Earlier this week, the U.S. House of Representatives approved a bill that would reauthorize and expand the State Children's Health Insurance Program (SCHIP). The Kaiser Network reports that the measure passed by a vote of 289 to 139. Children from families with incomes of up to three times the federal poverty level would qualify for SCHIP, a move that likely would cover three million more children. Under the bill, SCHIP would be extended for four-and-a-half years and cost $57.3 million, a … [Read more...] about Congress Reauthorizes and Expands SCHIP
California Supreme Court Bars Balance Billing
Emergency department doctors and hospitals in California can no longer directly bill insured patients for charges HMOs refuse to pay. Last week, the state's highest court barred balance billing and contended that ER doctors and HMOs must iron out their disagreements. The responsibility should not fall on patients. (Source) In a press release, Governor Arnold Schwarzenegger wrote: "This ruling will protect Californians who have done the right thing by obtaining insurance, but then later … [Read more...] about California Supreme Court Bars Balance Billing
Smaller Reimbursements for Home Health Agencies
According to the Kaiser Network, MedPAC has recommended reducing Medicare reimbursements to home health agencies by 5.5 percent from FY 2009 levels and increasing payments to long term care hospitals and dialysis centers. MedPAC, which advises Congress on Medicare issues, will send a report to the legislative body in March. The report will also contain a recommendation to change home health agency reimbursement rates in 2011 "to account for the average cost of care, develop studies to … [Read more...] about Smaller Reimbursements for Home Health Agencies
Information Letters: Special Purpose License Correction, Etc.
The Texas Department of Aging and Disability Services (DADS) issued two information letters and two memos from the Texas Health and Human Services Commission (HHSC): Change in the DAHS and CBA Provider Manuals Relating to Physicians with a Special Purpose License In a letter to Day Activity and Health Services (DAHS), Community Based Alternatives (CBA), and Integrated Care Management (ICM) Waiver Services providers, DADS notified them of a correction to the DAHS provider manual under … [Read more...] about Information Letters: Special Purpose License Correction, Etc.
Obama Seeks to Rein in “Entitlement” Medicaid
Texas Register Updates: Telemedicine Services Changes
The following information was obtained from the January 2 issue of the Texas Register: The Texas Health and Human Services Commission (HHSC) has proposed to repeal 1 TAC §354.1430, concerning Definitions; §354.1432, concerning Benefits and Limitations; and §354.1434, concerning Requirements for Telemedicine Providers, and to replace the repealed rules with proposed new 1 TAC §354.1430, concerning Definitions, and §354.1432, concerning Benefits and Limitations, under Chapter 354, … [Read more...] about Texas Register Updates: Telemedicine Services Changes
Information Letters: RUGs Questions, OCS through CDS Option
The Texas Department of Aging and Disability Services (DADS) released two information letters: RUGs Information Requiring Special Attention DADS issued an information letter to Nursing Facility providers to share questions that require special attention. DADS provided four questions and responses in a three-page letter. Example: Question 4: When calling PCS, what type of calls can be escalated to the supervisor? Response: A delay in the processing of the form which will cause … [Read more...] about Information Letters: RUGs Questions, OCS through CDS Option
Texas Register Updates: Board of Nursing Adopts Amendments
The following information was obtained from the December 26 issue of the Texas Register: Adopted Rules The Texas Board of Nursing (BON) adopted an amendment to 22 TAC §211.6, pertaining to Committees of the Board, which adds language to the rule reflecting the establishment of the Eligibility and Disciplinary Advisory Committee, which was known as the Eligibility and Disciplinary Committee Task Force. BON also adopted amendments to 22 TAC §217.16, relating to Minor Incidents, which … [Read more...] about Texas Register Updates: Board of Nursing Adopts Amendments
Nursing Facility Industry Experts Question Five Star Rating System
In the previous entry, I mentioned DADS's new Five Star Rating System for nursing homes. These facilities will be rated on health inspections, staffing, and quality. Kaiser Network is reporting than nursing facility industry experts say the new system is stricter in some states than others, which may result in better facilities in certain states. About 22 percent of almost 16,000 nursing facilities received the lowest rating, and 12 percent received the highest. National Citizen's Coalition … [Read more...] about Nursing Facility Industry Experts Question Five Star Rating System
DADS Alerts: CLASS Clarification, Etc.
The Texas Department and Aging and Disability Services (DADS) notified Community Living Assistance and Support Services (CLASS) providers that Form 8604, the Transition Assistance Services (TAS) Assessment and Authorization, has been replaced by Form 3621-A, CLASS Transition Assistance Services. See the TAS handbook for more information. DADS is offering new forms for programs like Deaf/Blind with Multiple Disabilities, Home and Community-based Services, and Intermediate Care Facilities for … [Read more...] about DADS Alerts: CLASS Clarification, Etc.
