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...]

News Alert/SNF News: 11/18 Webinar Rebroadcast

--  DADS will rebroadcast the quarterly webinar on HCS Quality Assurance Rule Revisions from September 9, 2013, on Monday, November 18, 2013, from 10:30-11:30 a.m. You may register and receive details about the webinar here. --  "More uniform reimbursements for skilled nursing facilities and inpatient rehabilitation facilities could be implemented soon, policy analysts recently told the Medicare Payment Advisory Commission." – McKnight's --  "More than 6,000 skilled nursing facilities … [Read more...]

TX Register Updates: 10/22 Hearing, BON Changes

The following information was obtained from the October 4 issue of the Texas Register. Public Hearing and Notices HHSC will hold a public hearing on Tuesday, October 22, 2013, at 9 a.m. to receive public comment on proposed rates for hospice routine home, continuous home, inpatient respite, and general inpatient care. The hearing will be held in the Public Hearing Room, Brown Heatly Building, located at 4900 North Lamar, Austin. HHSC intends to submit an amendment to the Texas State … [Read more...]

LTC News: ACA Discussion, Gov’t Shutdown

--  "Although CMS posted the new manual Tuesday, just one week before it goes into effect, the agency previously had issued guidance to long-term care providers on notable changes regarding therapy and nutritional status." - McKnight's --  "The Centers for Medicare & Medicaid Services has decided to ease guidelines concerning auditors' requests for additional documentation. CMS is giving providers a small break by saying auditors should accept additional documentation submissions in a … [Read more...]

TX Register Update: EHR Contract, Per Diem Rates

The following information was obtained from the September 6 issue of the Texas Register. Public Notices DADS published a notice of a limited waiver from requirements of Chapter 2254 and a consultant contract award. The University of Florida (P.O. Box 115500, Gainesville, Florida 32611) was selected as contractor to provide an assessment of the functionality of an electronic health record system that SSLCs currently use, and its potential for customization to meet DADS future needs. The … [Read more...]

TX Register Updates: 7/19 Hearing, Revised Hearing Notice

The following information was obtained from the July 5 issue of the Texas Register. Public Hearings and Notices HHSC will hold a hearing on Friday, July 19, 2013, at 1:30 p.m. to receive comment on proposed Medicaid payment rates for hospital outpatient imaging services, hospital outpatient reimbursement, and hospital inpatient reimbursement. The hearing will be held in the Public Hearing Room, Winters Building, located at 701 W. 51st Street, Austin. Revised Hearing Notice: [HHSC] is … [Read more...]

TX Register Updates: THTQIP, Hospital Waiver Payments

The following information was obtained from the June 7 issue of the Texas Register. Public Notice HHSC intends to submit to CMS a request to amend the Texas Healthcare Transformation Quality Improvement Program waiver program. An excerpt: Effective September 1, 2013, the expenditures for STAR+PLUS enrollees for elimination of the 30-day spell of illness limitation will no longer be authorized. Under this policy, after 30 days of inpatient care has been provided, additional inpatient care … [Read more...]

Enrolled House and Senate Bills

--  The following recently enrolled bills affect certain long term care providers: HB 33: Relating to alternative methods of dispute resolution in certain disputes between the Department of Aging and Disability Services and an assisted living facility licensed by the department. HB 908: Relating to the assessment of an elderly or disabled person's psychological status for purposes of an emergency order authorizing protective services. HB 1358: Relating to procedures for certain audits … [Read more...]

Medicaid Premiums and Disbursement

The Texas Tribune reports that state lawmakers gave HHSC approval to raise Medicaid premiums. An excerpt of an earlier story: To contain growing Medicaid costs, Texas expanded Medicaid managed care statewide in March. HHSC estimates the premium rate increases would reduce the cost savings achieved by managed care over the previous fee-for-service model from 13.2 percent to 9.7 percent. In response to the premium hike proposal, Dr. Michael Speer, president of the Texas Medical Association, … [Read more...]

LTC News: Convictions, Expansion, and Fraud

CMS recently released a report (PDF) on nursing homes, direct access employees, and criminal convictions. (McKnight's) Providers self-disclosing potential Medicare and Medicaid fraud. (McKnight's) Lawmaker proposes alternative to expanding Medicaid. (Texas Tribune) Hospitals and Medicaid expansion. (Pew) Providers push for whole-treatment payments. (USA Today) … [Read more...]