the White House for reimbursement for Medicare Part D prescription drugs. (See Texas Pharmacists Lobby White House) The pharmacists were not receiving sufficient reimbursement to make up for the millions of dollars worth of drugs they gave to Part D patients for free, in part because Part D was new and confusing, and patients who needed medications couldn’t afford to wait for approval. To make … [Read more...] about More Medicare Part D Fall-Out for Pharmacists
What’s Up At The Legislature?
The following are some filed bills that may interest you: SB 131 by West (D-Dallas) Requiring that for at least two unannounced inspections each licensing period, DADS would be required to invite someone from the facility's family council to participate. A family council member would also be required to sit in at the exit conference and receive a copy of deficiencies. The measure also provides for the organization, rights and protection of the council. SB 199 by Nelson (R-Flower Mound) … [Read more...] about What’s Up At The Legislature?
Democratic Seek to Increase Prescription Drug Regulation
Democrats on Capitol Hill are continuing their efforts to increase prescription drug regulation by introducing measures to expand the Food and Drug Administration’s (FDA) authority “by requiring drug approvals to be paired with programs to manage risk once they reach the market.†(Source) One issue of contention is whether to use the user-fee agreement between the FDA and drug companies to implement these changes. The user-fee agreement will expire this year. Wall Street Journal … [Read more...] about Democratic Seek to Increase Prescription Drug Regulation
Provider Letter: Joint Training Survey Announcement
In a new provider letter, the Texas Department of Aging and Disability Services (DADS) has asked assisted living facilities to complete a survey about their needs and preferences for future joint training courses. DADS offers courses to assisted living providers “related to common deficiencies and violations†and other topics of interest. To participate in the survey, follow this link. You may view the course offerings here and download the provider letter here. … [Read more...] about Provider Letter: Joint Training Survey Announcement
Increased Medicare Reimbursements for Long Term Care Hospitals?
Last week, the Centers of Medicare and Medicaid Services (CMS) proposed a 0.71 percent increase in standard Medicare reimbursement rates for long-term care hospitals for 2008. According to CMS, the rule would “assure appropriate payment for services by long-term acute care hospitals…to severely ill or medically complex patients, while providing incentives for more efficient care for Medicare beneficiaries.†Interested parties may comment on the proposed rule over the next 60 days, … [Read more...] about Increased Medicare Reimbursements for Long Term Care Hospitals?
Cost of Medicare Part D Lower Than Expected
According to the Congressional Budget Office (CBO), the cost of Medicare Part D over 10 years will be $265 billion less than estimated last August. (Source) The Medicare prescription drug benefit will cost $38 billion this year and $675 billion from 2007 through 2016. CBO director Peter Orszag (pictured) said the lowered cost estimate is attributed to the "lower-than-expected bids" of prescription drug plans. "The bids are coming in, and the pricing is coming in better than anticipated, … [Read more...] about Cost of Medicare Part D Lower Than Expected
Texas Register: Notice of Intent to Renew Consultant Contract
In the February 2 issue of the Texas Register, the Texas Health and Human Services Commission (HHSC) published its intent to renew a consultant contract with Public Strategies, Inc. HHSC issued a request for proposals from consultants to procure technical expertise to assist in the strategic development, implementation, and evaluation of a Texas healthy marriage initiative. Public Strategies, Inc. won renewal of the contract. Unless HHSC receives a “better offer,†it will extend the … [Read more...] about Texas Register: Notice of Intent to Renew Consultant Contract
Texas Register: Adopted and Proposed Reimbursement Rates
The Texas Health and Human Services Commission (HHSC) announced newly adopted interim per diem reimbursement rates for large, state-operated Intermediate Care Facilities for Persons with Mental Retardation (ICF/MR), including state schools operated by the Texas Department of Aging and Disability Services: $345.87 for Medicaid-only clients and $338.59 for dual eligibles. The public hearing was held on November 6, 2006. Mark your calendars for upcoming public hearings for proposed provider … [Read more...] about Texas Register: Adopted and Proposed Reimbursement Rates
Texas Register Updates: Reimbursement Rates for Medicaid Hospital Services
Last year, the Health and Human Services Commission (HHSC) proposed two amendments to implement a supplemental payment program to private hospitals. The Centers for Medicare and Medicaid Services approved the proposed amendments. For more information about the amendments, visit the relevant section in the January 19, 2007, Texas Register. Submit written comments within 30 days of publication in the Texas Register to Kevin Niemeyer by telephone at (512) 491-1366, by fax at (512) 491-1998, … [Read more...] about Texas Register Updates: Reimbursement Rates for Medicaid Hospital Services
Provider Letter: Expansion of the STAR+PLUS Program
The Texas Department of Aging and Disability Services (DADS) issued a provider letter to Community Based Alternative (CBA) providers about the expansion of the STAR+PLUS Program. To help CBA consumers transition to the STAR+PLUS waiver, DADS lays out some guidelines, including the following: 1. The CBA HCSSA is responsible for completing the annual reassessment activities for consumers, whose individual service plans (ISPs) end on 01/31/07 and 02/28/07. 2. For ISPs finalized before or … [Read more...] about Provider Letter: Expansion of the STAR+PLUS Program