TX Register Updates: Dual Eligibles, TANF, and SNAP

The following information was obtained from the April 20 issue of the Texas Register. Proposed Rules HHSC proposes to amend §354.1143, Coordination of Medicaid with Medicare Parts A, B, and C, which would authorize HHSC to make higher cost-sharing payments for dual eligibles for certain services if HHSC determines it’s necessary to ensure adequate access [...]

DADS News Alerts: Upcoming Meetings/Webinar

DADS has issued several alerts since April 10. An excerpt: –  A CLASS Stakeholder Quarterly Webinar is scheduled for April 24, 2012, from 1-2:30 p.m. Register here. – STAR program training in Wichita Falls has been rescheduled for April 25 for 1915 (c) Waiver Program providers. Please see the March 16 bulletin titled, “Training Schedule [...]

ILs/PLs: LTC Payment, DFPS Investigations

DADS released three information and two provider letters: CBA and HCSSA (revised letter): DADS case managers will add a dental buffer up to a maximum of $400 to each CBA initial ISP and annual reassessment, unless the amount of the buffer will cause the ISP to exceed the cost limit, effective April 19. (Letter) AFC, [...]

TX Register Updates: Contract Awards, Medicare Billing Prohibition

The following information was obtained from the April 13 Texas Register: Public Notices HHSC announced several contract awards. See the Texas Register for a listing of the companies. HHSC intends to submit transmittal number 12-010, which would convert the reimbursement methodology for non-emergency medical transportation services from fee-for-service to full risk capitation in the following [...]

OIG Launches Compliance 101 Website

On March 5, 2005, the Office of the Inspector General (“OIG”) launched its Compliance 101 website. The  website contains links to guidance and educational training materials for health care providers, practitioners and suppliers. The site contains segment-specific compliance guidance for nursing facilities, ambulance suppliers, physician practices, etc. Although the materials are from 1998-2008, the compliance program guidance [...]

Provider News Around the Web

Kaiser Health News reports on an study with expected findings: when times are hard, hospitals expand into affluent areas. In other words, hospitals seek more private-injured individuals. They also buy private practices in those areas and build more emergency services. The Texas Tribune reports that lawmakers will include drug reimbursements in the expanding Medicaid managed [...]

DADS News Alerts: MDS, Provider Meetings

DADS has issued about over a dozen news alerts since March 28. An excerpt beginning on the second page: –  DADS reminded providers that when a nursing home or swing bed facility completes an MDS 3.0 “discharge assessment-return anticipated”, and the resident does not return to the facility within 30 days, no further action is [...]

TX Register Updates: Employee Vaccines, SSLC Staff Training

The following information was obtained from the April 6 issue of the Texas Register: Public Notices HHSC intends to submit to CMS a request for MDCP and CBA waiver program renewals. HHSC also intends to submit transmittal number 12-007, which would add tobacco cessation counseling services for pregnant women, and transmittal number 12-001, which would [...]

Primary Care, Medicaid News

The shortage of primary care physicians and primary care in general has been widely reported. According to the Texas Tribune, for example, the federal government has declared Harris County a primary care physician shortage zone. The health care reform law will result in millions more Texans on the Medicaid rolls. Who will treat them? CMS [...]

ILs/PL: Rule Reminders for HCS and TxHmL

DADS released three information letters and one provider letter: NFs: DADS notified NFs that the compliance date for the Automated External Defibrillator Requirement has been extended to September 1, 2014. (Letter) HCS and TxHmL: DADS rules require these providers to include in an individual’s implementation plan a list outcomes and to document the progress or lack [...]

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