DADS released three new information letters: Per diem payment rates NFs and hospice directors, effective September 1, 2010, can be found here. Per diem payment rates for ICFs/MR, effective September 1, 2010, can be found here. CLASS and DBMD providers: DADS informed these providers that effective September 1, 2010, it will not allow providers to be paid for more than 24 hours of service in a 24-hour day. Claims submitted for more than 24-hour units in a … [Read more...] about Information Letters: NFs, ICFs/MR, CLASS, and DBMD
Solo Primary Care Physicians
The Houston Chronicle reported that in the last two years, about 350 Texas doctors have dropped the Medicare program. In 2008, 62 percent of those doctors were primary care physicians. Something similar is happening with Medicaid, the government health insurance program for low-income individuals and families. In the age of lower reimbursement rates, specializing may be a more attractive option for medical students than going into primary care. Would a solo practice trend encourage more … [Read more...] about Solo Primary Care Physicians
Information Letter: For Nursing Facilities
Two updates for NFs: The definition of "licensed health professional" has been moved to 40 TAC §19.101(56), from 40 TAC §19.101(57); The DADS Paid Feeding Assistant Training curriculum is available on the Regulatory Services Credentialing web page at the following url: http://www.dads.state.tx.us/providers/NF/credentialing/NATCEP/feedingassistant.pdf (98-page PDF) … [Read more...] about Information Letter: For Nursing Facilities
Texas Register Updates: ICFs/MR and Nursing
The following information was obtained from the August 20 issue of the Texas Register: Public Notices HHSC proposes new Medicaid per diem reimbursement rates for the Truman W. Smith Children's Care Center ($219.69 ) and DADS-operated/state-operated ICFs/MR (small $603.64; large Medicaid-only: $537.41; large dual-eligible Medicaid/Medicare: $516.23). See the Texas Register for more information. HHSC intends to submit Transmittal Number 10-050, Amendment Number 943, to the Texas State … [Read more...] about Texas Register Updates: ICFs/MR and Nursing
Texas Register Updates: RFP, Nursing, Reimbursement Changes
The following information was obtained from the August 13 issue of the Texas Register: Public Notices HHSC intends to submit to CMS a waiver amendment for the State of Texas Access Reform Program, a Managed Care waiver program under the authority of §1915(b) of the Social Security Act. The amendment would add new benefits for the proposed substance use disorder treatment services, including those provided in residential settings. HHSC is anticipating expanding the STAR+PLUS 1915(b) and … [Read more...] about Texas Register Updates: RFP, Nursing, Reimbursement Changes
DADS Alerts: MDS Training Materials, LTSS, HSC
The Minimum Data Set 3.0 training materials is posted online here. HHSC and DADS will host LTSS provider meetings in the Dallas and Tarrant service areas, which will allow HHSC, DADS, and five selected STAR+PLUS health maintenance organizations to present information for successful implementation of the STAR+PLUS program expansion. See the alert page for dates and times. News alert for HCS providers: Concerns have been raised by stakeholders over issues surrounding IPCs in the CARE system … [Read more...] about DADS Alerts: MDS Training Materials, LTSS, HSC
Information Letters: Hospice and Nursing Facilities
DADS released three information letters: Hospice: Hospice providers are responsible for know the Medicare and Medicaid eligibility for a hospice client. An excerpt: The DADS rule for Medicaid Hospice Payments and Limitations at 40 TAC §30.60(h) states: (h) Third-party resources. Medicaid pays only after all third-party resources have been used. In accordance with 40 TAC §30.60(h), it is the responsibility of the hospice provider to be aware of a client’s eligibility for Medicare … [Read more...] about Information Letters: Hospice and Nursing Facilities
Texas Register Updates: Board of Nursing, ICF/MR, HSC
The following information was obtained from the August 6 issue of the Texas Register: Public Notices and Hearings The Board of Nursing offered the Guidelines for Physical and Psychological Evaluations, which inform licensees, applicants, petitioners, and the public about the boards requirements and procedures regarding physical and psychological evaluations under the Nursing Practice Act. An excerpt: Authority to Require and Request Evaluations The Board is authorized under the … [Read more...] about Texas Register Updates: Board of Nursing, ICF/MR, HSC
Information Letters: Claims Processing Cut-Offs, STAR+PLUS Expansion
DADS released five information letters: HCS and TxHmL waiver claims processing cutoff dates: FY 2008 Miscellaneous Claims at NOON Friday, August 6, 2010 FY 210 Claims Processing Cutoff: NOON Friday, August 20, 2010 ICF/MR Community/State (Service Group 5) providers claims processing cutoff dates: FY 2008 Miscellaneous Claims Cutoff: NOON Monday, August 9, 2010 FY 2010 FY10 Claims Processing Cutoff: NOON Monday, August 23, 2010 Community Services, NFs, and ICF/MR Service Group 6 … [Read more...] about Information Letters: Claims Processing Cut-Offs, STAR+PLUS Expansion
Texas Register Updates: Reimbursement Rate Hearings
DADS adopted new reimbursement rates for the following: Nursing Facility Payment Rates for State Veterans Homes Non-State Operated ICF/MR Nursing Facilities HHSC announced a contract award to the Public Consulting Group, total value $50,000 plus contingency fee. For more information, see the Texas Register. HHSC will hold a public hearing on August 17, 2010, at 1:30 p.m., to receive comment on proposed Medicaid payment rate for the following (all take place in Lone Star … [Read more...] about Texas Register Updates: Reimbursement Rate Hearings
