DADS released two information letters and news alerts.
Medicaid Hospice Providers:
DADS clarified its Continuous Home Care (CHC) requirements at 40 TAC, Chapter 30 Medicaid Hospice Program, §30.54 Special Coverage Requirements and informed hospice providers of problems identified during annual CHC reviews that result in recoupment of CHC payments. An excerpt:
“Recoupment Process…Based on the review, a determination is made to…approve an extension of CHC beyond the five days; deny an extension but allow the first five days; or deny an extension and disapprove the first five days of CHC and recoup all monies paid beyond the routine home care amount.”
A case manager or service coordinator will send CDSAs Form 1584 (Consumer Participation Choice) as notice of referral. If the CDSA declines the referral, the CDSA must send the case manager or service coordinator written notification of referral decline using Form 2067, Case Information. Contact Elizabeth Jones at (512) 438-4855 or e-mail email@example.com with questions. (Letter)