Effective October 1, 2015, the Texas Department of Aging and Disability Services (DADS) implemented new billing codes and payment rates for Medicaid Hospice (Service Group 8) / Physician Direct Care services (Service Code 30). Each procedure code for physician directed care services has two new billing codes and payment rates. The new billing codes and payment rates are age-specific, one set of billing codes for services to individuals less than 21 years old and another for individuals 21 … [Read more...] about New Billing Codes and Payment Rates for Hospice Physician Directed Care Claims
CALIFORNIA’S NEW PAS LAW EVOKES WIDESPREAD RESPONSE
California joined four other states that allow physician-assisted suicide after Governor Jerry Brown, D-CA, signed the End of Life Option Act into law. The measure allows physicians to prescribe lethal doses of drugs to terminally ill patients diagnosed with fewer than six months to live. Limitations apply, as described below. The bill will take effect 90 days after the California legislature ends it session on healthcare. Predictions are that this will happen between January and November 2016. … [Read more...] about CALIFORNIA’S NEW PAS LAW EVOKES WIDESPREAD RESPONSE
Hospice – Advance Directives
Advance DirectivesThe 84th Legislative Session passed HB 3074, relating to the provision of artificially administered nutrition and hydration and life-sustaining treatment. Chapter 97 Home and Community Support Services Agencies Licensure rules require hospice agencies have policies in compliance with the Texas Health and Safety Code Chapter §166 Advance Directives. DADS staff are working on updating the advance directive forms. DADS Regulatory will be notifying providers of the … [Read more...] about Hospice – Advance Directives
CMS Published New ICD-10 Blog
ICD-10 Ombudsman and ICD-10 Coordination Center Here to Support Your Transition NeedsIt’s important that you know help’s available if you have problems with ICD-10:The ICD-10 Ombudsman, Dr. Bill Rogers, can be your impartial advocate. Dr. Rogers, a practicing emergency room physician, is known to many of you already. Since 2002, he has been the Director of the Agency’s Physicians Regulatory Issues Team, assisting physicians, other practitioners, and medical societies in identifying and … [Read more...] about CMS Published New ICD-10 Blog
Day Activity and Health Services Eligibility Criteria and Eligibility Assessment Procedures
DAHS providers that have a DAHS contract with the Texas Department of Aging and Disability Services (DADS) are advised of revised eligibility criteria and assessment procedures.Pending completion of proposed rule amendments to Texas Administrative Code (TAC), Title 40 Part 1, Chapter 48, §48.2915, providers of DADS DAHS are notified effective October 15, 2015, the following eligibility criteria will apply:? DAHS services must be prescribed by a physician who has certified that the individual … [Read more...] about Day Activity and Health Services Eligibility Criteria and Eligibility Assessment Procedures
Transition Assistance Services, Pre-enrollment Minor Home Modifications and Pre-enrollment Minor Home Modifications Assessments in the Home and Community-based Services
Texas Department of Aging and Disability Services (DADS) rules amendments go into effect for HCS providers and LIDDAs that address the provision of transition assistance services (TAS), pre-enrollment minor home modifications, and preenrollment minor home modifications assessments and are set forth below. Also illustrated below are other operational requirements for service coordinators and program providers regarding TAS, pre-enrollment minor home modifications, and pre-enrollment minor home … [Read more...] about Transition Assistance Services, Pre-enrollment Minor Home Modifications and Pre-enrollment Minor Home Modifications Assessments in the Home and Community-based Services
Draft guidelines for prescribing opioids for chronic pain
The CDC is requesting comments from stakeholders regarding the new draft guidelines. Here are some opinions---The National Hospice & Palliative Care Organization has given its response, stating that it is “pleased that the guidelines exclude patients who are at the end of life, with language that states ‘outside end-of-life care.’”NHPCO stated several concerns it has with the draft guidelines, including the short timeline of the commenting period, an apparent lack of documentation behind the … [Read more...] about Draft guidelines for prescribing opioids for chronic pain
HHSC – Sunset and the Transition of the State Agencies under HHSC; Vision of HHS Transformation
Health and Human Services Commission (HHSC) Acting on direction from the Texas Legislature, the health and human services agencies have startedactivities that lay the groundwork for transformation of the health and human services system. Thefollowing information was taken from the HHSC Connection. Contrary to what some might believe, the 84th Texas Legislature did not approve beginning-to-endinstructions for how the health and human services agencies should reorganize. Yes, … [Read more...] about HHSC – Sunset and the Transition of the State Agencies under HHSC; Vision of HHS Transformation
ICD 10; what to do with difficult submissions
As you know, ICD 10 begins October 1, 2015. CMS MLN released information to providers on claimsubmission alternatives when you have difficulties submitting ICD-10 claims due to being unable tocomplete necessary systems changes or having issues with billing software, vendor(s), orclearinghouse(s). The article states that the following claims submission alternatives are available: Freebilling software, provider internet portals, direct data entry (DDE), and paper claims. Each … [Read more...] about ICD 10; what to do with difficult submissions
Medicaid Payment Rates
Medicaid Payment RatesAs you know, the CMS Medicaid hospice payment rates memo was released on September 1, 2015. Therequirements reflect the Medicare final rule which was published on August 6, 2015. The rule changesimplement several items:? Payment methodology for routine home care (RHC) – beginning January 1, 2016 the RHC rateswill be implemented; a higher base payment for the first 60 days of care and a reduced rate forthe days thereafter.? Service Intensity Add-on – this is payment for … [Read more...] about Medicaid Payment Rates
