DADS released three information letters:
HCS, TxHmL, and ICF/MR providers:
DADS reminded these providers that they’re required to submit financial and statistical information through a 2010 Cost Report for each contract held DADS. HCS and TxHmL services are required to submit a single cost report per component code for the two programs combined; and ICF/MR services are required to submit a single cost report per component code for all facility classes combined. (Letter)
DAHS providers:
Through an audit, DADS learned that duplicate payments were found for the same dates when DAHS claims were matched against hospital claims. An excerpt:
These were not one-day overlaps with begin/end dates on the same day, but dates entirely contained within the hospital stay.
Additionally, some providers billed for the total number of units authorized in their Medicaid Eligibility Service Authorization Verification (MESAV) instead of billing as required only for actual services provided. Providers should be aware that billing for services that have not been provided constitutes fraud, as supported by the rules cited at the end of this letter.
NFs:
DADS reminded NFs of the necessity to notify HHSC of any change in a Medicaid resident’s monthly income or resources within 10 calendar days, effective December 1, 2009. (Letter)
Providers may refer to Chapter H of the HHSC Medicaid Eligibility for the Elderly and People with Disabilities Handbook for more information.
