Proposed Rule The Texas Health and Human Services Commission (HHSC) has proposed an amendment that will clarify that HHSC is responsible for setting the personal needs allowance for Medicaid recipients who live in long-term care facilities. For more information, see the relevant section of the September 14 Texas Register. Correction, Open Meeting, and Pre-Application Orientation Correction from HHSC: "Due to a Texas Register mistake, a typographical error appears in the first line of … [Read more...] about Texas Register Updates: Proposed Rule and Open Meeting
Provider and Information Letters: New Payment Rates, Life Safety Code
The Texas Department of Aging and Disability Services (DADS) issued a letter to Community Based Alternatives and Assisted Living/Residential Care Providers to inform them about Personal Care 3 Reimbursement Rates. These rates became effective on September 1, 2007. For more details, download the letter here. DADS informed the Medically Dependent Children Program and Home and Community Support Service Agencies about increases in provider rates. New rates and billing codes can be accessed here … [Read more...] about Provider and Information Letters: New Payment Rates, Life Safety Code
Provider and Information Letters: CHOW Requirements and New Convictions Barring Employment
In a letter to Nursing Facilities, the Texas Department of Aging and Disability Services (DADS) alerted these providers to changes in the code required by Senate Bill 344, passed by the 80th Legislature, Regular Session, 2007. Changes to Section 242.0336, Temporary Change of Ownership (CHOW) License, include: The Department of Aging and Disability Services (DADS) may not issue a temporary NF CHOW license prior to the 31st day after receiving (1) the application from the CHOW license … [Read more...] about Provider and Information Letters: CHOW Requirements and New Convictions Barring Employment
Provider and Information Letters: Minimum Wage, Medicaid Reimbursement Rate Increases, Etc.
The Texas Department of Aging and Disability Services (DADS) notified Community Based Alternatives (CBA), Home and Community Support Services Agencies, CBA Assisted Living/Residential Care Providers, Consolidated Waiver Program Providers, Deaf-Blind with Multiple Disabilities Waiver Providers, Medically Dependent Children’s Program Providers, Primary Home Care Providers, and Day Activity and Health Services Providers that the Texas Health and Human Services Commission has raised the minimum … [Read more...] about Provider and Information Letters: Minimum Wage, Medicaid Reimbursement Rate Increases, Etc.
Texas Register Updates: Payment Rates Adoption and Notices
The Texas Department of Health and Human Services (HHSC) has notified providers about new per diem payment rates for the nursing facilities program operated by the Texas Department of Aging and Disability Services. The new payment rates were effective on September 1, 2007. For more information, see the relevant section of the August 31 Texas Register. HHSC issued several public notices of its intent to submit amendments to the Texas State Plan for Medical Assistance, under Title XIX of the … [Read more...] about Texas Register Updates: Payment Rates Adoption and Notices
Update On Texas Medical Board Decision
I wrote here about a decision by the Texas Medical Board to reject an ALJ's proposal-for-decision.The case involves the Board's rejection of the ALJ's Proposal that the case against the physician be dismissed. The physician had committed a one time error by responding to a patient's request for medical records with a bill based on the amount that hospitals are allowed to charge, rather than in accordance with the Board rule laying out what physicians are allowed to charge. All of the parties … [Read more...] about Update On Texas Medical Board Decision
GAO Says CMS Failed to Properly Audit Private Insurance Companies
According to a new Government Accountability Office (GAO) report, the Centers for Medicare and Medicaid Services (CMS) failed to properly audit private insurance companies for overpayments or to recover the excess payments. (Kaiser Network) Medicare-participating private insurers kept "tens of millions of dollars" that could have been passed on to beneficiaries or returned to the government. Federal law requires CMS to audit financial records of at least one-third of such companies every … [Read more...] about GAO Says CMS Failed to Properly Audit Private Insurance Companies
A Troubling Texas Medical Board Decision–Just My Opinion
See my Update for the Board's side of the story. Administrative Law Judge, Wendy Harvel, of the Texas State Office of Administrative Hearings, personally presented her recommendation that a complaint against Texas Ob/gyn licensee Chris Kuhne MD be dismissed. The meeting was held on August 23 and 24th,2007, A complaint had been filed against Dr. Kuhne because he inadvertently overcharged a patient for medical records. He charged $81 rather than $39 by mistakenly using the guidelines for … [Read more...] about A Troubling Texas Medical Board Decision–Just My Opinion
DADS Letters – August 28-September 1
Last week, the Texas Department of Aging and Disability Services (DADS) issued a series of provider and information letters: Multiple Providers Reimbursement Rates Effective September 1, 2007 Nursing Facilities Amendments to Health and Safety Code (HSC) Chapter 242 Notification of Adverse Change in Financial Condition … [Read more...] about DADS Letters – August 28-September 1
Number of Beneficiaries Caught in Coverage Gap Reduced, Study Says
According to a new study published in the Health Affairs journal, Medicare Part D has "dramatically reduced" the number of beneficiaries caught in the coverage donut hole. The donut hole, also known as the coverage gap, is the period of time during the year when a beneficiary is not covered and is responsible for paying drug costs out-of-pocket. Over 16,000 seniors were surveyed last fall, and a quarter of respondents said they spent $100 or more out-of-pocket on Part D drugs per month, and 8 … [Read more...] about Number of Beneficiaries Caught in Coverage Gap Reduced, Study Says
