Provider and Information Letters: ICF/MR, HCSSA, NFs, Assisted Living

DADS released seven new provider letters and one information letter. DADS informed the following providers that in addition to an initial Nurse Aide Registry and the Employee Misconduct Registry search, they must search both registries every year for unlicensed employees and volunteers whose duties include face-to-face contact with clients, effective September 1, and document and [...]

NPR’s Primary Care Physician Series

Last week, we pointed you to the first part of NPR’s article series on primary care physicians in the post Solo Primary Care Physicians. NPR has published the second and third articles: Future Of Primary Care? Some Say ‘Medical Home’ Midlevel Providers Fill Primary Care Doctors’ Shoes

Texas Register: Boarding Home Facilities, ICFs/MR, HSSCAs, Etc.

The following information was obtained from the August 27 issue of the Texas Register: Public Notices HHSC withdrew its intent to submit Amendment 944, Transmittal Number TX 10-051, to the Texas State Plan for Medical Assistance, which would have proposed to cover certain pharmacy supplies as part of the home health benefit provided by a [...]

Information Letters: NFs, ICFs/MR, CLASS, and DBMD

DADS released three new information letters: Per diem payment rates NFs and hospice directors, effective September 1, 2010, can be found here. Per diem payment rates for ICFs/MR, effective September 1, 2010, can be found here. CLASS and DBMD providers: DADS informed these providers that effective September 1, 2010, it will not allow providers to [...]

Solo Primary Care Physicians

The Houston Chronicle reported that in the last two years, about 350 Texas doctors have dropped the Medicare program. In 2008, 62 percent of those doctors were primary care physicians. Something similar is happening with Medicaid, the government health insurance program for low-income individuals and families. In the age of lower reimbursement rates, specializing may [...]

Information Letter: For Nursing Facilities

Two updates for NFs: The definition of “licensed health professional” has been moved to 40 TAC §19.101(56), from 40 TAC §19.101(57); The DADS Paid Feeding Assistant Training curriculum is available on the Regulatory Services Credentialing web page at the following url: http://www.dads.state.tx.us/providers/NF/credentialing/NATCEP/feedingassistant.pdf (98-page PDF)

Texas Register Updates: ICFs/MR and Nursing

The following information was obtained from the August 20 issue of the Texas Register: Public Notices HHSC proposes new Medicaid per diem reimbursement rates for the Truman W. Smith Children’s Care Center ($219.69 ) and DADS-operated/state-operated ICFs/MR (small $603.64; large Medicaid-only: $537.41; large dual-eligible Medicaid/Medicare: $516.23). See the Texas Register for more information. HHSC intends [...]

Texas Register Updates: RFP, Nursing, Reimbursement Changes

The following information was obtained from the August 13 issue of the Texas Register: Public Notices HHSC intends to submit to CMS a waiver amendment for the State of Texas Access Reform Program, a Managed Care waiver program under the authority of §1915(b) of the Social Security Act. The amendment would add new benefits for [...]

DADS Alerts: MDS Training Materials, LTSS, HSC

The Minimum Data Set 3.0 training materials is posted online here. HHSC and DADS will host LTSS provider meetings in the Dallas and Tarrant service areas, which will allow HHSC, DADS, and five selected STAR+PLUS health maintenance organizations to present  information for successful implementation of the STAR+PLUS program expansion. See the alert page for dates [...]

Information Letters: Hospice and Nursing Facilities

DADS released three information letters: Hospice: Hospice providers are responsible for know the Medicare and Medicaid eligibility for a hospice client. An excerpt: The DADS rule for Medicaid Hospice Payments and Limitations at 40 TAC §30.60(h) states: (h) Third-party resources. Medicaid pays only after all third-party resources have been used. In accordance with 40 TAC [...]

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