The Texas Health and Human Services Commission (HHSC) approved rate changes for the
Medicaid Hospice program based on information provided by the Centers for Medicare and
Medicaid Services (CMS). The new rates, which are retroactive to 10/01/2014, can be accessed
through the HHSC Rate Analysis website at the following address:
http://www.hhsc.state.tx.us/rad/long-term-svcs/hospice/index.shtml
For federal fiscal year 2015, CMS approved two payment rates following the quality reporting
requirements for CMS, established by Section 3004 of the Affordable Care Act. As of 4/1/2014
hospice providers who have met the quality reporting requirements will be reimbursed at the
higher rate while providers who are not in compliance with CMS quality reporting requirements
will receive the lower rate. The providers who did not meet the requirements have received a
letter from CMS and DADS letting them know that they will be receiving the lower rate effective
October 1, 2014.
Providers should continue to bill for provided services using the portal at http://TMHP.com.
Since the electronic payment system has been updated with the new rates, a retroactive
adjustment will occur allowing the new rate for claims for dates of service beginning
10/01/2014; therefore, no additional action is required by individual providers.
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