In April, the Centers for Medicare and Medicaid Services proposed a rule that would cut reimbursements for implanted cardiac devices by up to 30 percent in an effort to close loopholes used by specialty hospitals. (Kaiser Network) Since the proposed rule changes, several groups have come out publicly against it. A group called AdvaMed, which represents medical device makers, says the proposal should be delayed for one year so "interested parties" can review and assess the changes. Scott Ward … [Read more...] about Groups Oppose Changes to Medical Device Reimbursements
Provider Letter: Adoption of Chapter 30 Medicaid Hospice Rules
In a letter dated June 2, the Texas Department of Aging and Disability Services (DADS) alerts Medicaid hospice providers to changes to Medicaid hospice rules, effective June 1. Hospice providers will have to follow additional requirements in the Contracting for Community Care Services rules in Chapter 49. For example, hospices must have a contract with DADS before billing Medicaid services and a written contract with a nursing or immediate care facilities before payment is made, and … [Read more...] about Provider Letter: Adoption of Chapter 30 Medicaid Hospice Rules
Long Term Care Providers Join Coalition to Eliminate Co-Payments
A group of long term care providers is calling for the elimination of Medicare Part D co-payments for patients "in certain homes" who are eligible for both Medicare and Medicaid. The National Center For Assisted Living and the American Health Care Association, which represent long term care providers, believe that beneficiaries receiving care in certain assisted living facilities and group homes who can't afford co-payments are adversely affected. From the Senior Journal: Under Part D, … [Read more...] about Long Term Care Providers Join Coalition to Eliminate Co-Payments
Proof of Citizenship for Medicaid
In a move that is sure to cause controversy (although it shouldn't), President George Bush plans to implement new standards requiring Medicaid recipients to prove American citizenship in order to receive benefits. Although the Senate and House of Representatives are trying to reach a compromise on the immigration bill, Bush signed the Medicaid citizenship requirements into law back in February. The requirements will take effect on July 1, 2006. From the New York Times (free registration … [Read more...] about Proof of Citizenship for Medicaid
Complaints About Texas Medicaid & Healthcare Partnership
I am collecting complaints from providers about service problems with Texas Medicaid & Healthcare Partnership (TMHP). So far, I have heard complaints that TMHP does not return telephone calls and that processing Electronic Data Interchange Agreements has been unduly slow, causing unconscionable delays in Medicaid payment to contractors for services they have provided. I have heard, from more than one source, that the delays have been blamed by TMHP supervisors on the illness and absence of … [Read more...] about Complaints About Texas Medicaid & Healthcare Partnership
Provider Letter: LTC Online Portal
The Texas Department of Aging and Disability Services (DADS) advises Consolidated Waiver Program, Waiver, Home and Community Support Services, Community Based Alternative, Hospice, Nursing Facilities, and Program of All-Inclusive Care for the Elderly Providers that effective August 21, 2006, the DOS-based CARE Form System software is being upgraded to a web-based system. Download the letter here. With the more user-friendly system, providers will be able to submit forms and corrections, and … [Read more...] about Provider Letter: LTC Online Portal
Long Term Care Hospital Units?
Will long term care units in hospitals become a trend? Iowa is considering adding long term care wings to its hospitals that could bring in more federal funding. Such a plan is currently illegal, but the director of the Iowa Department of Inspection and Appeals said the agency will rewrite the rules to allow the units. The decision to pursue the project was apparently prompted by a different agency's rejection of a plan to build four long term care hospitals in the state. Do hospitals … [Read more...] about Long Term Care Hospital Units?
Provider Letter: Medicaid Hospice Contracts
In a letter to dated May 31, DADS notifies Medicaid Hospice providers that the Provider Services - Community Services Contracts unit will now be responsible for enrolling Medicaid Hospice providers and administering Hospice contracts, effective June 1. The Provider Services - Institutional Services Contracts unit previously handled such enrollments and administration. For details, download the letter here. … [Read more...] about Provider Letter: Medicaid Hospice Contracts
Provider Letters: Handling and Movement Practices, Minimum Data Set Assessments
In a letter dated May 22, the Texas Department of Aging and Disability Services (DADS) advises licensed nursing facilities of new rules on safe resident handling and movement practices, effective June 1. You may download the letter and three-page attachment here. In a separate letter dated May 31, DADS reminds nursing facilities that they must submit ongoing Minimum Data Set (MDS) assessments to a state database for private-pay residents whose information has not been entered into the Centers … [Read more...] about Provider Letters: Handling and Movement Practices, Minimum Data Set Assessments
Provider Letters: Patient Restraint and Seclusion
In a letter dated May 22, 2006, the Texas Department of Aging and Disability Services (DADS) advised nursing facilities about new rules in Title 40 of the Texas Administrative Code, effective June 1. The new rules relate to the definition of restraints, frequency of use, notification of restraint use and seclusion to patients' legal representatives, etc. You may download the letter and the 25-page attachment (relevant TAC) here. DADS issued a similar letter to intermediate care facilities … [Read more...] about Provider Letters: Patient Restraint and Seclusion