-- December 2012 issue of The MDS Mentor -- On DADS' behalf, HHSC proposed new §98.105, Administrative Penalties, in Chapter 98, Adult Day Care and Day Activity and Health Services Requirements, which allows DADS to assess an administrative penalty against an adult day care facility that violates licensing requirements. See the Texas Register for details. -- CMS will host a National Provider Call on the "CMS National Partnership to Improve Dementia Care in Nursing Homes" on Thursday, … [Read more...] about DADS News Alerts: 1/31 Dementia Care Call, MDS Mentor
TX Register Updates: Types of Hearings, Rural Health
The following information was obtained from the January 18 issue of the Texas Register. Adopted Rules HHSC adopted an amendment to §357.17, Types of Hearings, which states that a client receiving Medicaid services through an MCO must exhaust the MCO's expedited appeals process before requesting an expedited fair hearing from HHSC unless the MCO has not sent a timely response to the request or the MCO has denied the request. HHSC adopted new §390.1, Definitions, and §390.2, Standards … [Read more...] about TX Register Updates: Types of Hearings, Rural Health
House and Senate Bills: Health Care Reform, Identification
The following long term care-related bills were recently introduced in the 83rd Legislative Session: HB 486: Relating to outsourcing a service performed by a health and human services agency to a private commercial contractor HB 459: Relating to the creation of a navigator program as described by the Patient Protection and Affordable Care Act. HB 395: Relating to the use by certain health care providers of electronically readable information from a driver's license or personal … [Read more...] about House and Senate Bills: Health Care Reform, Identification
IL/News Alerts: Cost Avoidance Project, New MOA
NF, Hospice, ICF/IID: DADS provided a status of the implementation of the Cost Avoidance Project. An excerpt: Release 1: Implemented August 2012 This release implemented new operations processes for validating insurance information on file for Long Term Care (LTC) individuals at Texas Medicaid & Healthcare Partnership (TMHP). This release provides phone support to providers requiring assistance with Other Insurance (OI) information on file for individuals in their facilities. Release … [Read more...] about IL/News Alerts: Cost Avoidance Project, New MOA
TX Register Updates: Notice Correction, Medical Board Changes
The following information appeared in the January 11 issue of the Texas Register. Public Notice Correction HHSC published a correction to an intent to submit an amendment to the Texas State Plan for Medical Assistance. An excerpt: The announcement incorrectly described the fiscal impact of the proposed state plan amendment. The correct fiscal impact is as follows: The proposed amendment is estimated to result in an additional annual aggregate expenditure of $21,300,000 for the … [Read more...] about TX Register Updates: Notice Correction, Medical Board Changes
State Insurance Exchanges Approved
CMS reports that the U.S. Department of Health and Human Services (HHS) has conditionally approved health insurances exchanges in California, Hawaii, Idaho, Nevada, New Mexico, Vermont, and Utah. "States across the country are working to implement the health care law and build a marketplace that works for their residents,” Secretary Kathleen Sebelius said. "In ten months, consumers in all fifty states will have access to a new marketplace where they will be able to easily purchase affordable, … [Read more...] about State Insurance Exchanges Approved
NURSING FACILITY COMPLIANCE PROGRAM: AUDITING OR THE ART OF FINDING OUT IF YOUR POLICIES WORK
The deadline for having your compliance plan in place is rapidly approaching on March 13, 2013. Having a compliance plan in place will be of no real benefit if you are not focusing on effectiveness. As part of the compliance program enforcement under the Affordable Care Act (ACA) starting in March of 2013, the Office of the Inspector General (OIG) and The Center for Medicare Services (CMS) state that a reliable audit and monitoring system are key elements to a effective compliance program. … [Read more...] about NURSING FACILITY COMPLIANCE PROGRAM: AUDITING OR THE ART OF FINDING OUT IF YOUR POLICIES WORK
TX Register Updates: NPI Changes
The following information was obtained from the January 4 issue of the Texas Register. HHSC adopted amendments to §354.1001, Claim Information Requirements, and §354.1121, Definitions. The changes require, among other things, the claim for services or supplies to include the name and associated NPI of the performing provider, the referring or ordering provider, and the supervising provider, if the referring or ordering provider is acting under the direction or supervision of another provider … [Read more...] about TX Register Updates: NPI Changes
News Alerts: 1/7/13 Stakeholders’ Meetings
DADS posted the following late-notice (January 4) stakeholders' meetings: CLASS Stakeholder Meeting Winters Building - 701 W. 51st Street Austin, TX 78751 Public Hearing Room January, 7, 2013 9:30 a.m. to 12:30 p.m. Home and Community Support Services Agencies Quarterly Stakeholder Meeting Winters Building - 701 W. 51st Street Austin, TX 78751 Public Hearing Room January, 7, 2013 1:00 p.m. to 5:00 p.m. See the news page for more information about these and other alerts. … [Read more...] about News Alerts: 1/7/13 Stakeholders’ Meetings
ILs/News Alert: Cost Reports, MDS Data
2012 Cost Report and Cost Report Training Requirements for (in PDF): CBA HCSSA, CLASS CMA and DSA, and PHC HCS, TxHmL, and ICF/IID CBA AL, DAHS, DBMD, NF, and RC MDS 3.0 update Everyone with a Quality Improvement Evaluation System (QIES) account to submit MDS data and view CASPER reports should now update their account. Be sure all MDS Coordinators, Swing Bed Coordinators, and any other corporate and provider staff who have a QIES account follow this process to ensure they … [Read more...] about ILs/News Alert: Cost Reports, MDS Data
