According to the code, the examining physician determines the severity of injuries in ICF/MR facilities. In a provider letter, DADS informed ICFs/MR that an examining PA and APN may also determine severity of injuries if delegated by an examining physician. Download the letter here. DADS is removing the cost limitation for Augmentative Communication Devices (ACDs) for residents in the DADS ICF/MR program. These providers may request an ACD for a Medicaid-eligible resident in the ICF/MR … [Read more...] about Provider and Information Letters: ICFs/MR, HSC, TxHml
Texas Register Updates: Contract Award, Reimbursement Rate Changes
The following information was obtained from the August 21 issue of Texas Register: Public Notices and Hearings DADS awarded a contract (total value $227,599) to Bailit Health Purchasing, Inc., to provide the procurement, implementation, and evaluation of the health home pilot project for children on Medicaid. For a list of per diem reimbursement rates DADS proposed for non-state ICF/MR providers, see this chart. HHSC will hold a public hearing on September 1, 2009, at 1:30 p.m., … [Read more...] about Texas Register Updates: Contract Award, Reimbursement Rate Changes
Provider and Information Letters: NFs, ICF/MRs, Assisted Living, and Others
DADS sent a 12-page letter with recommendations for infection control and prevention in long term care facilities to nursing and assisted living facilities and ICF/MRs. Among the recommendations are (Letter): An active, effective, facility-wide infection control program should be established. The purpose of the program is to help prevent the development and spread of infectious diseases (Category IC). … Oversight of the infection control program should be defined and should include … [Read more...] about Provider and Information Letters: NFs, ICF/MRs, Assisted Living, and Others
News from CMS
>> CMS recently announced that a 60-day supplier bidding period for the Round One Rebid of the Medicare Competitive Bidding Program for durable medical equipment, prosthetics, orthotics, and supplies will begin at the end of October. (Source) CMS's Jonathan Blum said, "Competitive bidding is an essential tool to help Medicare pay appropriately for health care—important not only to maintain Medicare beneficiaries' access to high quality medical items and services, but also to lower the cost … [Read more...] about News from CMS
Texas Register Updates: HSC, TxHmL, CWP, Nursing
The Texas Register's web pages are down as of this posting. You may download the following information, obtained from the August 14 issue of the Texas Register, in the PDF files linked in the post: Public Hearing HHSC will hold a public hearing on September 1, 2009, at 9 a.m. to receive public comment on proposed rates for HCS, TxHmL, and CWP waiver programs, in the Lone Star Conference room. This information is found beginning on page 8 of this file. Proposed Rules HHSC proposes to … [Read more...] about Texas Register Updates: HSC, TxHmL, CWP, Nursing
Long Term Care Providers and Health Care Form
How will President Barack Obama's massive health care reform proposal affect long term care providers? With a bill of over 1,000 pages and a budget in the trillions, the shift is bound to have a big impact. According to a story in Kaiser Health News, despite worries to the contrary, providers would benefit over the long term under the proposed plan. Nancy Chockley, president of the National Institute for Health Care Management, said, "Everyone has been nicked a little bit, but they are all … [Read more...] about Long Term Care Providers and Health Care Form
Provider and Information Letters: HCS, ICF/MR, TxHml, Etc.
DADS reminded providers about FY 2009 cut-off dates for miscellaneous claims and year-end close-out processing. You may download letters for the following providers: ICF/MR Group 5 ICF/MR Group 6 HCS and TxHml Community Services, Nursing Facility, and Therapy Providers DADS informed community-based ICF/MR providers of the initiation of adverse actions that may be taken by DADS against providers that don't comply with the Review of Living Options process, including requirements for … [Read more...] about Provider and Information Letters: HCS, ICF/MR, TxHml, Etc.
Texas Register Updates: ICF/MRs and Nursing Facilities
The following information was obtained from the August 7 issue of the Texas Register: Public Hearings and Notices The Texas Health and Human Services Commission (HHSC) will hold a public hearing on August 27, 2009, at 1 p.m. to receive public comment on the proposed interim per diem Medicaid reimbursement rates for small and large state-operated ICF/MRs. The hearing will be held in the Lone Star Conference Room of the Health and Human Services Commission, Braker Center, Building H, … [Read more...] about Texas Register Updates: ICF/MRs and Nursing Facilities
Documents from HCS & TxHmL External Stakeholder Meeting
On July 23, DADS hosted an HCS and TxHmL External Stakeholder quarterly meeting. Related documents are online and available for downloading, including the Waiver Survey and Certification Meeting Agenda and Waiver Survey and Certification Updates (both in PDF). See the news alert for the entire list. Addendum: DADS will hold an Adult Day Care stakeholder meeting on August 19. DADS has posted the agenda. Download the related Proposed changes to DAHS Rules/Provider Manual and meeting … [Read more...] about Documents from HCS & TxHmL External Stakeholder Meeting
2010 Payment Rate Changes
CMS announced that acute care hospitals will see a 2.1 percent payment rate increase as part of an inflation update. Skilled nursing facilities face a Medicare payment reduction of $360 million as part of a $1.050-billion case-mix adjustment decrease and a $690 million market-basket increase. Alan Rosenbloom of the Alliance for Quality Nursing Home Care said, "The nursing home community rightly fears the $12-$16 billion in cuts are just the tip of the iceberg. As Congress continues to … [Read more...] about 2010 Payment Rate Changes
