Medicaid Cuts for Texas Providers

The Texas Tribune, a non-profit public media organization, published a story about nursing facilities in Texas facing Medicaid rate cuts.
The article mentions a story we blogged about last month. To deal with a potential budget shortfall, Governor Rick Perry, Lieutenant Governor David Dewhurst, and House Speaker Joe Straus asked HHSC to reduce Medicaid spending by [...]

Information Letters for Hospice and CLASS Providers

DADS released two information letters:
Hospice providers – billing instructions update:
DADS informed hospice providers that they will use modifier U4 in the Modifier 4 location, along with Modifier U3 (Level of Care 1) in the Modifier 2 location, on the Medicaid Institutional Claim when billing hospice services for residents of State Supported Living Centers who are [...]

Information Letters and News Alerts: Hospice, CDSA Providers

DADS released two information letters and news alerts.
Medicaid Hospice Providers:
DADS clarified its Continuous Home Care (CHC) requirements at 40 TAC, Chapter 30 Medicaid Hospice Program, §30.54 Special Coverage Requirements and informed hospice providers of problems identified during annual CHC reviews that result in recoupment of CHC payments. An excerpt:
“Recoupment Process…Based on the review, a determination [...]

Information Letters: LVN/RN Form 3050, Etc.

DADS released three information letters:
Hospice providers:
DADS sent a corrected letter that notifies these providers that they can bill for ventilator services provided to residents in nursing facilities. In the attached letter, the corrections are indicated in red. (Letter)
Day Activity Health Services providers:
DADS determined that either an LVN or an RN can complete and sign the [...]

Information Letters: New Hospice Rates, Employment Svcs Training

DADS released two information letters.
Medicaid Hospice Providers:
HHSC recently approved rate changes for the Medicaid Hospice Program for Federal Fiscal Year 2010, effective October 1, 2009. See new rates on this web page. The adjustment will be retroactive, so providers don’t have to do anything, unless repayment fails. In that case, they’ll need to re-bill the [...]

Provider and Information Letters: HCS, TxHmL, CDSAs

DADS released one provider and three information letters:
HCSSAs: All Medicare-approved home health agencies or those seeking approval under Medicare must comply with Outcome and Assessment Information Set (OASIS)-C requirements. Download the patient classification table here and the letter here.
HCS, TxHmL, and CDSAs: HHSC approved new payment rates for these programs, effective September 1, available at [...]

Texas Register Updates: Rates for Nursing, Medical Board Rules

The following information was obtained from the October 2 issue of the Texas Register:
Public Notices
HHSC has adopted new Medicaid per diem payment rates for the nursing facility program operated DADS, effective September 1, 2009:

Base Rates by RUG
Add-on Rates by Enhancement Level
Liability Insurance

See the relevant section of the Texas Register for more information.
HHSC will hold a [...]

Information Letters: ICF/MR, HCS, CDSAs, DBMD

DADS released four information letters:
Screen 573 allows ICFs/MR to monitor compliance with RLO. The screen’s new function is to identify individuals in each queried component code that have not received a RLO due to being a new admission. These individuals will show as “Not Found” on Screen 573. A vendor will place a hold on [...]

Provider and Information Letters: HCS, ICF/MR, TxHml, Etc.

DADS reminded providers about FY 2009 cut-off dates for miscellaneous claims and year-end close-out processing. You may download letters for the following providers:

ICF/MR Group 5
ICF/MR Group 6
HCS and TxHml
Community Services, Nursing Facility, and Therapy Providers

DADS informed community-based ICF/MR providers of the initiation of adverse actions that may be taken by DADS against providers that don’t [...]

Provider and Information Letters: Emergency Preparedness, Hospice Rates

The Texas Aging and Disability Services (DADS) issued a provider and information letter:

Emergency Preparedness Reminder

DADS reminded all Adult Day Care Facilities, Assisted Living Facilities, Home and Community Support Service Agencies, Intermediate Care Facilities for Persons with Mental Retardation or Related Conditions, and Nursing Facilities to review their emergency preparedness and response plans and available resources [...]

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