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 [...]

MedPAC Recommends Adjusted Medicare Payment Rates

MedPAC, which advises Congress on Medicare, released a set of recommendations. (Source – PDF)
An excerpt:
“To restore budget neutrality, the Congress should require the Secretary to fully offset increases in inpatient payments due to hospitals’ documentation and coding improvements. To accomplish this, the Secretary must reduce payment rates in the inpatient prospective payment system by the [...]

CMS: Health Care Spending Rate Slowest Since 1960

CMS issued an annual report on national health care spending that showed nominal spending in the U.S. grew 4.4 percent last year, to $2.3 trillion, the slowest rate of growth since CMS started tracking health care spending in 1960. The health care spending rate in 2007 was 6.0. However, health care spending grew faster than [...]

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 [...]

TxHmL & HCS — Elimination of the Monthly Admin & Operations Fee

As you probably know by now, the admin/op fee of approx. $935 per consumer is set to be eliminated and tied directly to individual service rates. This rule will be republished in this Friday’s Texas Register and implemented October (not September) 1, 2009.
Today, July 24, 2010, professional rates (RNs, LVNs, OTs, PTs, etc) will [...]

New Review Process for Waiver Programs

The reviewers will be using standardized checklists as part of the new review process. The good news is that these checklists are available for providers and may be printed and used as internal QA.

Moving Case Mgmt from the Provider to MRA

SB 1 Sect. 48 moved HCS case management to Mental Retardation Authorities (MRA).
Currently, DADS does not plan on phasing in this shift, instead, DADS intends to ochestrate a mass move in June of 2010. DADS will hold a training for MRAs and providers in the spring before the change.
The MRA will conduct enrollment [...]

Legislative Summary: Bills Affecting HCS & TxHmL Programs

SB 643–Protection and care of individuals with mental retardation
• Renames state schools–State supported living centers
• Requires annual inspections of HCS group homes
• Requires independent mortality reviews
• Establishes a single investigative database (DFPS & reg. issues)
SB 1–General Appropriations Bill
• Funds provider rate increase
• Funds attendant wage increase
• Funds additional HCS slots (approx 50,000)
• Moves HCS case management to Mental Retardation Authorities (MRAs)

Upcoming CDS Town Hall Meetings

DADS is hosting Town Hall Meetings throughout the state this summer to provide an opportunity for DADS consumers and family members, service providers and the public to learn more about the Consumer Directed Services (CDS) service delivery option available in many Texas programs. Currently, only 2% of HCS programs (OHFH) and 4% of TxHmL Programs [...]

Changes to TxHmL Critical Incident Reporting (CARE)

TxHmL providers report to DADS through the CARE system and the required reporting information has changed (SB 325). Providers must begin collecting data in compliance with the new requirements on August 1, 2009. Providers must now report the total number of medication errors, serious injuries, behavior plans authorizing restraint, emergency restraints used (including type of [...]

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