In a March 29 letter to Primary Home Care and Day Activity and Health Services providers, the Texas Department of Aging and Disability Services (DADS) wanted to make sure these providers were aware that they can bill DADS for PHC or DAHS services provided to consumers in counties covered by the STAR+PLUS program in rare cases. Consumers living in STAR+PLUS program coverage areas began receiving services from a Health Maintenance Organization on March 1. For more information, including what … [Read more...] about Provider Letters: STAR+PLUS, Monthly Service Fees Updates, Etc.
Funds for Kidney Patients Under Medicare Part D
Medicare Part D recipients who are qualified kidney dialysis patients will have extra assistance getting bone disease Medicare Part D prescription drugs. (Medical News Today) The American Kidney Fund (AKF) may give eligible patients up to $2,000 a year in drug assistance funds. These grants will help cover “donut hole†costs for recipients caught in the coverage gap. AKF CEO LaVerne A. Burton said, “Because they take so many prescription medications, many dialysis patients have … [Read more...] about Funds for Kidney Patients Under Medicare Part D
Provider Letters: DAHS Billing Policy, ICM, Etc.
In a provider letter to Day Activity and Health Services (DAHS) Providers dated March 30, the Texas Department of Aging and Disability Services (DADS) offered a clarification of the DAHS billing policy. An excerpt: 40 Texas Administrative Code, §49.41(c)(1)(A) states that “a provider agency is entitled to payment if the services are authorized by DHS (DADS) in writing...†The consumer’s case manager determines the number of units of service the consumer is authorized to receive, with … [Read more...] about Provider Letters: DAHS Billing Policy, ICM, Etc.
Texas Register Updates: Repeals, Health Passports
On behalf of the Texas Department of Aging and Disability Services (DADS), the Texas Health and Human Services Commission (HHSC) proposes to delete an obsolete rule in the DADS rule base and to facilitate the consolidation of state standards for Intermediate Care Facilities for Persons with Mental Retardation or Related Conditions providers. For more information, including a section-by-section summary of the changes, see the relevant section of the March 30 Texas Register. In another … [Read more...] about Texas Register Updates: Repeals, Health Passports
DADS Updates: Amendments, Waivers, and Newsletter
On behalf of the Texas Depart of Aging and Disability Services (DADS), the Texas Health and Human Services Commission adopted amendments to the Adult Day Care and Day Activity and Health Services section of the code that allows updates to terminology and agency names and to correct rule cross references. For more information about the amendments, see the relevant section of the March 23 Texas Register. DADS has posted the Community Needs Waivers Requests on its web site. The form contains … [Read more...] about DADS Updates: Amendments, Waivers, and Newsletter
Last week, the New York Times ran an extremely troubling story about Long Term Care Insurance. Apparently, some Long Term Care Insurance companies are using bureacratic tactics to delay payment of claims until the insured dies, or is outright denying them. In depositions conducted on behalf of angry policyholders, Conseco employees described bureaucratic obstacles that prevented payment of claims. Those depositions were sealed in settlement agreements but were obtained by The … [Read more...] about
Texas Register Update: Legacy Agency References Updates
The Health and Human Services Commission (HHSC) adopted an amendment that would allow it to update legacy agency references and outdated citations related to legacy agencies rule references. According to the Texas Register, HHSC didn’t receive comments on the proposed rule during the comment period. For more information, see the relevant section of the March 23 Texas Register. … [Read more...] about Texas Register Update: Legacy Agency References Updates
CMS Webcast On Improving Nursing Home Quality and Payment
On Friday, March 23, 2007, the Centers for Medicare and Medicaid Services (CMS) broadcast a two-hour presentation on improving nursing home quality and payments via satellite and the Internet. The presentation was shown on the CMS digital network channel 712. Providers interested in seeing the presentation can watch it via webcast for up to 12 months at CMS's webcast page. For more information about topics discussed, download the memo here. … [Read more...] about CMS Webcast On Improving Nursing Home Quality and Payment
Provider Letters: Medicare Certification Surveys, Personal Needs Allowance, Etc.
The Texas Department of Aging and Disability Services (DADS) has released four new letters addressed to the following providers: Home Health Agencies (HHAs): DADS notified HHAs seeking Medicare certification that the Centers for Medicare and Medicaid Services has asked DADS to stop scheduling Medicare certification surveys of HHAs. For more information, download the seven-page letter here. Medicaid-certified HHAs: DADS reminded Medicaid-certified HHAs that effective May 23, 2007, they must … [Read more...] about Provider Letters: Medicare Certification Surveys, Personal Needs Allowance, Etc.
Lawmaker Proposes Changes to Asset Test for Medicare Part D
In an effort to extend federal subsidies for Medicare Part D to more low-income beneficiaries, Congressman Lloyd Doggett of Texas seeks to revise the asset test for receiving such subsidies. (Kaiser) Doggett introduced a measure that would extend subsidies to about 3.27 million people currently qualified for but who don’t receive subsidies. One way the bill would accomplish this goal is to exclude certain financial assistance from adult children of recipients as “income†when … [Read more...] about Lawmaker Proposes Changes to Asset Test for Medicare Part D