In a provider letter to Day Activity and Health Services (DAHS) Providers dated March 30, the Texas Department of Aging and Disability Services (DADS) offered a clarification of the DAHS billing policy. An excerpt:
40 Texas Administrative Code, §49.41(c)(1)(A) states that “a provider agency is entitled to payment if the services are authorized by DHS (DADS) in writing…†The consumer’s case manager determines the number of units of service the consumer is authorized to receive, with one unit equal to one-half day of service. Section 5130 of the DAHS Provider Manual states “the caseworker (case manager) cannot authorize more than 10 units of DAHS per weekâ€, or the equivalent of five days of service per week. These services are authorized on DADS Form 2101, Authorization for Community Care Services. DAHS providers may only bill for the amount of services authorized weekly, and in any case, may not bill for more than 10 units weekly.
For more information, download the letter here.
In an April 2 letter, DADS informed community services providers that the Integrated Care Management Program (ICM) was formed pursuant to a directive from the Texas legislature to the Texas Health and Human Services Commission (HHSC) to implement a “non-capitated, enhanced primary care case management model of Medicaid managed care for certain aged, blind, and disabled clients.†HHSC has contracted Evercare to assist in implementing ICM. You may download the letter here.
In a letter dated April 2, DADS reminded Community Living Assistance and Support Services, Case Management Agencies, and Deaf-Blind with Multiple Disabilities Program Providers about a new procedure designed to assist case managers with coordinating transition of service delivery. DADS states that notification by Regional and Local Services Interest List staff will not at this time indicate whether an applicant is presently enrolled in the Home and Community-based Services or Texas Home Living Program. You may download the letter here.
