DADS released one information and two provider letters.
CLASS CSA, CLASS, DSA, HCS, TxHmL, CDA, and Local Authorities:
DADS is expanding utilization management and review activities for its Medicaid community entitlement and waiver programs, effective January 1, 2012. (Letter)
ADC, ALF, HCSSA, ICF/ID, and NF:
Beginning March 1, 2012, if the name of an applicant or associated person is listed in a health and human services agency record of adverse licensing, DADS may deny the person’s application for a license or renewal. (Letter)
Hospice, ICF/ID, and NF:
DADS clarified how to apply CMS S&C Letter 11-30-NH in the context of DADS’ current incident reporting requirements. An excerpt:
Here are some points of guidance with regard to applying the provisions of S&C 11-30-NH in the context of DADS’ current incident reporting requirements:
• Section 1150B requires reporting of “any reasonable suspicion of a crime” to at least one local law enforcement agency of jurisdiction and to DADS. Reports to DADS (and the Department of Family and Protective Services, if appropriate) must also be made in accordance with current reporting guidelines as outlined in Provider Letter 06-12 and 40 TAC §97.249 (Hospice), Provider Letter 06-43 (NF), Provider Letter 09-02 (non-licensed ICF/ID) and Provider Letter 10-24 (licensed ICF/ID).
• Facilities, per page 3 of S&C 11-30, should coordinate with local law enforcement entities to determine what actions are considered crimes within their political jurisdiction. In the event more than one local law enforcement entity may have jurisdiction, such as a local police or sheriff’s department, DADS recommends facilities confirm which law enforcement entity should receive reports. DADS also recommends that owners, operators, employees, managers, agents or contractors of facilities and agencies review the Texas Penal Code, in particular the offenses in Chapters 22 (Assaultive Offenses), 31 (Theft) and 32 (Fraud). The Texas Penal Code is available on the Texas Legislature’s website at http://www.statutes.legis.state.tx.us/. Incidents of abuse, neglect and exploitation reported to law enforcement may result in a criminal investigation for one or more of the offenses in Chapters 22, 31 or 32.
