Earlier this week, the Centers for Medicare and Medicaid Services (CMS) proposed to change the way it pays Medicare reimbursements to hospitals. CMS seeks to encourage higher quality of care in hospitals by rewarding those that meet a certain threshold. To fund the "incentive payment pool," CMS will cut payments by a flat rate of 2 percent to 5 percent. The American Hospital Association (AHA) has responded to CMS’s proposal. Noting that the changes could create financial problems, AHA … [Read more...] about AHA Responds to CMS Proposal to Change Medicare Reimbursement System
Information Letter: NPI Contingency Period Ends March 1, 2008
In a three-page letter, the Department of Aging and Disability Services (DADS) informed Nursing Facilities, Community Services, ICF/MR, and Therapy Providers that the National Provider Identifier (NPI) contingency period ends on March 1, 2008. NPI will replace legacy provider identifiers. Providers’ claims can’t be paid if they are submitted without NPI data. For more information, download the letter here. … [Read more...] about Information Letter: NPI Contingency Period Ends March 1, 2008
CMS Set to Base Medicare Hospital Reimbursements on Quality of Care
Yesterday, the Centers for Medicare and Medicaid Services (CMS) proposed to change the way it pays Medicare reimbursements to hospitals. (Kaiser Network) CMS seeks to reduce payments by a flat rate (2 percent to 5 percent) to create an "incentive payment pool" for hospitals that meet quality of care thresholds. According to CQ HealthBeat, the plan would create a "Value-Based Purchasing Program." Under this program, a hospital's diagnosis-related group reimbursements would be based on quality … [Read more...] about CMS Set to Base Medicare Hospital Reimbursements on Quality of Care
Texas Register Updates: Board of Nursing License Renewal, Post-License Nursing Programs
The following information was obtained from the November 16 edition of the Texas Register: Proposed Rules The Texas Board of Nursing (BON) proposes to amend 22 TAC §§216.1 - 216.7, relating to Continuing Education, pursuant to Senate Bill 993 (SB 993), which deleted the portion of the Nursing Practice Act that required the Board to allow Type II CE. Currently, the BON has discretion to accept only Type I CE courses for license renewal. BON also proposes to amend Title 22, Texas … [Read more...] about Texas Register Updates: Board of Nursing License Renewal, Post-License Nursing Programs
Texas Register Updates: Changes in Reimbursement Methodology, Etc.
The following information was obtained from the November 9 edition of the Texas Register: Open Meeting The Texas Health and Human Services Commission (HHSC) will hold a public hearing on November 28, 2007, at 9:00 a.m. to receive public comment on the proposed rate for Support Consultation Services. The hearing will be held in the Lone Star Conference Room of the Health and Human Services Commission, Braker Center, Building H, located at 11209 Metric Blvd, Austin, Texas. See the relevant … [Read more...] about Texas Register Updates: Changes in Reimbursement Methodology, Etc.
Provider and Information Letters: CLASS Enrollment, IRoD Process
The Texas Department of Aging and Disability Services (DADS) informed Community Living Assistance and Support Services (CLASS), Case Management Agencies, and Direct Services Agencies that before CLASS enrollment can be finalized, an applicant’s enrollment in other community service programs, including Personal Care Services, must end. For more information, download the letter here. In a provider letter to Home and Community Support Services Agencies (HCSSA), DADS clarified the Informal … [Read more...] about Provider and Information Letters: CLASS Enrollment, IRoD Process
Provider Letters: Workload Prioritization of Initial Certification Surveys, OASIS-B1
The Texas Department of Aging and Disability Services (DADS) issued a provider letter to Nursing Facilities and Hospitals Seeking Medicare Certification for a Skilled Nursing Care Unit to inform them about new policy documents issued by the Centers for Medicare and Medicaid Services (CMS) regarding workload prioritization on initial certification surveys. Attached to the two-page letter is a two-page Q&A memo. Download the letter and attachment here for more information. CMS published … [Read more...] about Provider Letters: Workload Prioritization of Initial Certification Surveys, OASIS-B1
Information Letters: Payment System Downtime, CDS Training
The Texas Department of Aging and Disability Services (DADS) notified all Long Term Services and Supports Providers about tentative plans for late-January Health and Human Services Commission system changes that will affect all claim payments. Because of a system upgrade, claims will not be paid between January 24 and February 6, 2008. For more information, download the letter here. DADS notified Home and Community-based Services (HCS), Texas Home Living (TxHmL) Service Providers, and Mental … [Read more...] about Information Letters: Payment System Downtime, CDS Training
Medicare Part D Open Enrollment
Texas Register Updates: ICF/MR and Board of Nursing Proposed Rules
Proposed Rules The Texas Health and Human Services Commission (HHSC) has proposed to amend §§352.1 - 352.9, concerning the quality assurance fee for the Intermediate Care Facilities Mental Retardation (ICF/MR) program. The amendments would establish the quality assurance fee for facilities in the ICF/MR program. See the relevant section of the November 2 Texas Register for more information. The Texas Board of Nursing (BON) has proposed to repeal §217.13 (Peer Assistance Programs), … [Read more...] about Texas Register Updates: ICF/MR and Board of Nursing Proposed Rules
