IL and PLs: Adverse Licensing, Crime Reporting

DADS released one information and two provider letters. CLASS CSA, CLASS, DSA, HCS, TxHmL, CDA, and Local Authorities: DADS is expanding utilization management and review activities for its Medicaid community entitlement and waiver programs, effective January 1, 2012. (Letter) ADC, ALF, HCSSA, ICF/ID, and NF: Beginning March 1, 2012, if the name of an applicant [...]

TX Register Updates: Military Spouses, Denying Licenses

The following information appeared in the January 13 issue of the Texas Register. Public Notices HHSC adopted a new per diem payment rate for the Tyler state-owned veterans nursing facility: $237.00. HHSC intends to submit to CMS a request to amend the Youth Empowerment Services waiver to expand the geographical area of the waiver to [...]

ILs and PLs: COLA Delay, ICF/ID Changes

DADS released three information and three provider letters: Community Care for the Aged and Disabled RC providers, CBA, AL/RC, and AFC: CMS recently announced a 3.6 percent COLA increase in federal benefits. Because of late receipt of this news, HHSC will not implement the increase until February 1, 2012. (Letter) NF, ICF, HCS, and TxHmL: [...]

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 [...]

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 [...]

IL/News Alerts: Electronic Submission, December Webinars

AFC, AL/RC, CAS, CBA, CDS, DAHS, ERS, FC, HDM, MDCP, and PHC: DADS will participate in the Electronic Document Submission Pilot, which entails transmitting documents between DADS case manages and providers/CDSAs. The program begins on December 19, 2011 and will continue for six months. (Letter) –  DADS will implement a new service code in the [...]

TX Register Updates: CBA Changes, Staff Training

The following information was obtained from the November 4 issue of Texas Register: Public Hearings and Notices HHSC will hold a public hearing on December 1, 2011, at 9 a.m., to receive public comment on proposed payment rates for the AL/RC services under the CBA program, CBA Personal Care III services, and the Residential Care [...]

TX Register Updates: Corrections, Medicaid Buy-In

The following information was obtained from the October 21 issue of the Texas Register: Public Notice DADS proposed to amend 40 TAC §92.2, Definitions, in the October 7, 2011, issue of the Texas Register and included outdated definitions for paragraph (8), “behavioral emergency” on page 6702, and paragraph (36), “personal care services” on page 6703, [...]

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 [...]

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