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 [...]

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 [...]

New Cultural Change Initiative

DADS invites providers to register for the webinar, “The Bathing Experience: A DADS Culture Change Initiative,” scheduled for April 4, 2012, from 2-3 p.m. You may register at Go to Meeting. For more information, contact DADS at DADSCultureChange@dads.state.tx.us.

ILs/PL: LTC Claim Errors, Criminal History Checks

DADS released two information letters and one provider letter: AFC, ALF, CBA, CLASS, DAHS, HDM, Hospice, ICF/ID, NF, PACE, and other providers: Last year, LTC CMS processed over 15 million claims, which included 423,185 rejected claims and 456,967 denied claims. DADS provided guidelines to deal with the most common errors that delay LTC provider claim [...]

DADS News Alerts: MDS 3.0 Updates, DADS 1915(c) Training

–  A Medical Necessity and Level of Care Item by Item Guide is scheduled for release on April 1, 2012. This is the link (PDF) to the November 2011 Item by Item Guide: . Effective April 1, 2012 it will link to the April revision. –  An MDS 3.0 RAI Manual (v1.08) Errata document labeled “MDS 3.0 [...]

ILs: Revised MDS 3.0, Hospice Forms

DADS released four information letters: All contracted NFs: CMS revised the MDS 3.0 Assessments, effective April 1, 2012. Details and revisions to the RAI Manual may be found on this CMS webpage. (Letter) ADC, ADF, CAS, CLASS, DBMD, MDCP, PACE, and other providers: CMS has mandated an April 1 deadline for all transactions to be compliant [...]

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