CHARTING BY EXCEPTION–THE FAST TRACK TO RUG ERRORS?

  Charting by exception is the single most problematic form of nursing charting. Charting by exception is a tool used for residents who require little to no nursing intervention or care.   This type of charting, if not done correctly, will leave the facility subject to allegations of RUG review errors.  Reviewers scrutinize nurse charting to [...]

RUG REVIEWS: HHSC-OIG reviewers are here – help!

  Nursing Homes will be facing a RUG Utilization review in the near future.  This review will cover the years from 2008 through 2010 for MDS 2.0 items. What it is and how it works          Surveyors select a group of residents from predetermined RUG categories.  We have all read how Medicare/Medicaid is going after [...]

TX Register Updates: Anesthesiologist Assistants

May 30, 2013 by  
Filed under Medicaid, Medicare

The following information was obtained from the May 24 issue of the Texas Register. Public Notice HHSC intends to submit an amendment to the Texas State Plan for Medical that would add Anesthesiologist Assistants to the fee schedules in the current state plan by adding fees for existing services. See the Texas Register for more [...]

TX Register Updates: Board of Nursing, PASRR Changes

The following information was obtained from the May 17 issue of the Texas Register. Public Notice The Texas Board of Nursing proposed to amend 22 TAC §§213.27, 213.28, 213.29, 213.30, and 213.33, concerning Practice and Procedure: Disciplinary Guidelines for Criminal Conduct (PDF) Proposed Rules HHSC proposed to amend §355.8401, Case Management Reimbursement Methodology, which would update [...]

TX Register Updates: UPL, Medical Board Changes

The following information was obtained from the May 3 issue of the Texas Register. Proposed Rules HHSC proposed to amend §355.105, General Reporting and Documentation Requirements, Methods, and Procedures, which would clarify limitations on reporting related-party compensation on Medicaid cost reports; incorporate changes to reflect person-first respectful language; and clarify the references in subsection (a). [...]

TX Register Updates: 5/15 Hearing, Administrative Penalties

The following information was obtained from the April 26 issue of the Texas Register. Public Hearing and Notice HHSC will hold a public hearing on proposed Medicaid payment rates for anesthesiologist assistants on Wednesday, May 15, 2013, at 1:30 p.m. in the HHSC Brown Heatly Building on 4900 North Lamar, Austin. HHSC intends to submit [...]

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)

Positive Behavior Management Workshops

April 8, 2013 by  
Filed under ICF-MRs, Medicaid, Medicare

–  Registration has opened for Positive Behavior Management Workshops. The first will be held in Abilene on July 8 & 9, 2013, and the second in Denton on August 1 & 2, 2013. See the news alert page for details, including contact information. –  You may download the corrected (4/5/13) “Change of Therapy (COT) Determination [...]

TX Register Updates: Fee Schedules and Rates

March 26, 2013 by  
Filed under Medicaid, Medicare, Physicans

The following information was obtained from the March 22 issue of the Texas Register. Public Notices HHSC intends to submit an amendment to the Texas State Plan for Medical Assistance to update the fee schedules in the current state plan by including fees for new services and modifying fees for existing services: Dental Services; Durable [...]

ILs/PLs: Dental Contractor, Asbestos Survey

DADS released two information and two provider letters: NF, Hospice, and ICF/IID: DADS informs providers that when billing for non-Medicare covered services, they’re not required to file a claim to determine the liability of a Medicare Supplemental Insurance policy. (Letter) CLASS, CMA DSA: DADS recently contracted with contract with the University of Texas Health Science [...]

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