DADS released two provider and three information letters.
Licensed Type C ALs:
DADS will conduct a two-year review of licensed Type C assisted living facilities that no longer serve adult foster care (AFC) clients, effective September 14, 2011, which replaces the assessment completed by the AFC contract specialist when the services were provided to those clients. Use Form 1123, Review of Assisted Living Facility Type C. (Letter)
HCSSAs:
Attached to this letter is a five-page document titled, “What to Expect during Your Agency’s Survey” (Replaces PLs 07-21, 05-47 and 05-28).
NFs:
DADS reminded NFs of the correct process for refunding Medicaid claims payments to DADS when a provider is paid by both private insurance and DADS for the same dates of service. An excerpt:
There are two valid methods for refunding DADS when providers are paid by both private insurance and by DADS for the same dates of service:
- Providers can send a check to DADS for the total amount due and should include the client name, Medicaid number, and dates of service on the check. Providers should also submit a copy of the client’s Explanation of Benefits. Checks are payable to Texas DADS and should be sent to Texas DADS Third Party Recovery (TPR) Unit (E-400), P. O. Box 149081, Austin, Texas 78714-9081.
- Providers can request DADS to process a deduction by contacting TPR at 512-438-2200, Option 4.
Community Services, Hospice, NF, and ICF/MR:
DADS is considering moving to all electronically-submitted Long Term Care (LTC) claims by early 2012, which will affect providers that use LTC Form 1290 to bill the TMHP for payment. See TexMedConnect for more information. (Letter)
ICF/MR with MR (excluding state-supported living centers):
DADS will conduct mortality reviews for deaths that occurred during Fiscal Year 2012 for decedents who lived in ICF/MR with MR at the time of their death; or died within 90 days of discharge. (Letter)
