Three Year Old Denied Kidney Transplant because She is Special Needs

So this is what they think of the clients of providers of care for the developmentally disabled. Does it all come back to this?

ILs and PL: Cost Reporting, 1915(c) Waiver

DADS released eight information letters and one provider letter. CLASS CSAs, CLASS DSAs, and CDSAs: Effective January 1, 2012, a CMA and DSA can bill for pre-enrollment assessment activities on the same day. (Letter) ICF/MRs: DADS issued this letter to guide providers on using video surveillance cameras to monitor common areas. An excerpt: There is [...]

Proposed Changes to Cost Reporting and Auditing in Chapter 355

On November 10, 2011, HHSC presented proposed amendments to cost reporting and auditing rules to the Medical Care Advisory Committee (“MCAC”). The proposed rules impact Title 1 of the Texas Administrative Code at Part 15, Chapter 355, Subchapter A, §§355.101 and 355.107 and apply to of Intermediate Care Facilities for Persons with Mental Retardation, Home and Community-based Services, Service [...]

ILs/News Alerts: HIPAA, HSC Billing Training

DADS released two information letters and two news alerts: Most LTC providers: HIPAA rules mandate that all Electronic Data Interchange (EDI) transactions must use EDI Version 5010. CMS has extended the December 31, 2011, compliance deadline until April 1, 2012. (Letter) ICF/MR: DADS reminds providers of their responsibility to maintain current and accurate information in [...]

TX Register Updates: Nursing, Medical Board Changes

The following information was obtained from the November 25 issue of the Texas Register: Public Notices HHSC intends to submit to CMS a request to amend the Non-Emergency Medical Transportation waiver program, which would add Colorado, Erath, Palo Pinto, and Somerville counties to the waiver to realign the counties in the full-risk broker model areas [...]

ILs: Mortality Reviews, Cost Containment Initiative

DADS released six information letters: CAS, CBA, FC, and PHC providers: Regarding personal attendant services, the attendant may not directly transport the individual receiving the services. He may arrange for transportation, accompany the individual when using public transportation, or meet the individual at the location. (Letter) ICF/MR (excluding state-supported living centers): DADS will conduct mortality [...]

DADS News Alerts: STAR+PLUS Expansion, Work Sessions

DADS posted a number of news alerts since October 21. A sample: –  On November 3, 2011, from 12:30-2 p.m. CT, CMS will host a National Provider Call on “Skilled Nursing Facility Prospective Payment System (PPS) Minimum Data Set (MDS) 3.0 and Resource Utilization Group-Version 4 (RUG-IV) Policies and Clarifications.” Registration is required to attend [...]

TX Register Updates: PASRR Changes, TxHmL Renewal

The following information was obtained from the October 14 issue of the Texas Register: Public Notices HHSC intends to submit an amendment to the Texas State Plan for Medical Assistance, which would add categorical determinations to the Preadmission Screening and Resident Review (PASRR) program. HHSC intends to submit an amendment that would define the PASRR [...]

Requirements for Informal Review Requests will be Enforced Beginning September 1, 2011

DADS has issued Provider Letter 11-11 outlining changes for requirements to informal review requests for cost reports, effective September 1, 2011. Beginning September 1, if a provider submits an informal review request that does not meet the requirements of 1 TAC §355.110(c)(1)(B) the request will not be accepted. Under 1 TAC §355.110(c)(1)(B), a provider must [...]

TX Register Updates: Oct. Hearings, Nursing & Physician Changes

The following information was obtained from the October 7 issue of the Texas Register: Public Hearings and Notice HHSC will hold a public hearing on October 27, 2011, at 9 a.m. to receive public comment on proposed rates for Hospice routine home, continuous home, inpatient respite, and general inpatient care, to be held in the [...]

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