In a letter that replaces PL #06-08, the Texas Department of Aging and Disability Services (DADS) alerted Home and Community Support Services Agencies (HCSSA) to expect more delays for initial licensure and Medicare certification. Region 6 (Houston Regional Office) and Region 3 (Arlington Regional Office) could see delays of up to a year. In the updated letter, DADS added or changed information about the process. For example, providers must request initial licensure at least six months … [Read more...] about Provider Letter: More Licensure and Medicare Certification Delays
CMS Revises Guidance for Coverage Determinations
In an effort to help make sure patients are getting appropriate care, the Centers for Medicare and Medicaid Services (CMS) revised guidance for national coverage determinations (NCDs), according to the news release. As a condition of payment, providers must develop and capture additional patient information to supplement standard claims. CMS Administrator Mark B. McClellan said, "Our goal is to speed access to valuable new technologies, and to promote the effective use of those technologies … [Read more...] about CMS Revises Guidance for Coverage Determinations
Medicare Part D Costly and Burdensome for Nursing Home Providers
Pharmaceutical representatives testified before Congress earlier this month about the administrative burden placed on long term care providers, particularly nursing homes, by Medicare Part D, the new prescription drug program. They also said providers are losing money because of the program. The new drug program was created to give seniors more choices, but it seems to be offering conflicting and confusing choices. For example, Long Term Care Pharmacy Alliance executive director Paul Baldwin … [Read more...] about Medicare Part D Costly and Burdensome for Nursing Home Providers
Provider Letter: Repeal of 40 TAC Criminal History Check
The Texas Department of Aging and Disability Services (DADS) informs all facilities covered by the Health and Safety Code (HSC) that 40 Texas Administrative Code, Chapter 76, Criminal History Check of Employees in Facilities for Care of the Aged and Persons with Disabilities, will be repealed, effective June 1, 2006. The provision was repealed because DADS currently requires facilities to comply with Chapter 250 of the HSC. According to the rule, certain elderly and disabled care facilities … [Read more...] about Provider Letter: Repeal of 40 TAC Criminal History Check
Provider Letter: 211 System
The Texas Department of Aging and Disability Services (DADS) has issued a provider letter (July 17) to Home and Community Support Services Agencies (HCSSA) and Adult Day Care Facilities (ADC) on using the 211 system. The 211 system is a telephone number that connects callers to local health and human services agencies. People looking for social service assistance for food, housing, education, legal help, child care, physical and mental health, financial support, transportation, or emergencies … [Read more...] about Provider Letter: 211 System
Bush Administration Relaxes Proof of Citizenship Requirement
The Bush Administration has backtracked on its commitment to require Medicaid recipients to show proof of citizenship to continue receiving benefits. At least eight million people will be exempted from the requirement because they established citizenship when they applied for Medicare or Supplemental Security Income. Is "established" the same as "proved"? Did the Medicare and Supplemental Security Income recipients show documentation or simply check a box? Last week I wrote that the new … [Read more...] about Bush Administration Relaxes Proof of Citizenship Requirement
Survey: Pharmaceutical Companies Should Help Educate on Medicare Part D
Verispan, a health care research company, has issued the results of a spring 2006 survey of long term care providers. According to the survey, 94 percent of long term care providers expect pharmaceutical companies to help educate prescribers about Medicare's new prescription drug plan, and 54 percent said they expect companies to help educate patients. (Source) Long term care providers suggested several ways pharmaceutical companies can educate them about the plan, including webcasts, online … [Read more...] about Survey: Pharmaceutical Companies Should Help Educate on Medicare Part D
Provider Letter: Remittance and Status Reports
In a provider letter dated June 30, 2006, the Texas Department of Aging and Disability Services reminded community service providers, ICF-MR provider agencies, nursing facilities, and therapy providers of the "importance and usefulness" of Remittance and Status reports (R&S). Providers should review the reports to make sure billing is correct and recoupments are valid. Providers should also alert the state office staff about incorrect billing and invalid recoupments within the 12-month filing … [Read more...] about Provider Letter: Remittance and Status Reports
HIPAA and Emergency Preparedness
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) protects individuals' Private Health Information (PHI) held by "covered entities," like health plans, health care providers, and health care clearinghouses, and regulates the use and disclosure of PHI. In order to help emergency preparedness and recovery planners stay in compliance with HIPPA while accessing and using protected health information for the disabled, the U.S. Department of Health and Human Services (HHS) … [Read more...] about HIPAA and Emergency Preparedness
Medicaid Proof of Citizenship in Effect
On July 1, a new rule went into effect that requires new Medicaid applicants and current beneficiaries re-enrolling in Medicaid to show proof of U.S. citizenship in order to collect benefits. Last month I wrote about the new law and followed up with a post about the Texas Health and Human Services Commission's intention to verify the citizenship and identity of beneficiaries in Texas. At least one state will delay implementing the new law. North Carolina will push the effective date back as … [Read more...] about Medicaid Proof of Citizenship in Effect