There were several new provider letters issued last week for Intermediate Care Facilities for Persons with Mental Retardation or a Related Condition (ICF-MR/RC).
In an August 3 provider letter, the Texas Department of Aging and Disability Services (DADS) described providers’ options when an ICF-MR/RC survey team determines that a person living in one of these facilities no longer needs “active treatment services” (standard W 198). To read about these options, download the letter here.
In a letter dated August 7, DADS alerted ICFs to changes in the timing of the annual recertification survey for some facilities with a capacity of 17 or more people. Read about these and other changes in the letter.
In the most recent letter, dated August 11, DADS reminded ICF facilities of their roles and responsibilities when choosing to contract for hospice services. The six-page letter includes a helpful question and answer section. An excerpt:
Can a Medicaid recipient elect hospice care if they are residing in an ICF-MR/RC?
Yes, a Medicaid recipient living in an ICF-MR/RC may elect to receive hospice care in an ICF-MR/RC that has a contract with a Medicaid hospice provider.Are ICF-MR/RC and hospice providers required to enter into contracts with each other?
Yes, an ICF-MR/RC and a hospice provider must enter into a contract with each other for the hospice provider to provide Medicaid hospice services to residents of the ICF-MR/RC. However, the decision to enter into any particular contract is made by the parties to the contract, i.e., by the ICF-MR/RC and the hospice provider.What should an ICF-MR/RC do if it does not contract for any hospice services or with a specific hospice provider requested by a resident?
The ICF-MR/RC must assist the resident in locating an ICF-MR/RC that contracts for hospice services.
You may download the letter here.
Updated (8/16): In two letters recently posted, DADS informed ICF/MR Service Group 5 and Service Group 6 providers that FY 04 claims – from September 1, 2003 through August 31, 2004 – received after August 15 are processed as “Miscellaneous” and will not be paid through the standard payment process. The letters also contain information about DADS and State Comptroller cut-off dates.
