Adventist Health System has agreed to pay $118.7 million to settle a whistleblower lawsuit that alleges the Florida-based company paid kickbacks to doctors in exchange for referrals.The 2012 lawsuit alleges Adventist, which operates skilled nursing facilities, rehabilitation facilities, hospitals and other healthcare facilities in 10 states, gave physicians bonuses and increased salaries, and allowed them to overbill, in exchange for referring their patients to Adventist facilities. The suit was … [Read more...] about Adventist Health – To Pay $118MM
SNF aide, 77, pleads guilty to rape, faces $15 million fine if abuses again
A former employee of a Minneapolis nursing home pleaded guilty this week to chargesthat he raped a resident who suffered from dementia. He also agreed to an unusual settlement that would require him to pay $15 million to the victim's estate if he is convicted again.George Sumo Kpingbah, 77, was working as an aide at Walker Methodist Health Center when he was found abusing an 83-year-old resident by a nurse on her rounds in December 2014. A Department of Health investigation found the facility … [Read more...] about SNF aide, 77, pleads guilty to rape, faces $15 million fine if abuses again
HCS Dental Limit Increased to $2000/year 9/1 Documents You Need to Proceed
Information Letter No. 2015-51 - Service Limit Increase for Dental Treatment in the Home and Community-based Services ProgramAddressed to:Home and Community-Based Services (HCS) ProvidersLocal Intellectual and Developmental Disability AuthoritiesHome and Community-based Services (HCS) Program Billing Guidelines09/01/2015 05:30 AM CDT Dental Limit Increase Questions about Dental Requisition Fees?Check page 2 of "HCS Rates Effective September 1, 2015."Visit us at Garlo Ward, PC … [Read more...] about HCS Dental Limit Increased to $2000/year 9/1 Documents You Need to Proceed
Revised HCS, CLASS, DBMD, TxHmL Forms – Includes HCS Transportation, TAS, and Pre-Enrollment Minor Home Modifications
DADS has published the following revised forms related to transportation, transition assistance services (HCS only), and pre-enrollment minor home modifications (HCS only). Please begin using the current versions of these forms during the service planning process. As the agency continues to release new or revised forms, providers will be notified.Revised forms:Form 3595 - IPP Service ReviewForm 3598 - Individual Transportation PlanForm 3608 - Individual Plan of Care (IPC) - HCS/CFCForm … [Read more...] about Revised HCS, CLASS, DBMD, TxHmL Forms – Includes HCS Transportation, TAS, and Pre-Enrollment Minor Home Modifications
EVV Delay in Compliance Penalties
The Health and Human Services Commission (HHSC), Department of Aging and Disability Services (DADS), and Managed Care Organizations (MCOs) recognize the continued system challenges faced by providers in using the Electronic Visit Verification (EVV) system. While all required providers are expected to fully utilize EVV, the respective payors (HHSC, MCOs and DADS) have agreed to not impose penalties around compliance levels at this time. HHSC will issue detailed guidance on compliance for … [Read more...] about EVV Delay in Compliance Penalties
HHSC Seeks Input on Workgroups, Councils Structure
HHSC Seeks Input on Workgroups, Councils Structure The Texas Health and Human Services Commission (HHSC) is asking for comments on existing advisory committees. In response to approved Sunset legislation, HHSC conducted a comprehensive analysis of 132 existing advisory committees. This analysis, along with stakeholder input, will be used to determine the future advisory committee structure. Comments should be emailed to HHSAdvisoryCommittees@hhsc.state.tx.us by close of businessSept. 25.Some of … [Read more...] about HHSC Seeks Input on Workgroups, Councils Structure
Medicaid Re-enrollment Website Launched
All provider types must re-enroll by March 24, 2016DADS Medicaid providers that render services either through Medicaid managed care organizations or traditional fee-for-service Medicaid are required to revalidate their information every 3-5 years. In Texas, the deadline for the next re-enrollment is March 24, 2016.To help providers better understand this process, DADS has created a Texas Medicaid LTSS Provider Re-enrollment website at http://www.dads.state.tx.us/providers/mpre/. The site … [Read more...] about Medicaid Re-enrollment Website Launched
Medicaid Re-enrollment Website Launched
Medicaid Re-enrollment Website LaunchedAll provider types must re-enroll by March 24, 2016 DADS Medicaid providers that render services either through Medicaid managed care organizations or traditional fee-for-service Medicaid are required to revalidate their information every 3-5 years. In Texas, the deadline for the next re-enrollment is March 24, 2016.To help providers better understand this process, DADS has created a Texas Medicaid LTSS Provider Re-enrollment website at … [Read more...] about Medicaid Re-enrollment Website Launched
Internati onal Classification of Disease Transition, and Changes to the Department of Aging and Disability Services Form 8578 and Tra nsition Submission Instructions
DADS prepared a an information letter to provide information and guidance to Home andCommunity-based Services (HCS) and Texas Home Living (TxHmL) program providers and LocalIntellectual and Developmental Disability Authorities (LIDDAs) about the InternationalClassification of Disease (ICD) transition from Version 9 (ICD - 9) to Version 10 (ICD - 10) and associated changes for submitting diagnostic codes on Department of Aging and DisabilityServices (DADS) Form 8578, Intellectual … [Read more...] about Internati onal Classification of Disease Transition, and Changes to the Department of Aging and Disability Services Form 8578 and Tra nsition Submission Instructions
HHSC Seeks Input on Workgroups, Councils Structure
The Texas Health and Human Services Commission (HHSC) is asking for comments on existing advisory committees. In response to approved Sunset legislation, HHSC conducted a comprehensive analysis of 132 existing advisory committees. This analysis, along with stakeholder input, will be used to determine the future advisory committee structure. Comments should be emailed to HHSAdvisoryCommittees@hhsc.state.tx.us by close of business Sept. 25.Some of the committees related to DADS include:Aging … [Read more...] about HHSC Seeks Input on Workgroups, Councils Structure