For Nursing and Assisted Living Facilities, and Intermediate Care Facilities Serving Persons with Mental Retardation or a Related Condition The Texas Department for Aging and Disability Services (DADS) released a letter, dated November 24, alerting providers to guidelines for amelioration of administrative penalties. The letter explains what amelioration is (allowing "a facility, instead of paying fines for violations, to invest monies back into the facility"), legal authority, what DADS … [Read more...] about Provider Letters: Alerts for NFs, ALs, and ICF-MR/RCs
Provider Letter: Medicare Certification Alert for HCSSAs
In a provider letter dated December 1, the Texas Department of Aging and Disability Services (DADS) notified home health agencies seeking Medicare certification that DADS will no longer schedule initial Medicare certification surveys, per a directive by the Centers for Medicare and Medicaid Services. From the letter: Background Over the last five years, Texas has experienced unprecedented growth in the number of HHAs seeking certification. The five-state CMS Region 6 (Texas, New … [Read more...] about Provider Letter: Medicare Certification Alert for HCSSAs
Medicaid Report and Issue Brief
Last month, a federal advisory panel called the Medicaid Commission released a report with recommendations to prevent Medicaid from going bankrupt. Once again, it’s all about the baby boomers, and once again, Republicans and Democrats are split on the issue. (The Kaiser Network) The Bush administration wants to implement changes intended to save money in the long run, while the new Democratic Congress likely will resist the recommended changes. The report has not been posted … [Read more...] about Medicaid Report and Issue Brief
New Rules for Licensing Standards
The Texas Department of Health and Human Services Commission has adopted several amendments that will affect licensing standards for Home and Community Support Services Agencies, published September 8, 2006. The rule changes "set for the criteria" used for determining whether a conviction will bar a person from obtaining licensure or participating in agency management. The amendments and new section also adds definitions, corrects, errors, and eliminates certain offenses that currently bar … [Read more...] about New Rules for Licensing Standards
Hearing on Provider Payment Rates
The Texas Department of Health and Human Services Commission will hold a hearing for public comment on proposed payment rates for the following operated by DADS: Residential Care program, assisted living/residential care services under the Community Based Alternatives program, and assisted living/residential care services under the Consolidated Waiver program. Rates will be effective January 1, 2007. The public hearing will be held on December 12, 2006, at 9:00 a.m. in the Lone Star … [Read more...] about Hearing on Provider Payment Rates
‘Cultural Transformation’ in the Long Term Care Industry
I’ve blogged about the impending retirement of waves of baby boomers before. It’s a hot topic in the health care industry, which will need to adjust to the influx of Americans who’ll need long term, and sometimes specialized care. A bipartisan committee called The National Commission for Quality Long-Term Care, co-chaired by former U.S. Sen. Bob Kerrey and former House Speaker Newt Gingrich, will release a report that will guide the industry and help it prepare for new patients and new … [Read more...] about ‘Cultural Transformation’ in the Long Term Care Industry
Medicare Part D Open Enrollment
Open enrollment for Medicare Part D, the new prescription drug program, began last Wednesday and will end on December 31. Current beneficiaries may switch plans and first-timers may sign up for new plans. For more information, visit the Medicare.gov web page. … [Read more...] about Medicare Part D Open Enrollment
Industry vs. State: California Seeks to Control Drug Prices
Effective January 2007, the state of California will be authorized to seek drug discounts up of up to 60 percent for California residents receiving benefits from Medicare Part D. Drug companies are “alarmed,†of course. From the Kaiser Network: Although state officials say the measure is voluntary, the law also includes language that permits California in 2010 to remove from its Medicaid formulary treatments sold by companies that do not comply with the law. According to the Globe, … [Read more...] about Industry vs. State: California Seeks to Control Drug Prices
Texas Register Update: Nursing Facility Payment Rates for State Veterans Homes
The Texas Health and Human Services Commission (HHSC) has adopted new pay per day payment rates for state-owned veterans nursing facilities for state fiscal year 2007, which became effective September 1, 2006: Big Spring, $133.00; Bonham, $133.00; Floresville, $133.00; Temple, $133.00: McAllen, $133.00 and El Paso, $133.00. For more information, see the relevant section of the November 17 issue of the Texas Register. … [Read more...] about Texas Register Update: Nursing Facility Payment Rates for State Veterans Homes
Fifth Circuit: No Private Cause of Action for HIPAA Violations
While HIPAA protects the health information of individuals, it does not create a private cause of action for those aggrieved (65 Fed. Reg. 82566).  This is made abundantly clear from the commentary to the regulations and HIPAA’s legislative history. And while many federal district courts have dismissed individual plaintiffs’ lawsuits under this rule, the Fifth Circuit, in the case of Acara v. Banks (5th Cir. Nov.13, 2006), has become the first federal appellate court to affirm the ruling. … [Read more...] about Fifth Circuit: No Private Cause of Action for HIPAA Violations