HHSC – Learning Collaborative Summit

HHSC has posted information on the August 27th - 28th Statewide Learning Collaborative Summit, including the livestream link and agenda, on the Dates and Deadlines page. Visit us at Garlo Ward, PC … [Read more...]

LTC News: Home Health, SNF

--  "CMS recently updated the manual to make it clearer that Medicare may reimburse for skilled nursing services meant to maintain, not improve, a beneficiary's condition. The agency was required to make these updates per the settlement in the Jimmo v. Sebelius case." – McKnight's --  "Too many Medicare providers are receiving improper payments, and the Centers for Medicare & Medicaid Services should clamp down by doing a better job overseeing its contractors' error rate reduction plans, … [Read more...]

TX Register Updates: TxHmL, Bed Allocation Waivers

The following information was obtained from the January 10 issue of the Texas Register. Public Notices HHSC intends to submit Transmittal Numbers 13-047 and 13-057 to the Texas State Plan for Medical Assistance, to include current information on agency names and organizational structure. HHSC will also submit to CMS a request to amend the TxHmL waiver program to update the performance measures for consistency across waivers and the process for HHSC's administrative oversight of DADS, and … [Read more...]

LTC News: CMS Rules, Provider Court Case

--  "After years of trying to clamp down on hospital spending, the federal government wants to get control over what Medicare spends on nursing homes, home health services and other medical care typically provided to patients after they have left the hospital." - Kaiser --  "In a rule issued today, [CMS] finalized payment rates and policies for 2014, including a major proposal to support care management outside the routine office interaction as well as other policies to promote high quality … [Read more...]

LTC News: Drs. Medicare Payment

--  "The Democratic and Republican leaders of two key congressional committees have agreed on a framework to scrap the problematic Medicare payment formula for physicians and replace it with one that would link physician reimbursement to the quality of care provided, a step that could put an end to the annual "doc fix" debate." - Kaiser --  "A bill in the House of Representatives aims to create a 'trusted provider' status in the Medicare program, which would potentially streamline the … [Read more...]

IL and PLs: Sex Offender Registry

DADS released one information letter and three provider letters. CBA, CLASS, DBMD, FMS, and MDCP: DADS provided current information regarding when room and board are included in the reimbursement rate for in-home and out-of-home respite. (Letter) ALF: DADS notified providers that it intends to adopt the 2000 edition of the NFPA 101, the LSC, effective January 6, 2014, for assisted living facilities. (Letter) DADS informed ALF managers of a new requirement mandated by the Texas … [Read more...]

TX Register Updates: Correction, Base Wage

The following information was obtained from the October 11 issue of the Texas Register. Public Notice Correction HHSC published a notice in the September 20 issue about the agency's intent to submit a request to amend the THTQIP. An excerpt: In the prior public notice published in the September 20, 2013 issue of the Texas Register, HHSC discussed the agency's intent to request the addition of cognitive rehabilitation therapy as an available service in the STAR+PLUS home and community … [Read more...]

TX Register Updates: Correction, Base Wage

The following information was obtained from the October 11 issue of the Texas Register. Public Notice Correction HHSC published a notice in the September 20 issue about the agency's intent to submit a request to amend the THTQIP. An excerpt: In the prior public notice published in the September 20, 2013 issue of the Texas Register, HHSC discussed the agency's intent to request the addition of cognitive rehabilitation therapy as an available service in the STAR+PLUS home and community … [Read more...]

TX Register Updates: Area Agencies on Aging

The following information was obtained from the September 20 issue of the Texas Register. Public Notices HHSC intends to submit an amendment to the Texas State Plan for Medical Assistance to adjust fees for the following existing services: Hearing and Audiometric Evaluations; Durable Medical Equipment, Prosthetics, Orthotics, and Supplies; Physicians and Other Practitioners; and Home Health Services. HHSC intends to submit to CMS a request to amend the THTQIP to expand STAR+PLUS to the … [Read more...]

ILs and PLs: Required Base Wage, CMS Survey

DADS released four information letters and two provider letters. NF: A review of the medical necessity determinations revealed errors. DADS identified the accuracy of assessment data drawn from the MDS assessment and clinical record as one reason for errors. (Letter) CMPAS: DADS informed these providers of rules on the required base wage. (Letter) CBA, PHC, CAS, FC, MDCP, and DAHS: DADS informed these providers of rules on the required base wage. (Revised Letter) Financial … [Read more...]