A National Provider Identifier (NPI) is a 10-digit number used to identify providers under the 1996 Health Insurance Portability and Accountability Act (HIPAA). According to the Centers for Medicare and Medicaid Services, there are only 151 days left to comply with the NPI requirement. From the site: If you are a health care provider who bills for services, you probably need an NPI. If you bill Medicare for services, you definitely need an NPI! Getting an NPI is easy. Getting an NPI is … [Read more...] about National Provider Identifier
Pharmacists Face Reduced Medicaid Reimbursements
Pharmacists may see their Medicaid reimbursements reduced if a proposed new rule becomes a reality. The Kaiser Network reports (via the New York Times) that the Bush administration proposed a rule that would save the government $8.4 billion over the next five years. This would allow the government to offer drug discounts to beneficiaries similar to those offered in the private sector. The proposed rule would limit the federal government’s share of Medicaid costs, which would reduce … [Read more...] about Pharmacists Face Reduced Medicaid Reimbursements
Provider Letter: Medicaid Estate Recovery Program
In a provider letter to nursing facilities dated December 18, the Department of Aging and Disability Services (DADS) asked these facilities for help with providing personal representative information to the Medicaid Estate Recovery Program. Although some providers fill out the personal representative information request form, others do not. From the letter: The expectation is that once the Texas Integrated Eligibility Redesign System (TIERS), the new Medicaid database, is available … [Read more...] about Provider Letter: Medicaid Estate Recovery Program
Provider Letter: Payment Disallowed for Date of Death During a Medicare Co-insurance Stay
The Department of Health and Human Services has notified nursing facilities that in some cases, Medicaid is improperly billed and therefore pays for the date of death that occurs during a Medicare Part A skilled nursing facility stay in error. This determination was made after a review of the Texas Medicaid Long Term Care payments for individuals with Medicare and Medicaid coverage. In some cases, however, Medicaid does pay for date of death if the patient falls under a certain … [Read more...] about Provider Letter: Payment Disallowed for Date of Death During a Medicare Co-insurance Stay
Physicians Medicare Reimbursement Reduction Reversed
Physicians receiving Medicare reimbursements will get a reprieve. Before adjourning last week, Congress passed a bill that will reverse a 5.1 percent reduction in reimbursement. (Kaiser Network) Reimbursement rates will remain at their current levels, and physicians who report quality-of-care data will get a 1.5 percent increase. Back in September, one lawmaker, House Ways and Means Committee Chair Bill Thomas, offered to block the reduction if the American Medical Association (AMA) and other … [Read more...] about Physicians Medicare Reimbursement Reduction Reversed
Survey Says Most U.S. Residents Favor Government Price Negotiations
A survey conducted by the Kaiser Family Foundation showed that 85 percent of U.S. residents favor government price negotiations for Medicare prescription drugs. The federal government currently is prohibited from negotiating drug prices or establishing a list of preferred drugs. (Kaiser Network) According to the survey, 92 percent of Democrats, 85 percent of Independents and 74 percent of Republicans favor government negotiation of Medicare drug prices. If that’s the case, “party-line … [Read more...] about Survey Says Most U.S. Residents Favor Government Price Negotiations
Provider Letters: Alerts for NFs, ALs, and ICF-MR/RCs
For Nursing and Assisted Living Facilities, and Intermediate Care Facilities Serving Persons with Mental Retardation or a Related Condition The Texas Department for Aging and Disability Services (DADS) released a letter, dated November 24, alerting providers to guidelines for amelioration of administrative penalties. The letter explains what amelioration is (allowing "a facility, instead of paying fines for violations, to invest monies back into the facility"), legal authority, what DADS … [Read more...] about Provider Letters: Alerts for NFs, ALs, and ICF-MR/RCs
Provider Letter: Medicare Certification Alert for HCSSAs
In a provider letter dated December 1, the Texas Department of Aging and Disability Services (DADS) notified home health agencies seeking Medicare certification that DADS will no longer schedule initial Medicare certification surveys, per a directive by the Centers for Medicare and Medicaid Services. From the letter: Background Over the last five years, Texas has experienced unprecedented growth in the number of HHAs seeking certification. The five-state CMS Region 6 (Texas, New … [Read more...] about Provider Letter: Medicare Certification Alert for HCSSAs
Medicaid Report and Issue Brief
Last month, a federal advisory panel called the Medicaid Commission released a report with recommendations to prevent Medicaid from going bankrupt. Once again, it’s all about the baby boomers, and once again, Republicans and Democrats are split on the issue. (The Kaiser Network) The Bush administration wants to implement changes intended to save money in the long run, while the new Democratic Congress likely will resist the recommended changes. The report has not been posted … [Read more...] about Medicaid Report and Issue Brief
New Rules for Licensing Standards
The Texas Department of Health and Human Services Commission has adopted several amendments that will affect licensing standards for Home and Community Support Services Agencies, published September 8, 2006. The rule changes "set for the criteria" used for determining whether a conviction will bar a person from obtaining licensure or participating in agency management. The amendments and new section also adds definitions, corrects, errors, and eliminates certain offenses that currently bar … [Read more...] about New Rules for Licensing Standards