Texas Health and Human Services Commission (HHSC) has adopted new rules that affect various provisions of Chapter 358, Medicaid Eligibility. The following are new sections: (from the September 22 Texas Register): §358.431 Transfer of Assets §358.432, Home Equity Treatment §358.433, Treatment of Entrance Fees for Individuals Residing in Continuing Care Retirement Communities HHSC adopted the changes to incorporate mandatory provisions of the Social Security Act. In related … [Read more...] about Texas Register Updates: Transfer of Assets, Provider Payments
CMS Pressured to Delay Changes to Medical Equipment Medicare Coverage
Unless the Centers for Medicare and Medicaid Services (CMS) delays a policy change, schedule to take effect on October 1, certain Medicare beneficiaries will be forced to use medical equipment, such as scooters and wheelchairs, that doesn’t suit their particular needs, say lawmakers and stakeholders. From Medical News Today: Sen. Santorum noted that while the National Coverage Determination revamped the coverage criteria for mobility equipment more than a year ago, "since that time, others … [Read more...] about CMS Pressured to Delay Changes to Medical Equipment Medicare Coverage
Physicians Reject Offer To Block Reimbursement Rate Cuts
Last month I mentioned that the American Medical Association (AMA) and other doctors groups planned to lobby Congress during the August recess to block a scheduled reduction in Medicare reimbursement rates. In the ongoing saga, one lawmaker recently made an offer that was easy to refuse: send us quality-of-care reports, and we’ll block the reduction. (Kaiser Network) No thanks, said the AMA. Physicians are not only trying to block the cut; they’re seeking a 2 percent increase in … [Read more...] about Physicians Reject Offer To Block Reimbursement Rate Cuts
Provider Letter: Online Program Notifications
In a letter dated September 12, 2006, the Department of Aging and Disability Services informed providers that it will no longer send program notifications through the mail. Notifications will be posted online, effective October 1. Providers can access notifications in two ways: 1) By following this link and clicking on “Communications,†where you’ll find links to alerts, bulletins, and other providers letters; 2) By signing up to receive notifications through e-mail. On the home page … [Read more...] about Provider Letter: Online Program Notifications
Medicare Part D Windfall For Drug Companies…For Now
Some Democrats already believe Medicare Part D is a "Republican-engineered windfall†for pharmaceutical companies, but the good fortune may not last, say the experts. (Philadephia Inquirer) According to Verispan, a health information company, Medicare Part D accounted for as much as 13.6 percent (Bristol-Myers Squibb) of drugs sales from January to July. Medicare Part D prescription drugs accounted for 8.8 percent of Pfizer's retail sales, 10.9 percent of Merck's, and 9.5 percent of Eli … [Read more...] about Medicare Part D Windfall For Drug Companies…For Now
Bob Dole Hosts Weekly Medicare Podcast
Senator Bob Dole has gone high-tech. Every Monday, he hosts a podcast called Success: The Benefits of the New Medicare Drug Plan, with interviews from Medicare beneficiaries signed up for the new prescription drug program. (Medical News Today) According to the site, there are 70+ days remaining until the enrollment period starts for Medicare Part D. Dole’s podcast is apparently designed to encourage beneficiaries to enroll. He said, “Now is the time for seniors to learn about their … [Read more...] about Bob Dole Hosts Weekly Medicare Podcast
Texas Register Updates: Medicaid Payment Limits; Patients Rights
The Texas Health and Human Services Commission (HHSC) will submit Amendment Number 747 to the Texas State Plan for Medical Assistance. From the September 8 Texas Register: Amendment 747 revises the methodology used by the State to estimate the Medicaid Upper Payment Limit (UPL) for hospital inpatient services. The UPL is the federal limit on Medicaid payments to a group of hospitals and is determined under Federal regulations as a reasonable estimate of the amount that would be paid for the … [Read more...] about Texas Register Updates: Medicaid Payment Limits; Patients Rights
CMS Chief to Resign
Mark McClellan, Administrator of the Centers for Medicare and Medicaid Services (CMS), is resigning. McClellen had been CMS chief since March 2004. According to Medical News Today, McClellan is headed to the conservative think tank, American Enterprise Institute. McClellan, born right here in Austin, Texas, oversaw the launch of Medicare's new prescription drug program, Medicare Part D. He is a medical doctor who's served in the federal government since the late 1990s. He is the brother … [Read more...] about CMS Chief to Resign
Pharmaceutical Association Accused of Medicare Conflict of Interest
The Pharmaceutical Research and Manufacturers of America (PhRMA) has been accused of unethical behavior by "political officials." (Medical News Today) PhRMA is alleged to have given money to the U.S. Chamber of Commerce for an advertising campaign praising politicians who voted for Medicare Part D, the new prescription drug program. Quoting the AP, Medical News Today reports that Eric Wohlschlegel, spokesman for the Chamber of Commerce, said his agency paid for the ads but didn't say whether … [Read more...] about Pharmaceutical Association Accused of Medicare Conflict of Interest
Provider Medicare Payments To Be Withheld
In order to move $5.2 billion from the closing fiscal year to the new one, beginning October 1, the federal government will not send providers Medicare reimbursements until after that date. Providers will be paid in full but won't receive interest on the delayed payments. According to Herb Kuhn, director of the Center for Medicare Management at the Centers for Medicare and Medicaid Services (CMS), providers have not complained to his agency about the so-called Medicare holiday. Providers may … [Read more...] about Provider Medicare Payments To Be Withheld