To say that long term care providers will be impacted by the presidential election two months away is an understatement. The political parties have different philosophies and approaches to Medicaid and Medicare, and whoever ends up in the White House will seek to push through his priorities. The New York Times reports on the health care law and the election. An excerpt: To fulfill the law's goal of near-universal coverage, the president envisions adding as many as 17 million people to the … [Read more...] about Long Term Care Providers and the Election
IL/PL & News Alerts: Resident Death Reports, 10/1 Meeting
CBA HCSSAs, DBMD, PHC, and CDS: DADS reminded these providers that claims submitted for Personal Assistance Services should be based on the actual days and hours that services were provided and documented on the consumer's timesheet, not on the period of time when he/she was in the hospital. (Letter) All licensed ICF/ID and NFs: DADS has changed the process for submitting resident death reports: The Texas Health and Safety Code, §260A.016 (formerly §242.134) and §252.134, requires a … [Read more...] about IL/PL & News Alerts: Resident Death Reports, 10/1 Meeting
TX Register Updates: 9/13 Hearing, Medicare Equalization
The following information was obtained from the August 31 issue of the Texas Register: DADS will hold a public hearing on Thursday, September 13, 2012, at 10 a.m. on the Long-Term Care Plan for ICFs/MR. The hearing will be held in the Public Hearing Room, 701 W. 51st, Austin. See the Texas Register for contact information. HHSC intends to submit Transmittal Number 12-035 to the Texas State Plan for Medical Assistance, which would exempt emergency ambulance transports and … [Read more...] about TX Register Updates: 9/13 Hearing, Medicare Equalization
Texas Counties Want Medicaid Expansion
Although Governor Rick Perry said Texas would not expand Medicaid to implement the health care reform law nor set up a state insurance exchange, some counties in Texas want to expand the program. The counties are considering defying the governor. An excerpt: For years, Texas's six most populous counties, as well as some smaller localities, have offered free or low-cost health care for uninsured residents with incomes as much as three times the federal poverty level, or about $57,000 for a … [Read more...] about Texas Counties Want Medicaid Expansion
ILs and S&CC Memos: Respite, ICD-10-CM
DADS issued two information letters, and several Federal Survey and Certification letters of interest to nursing facilities. MDCP: DADS clarified that respite can occur in places other than the individual's residence. An excerpt: Respite provided in these settings should not be confused with out-of-home respite which is provided in the following licensed and/or contracted settings: • special care facilities • licensed day care facilities • hospitals • nursing facilities • camps … [Read more...] about ILs and S&CC Memos: Respite, ICD-10-CM
TX Register Updates: 9/18 Hearing, Nursing Changes
The following information was obtained from the August 24 issue of Texas Register. Public Notices and Hearing HHSC intends to submit an amendment to the Texas State Plan for Medical Assistance, which would delete obsolete and outdated information in the reimbursement methodology for case management for blind and visually impaired children. HHSC intends to submit an amendment to comply with Chapter 536 of Texas Government Code, which requires the agency to convert hospital reimbursement … [Read more...] about TX Register Updates: 9/18 Hearing, Nursing Changes
Physicians Speak Out on Government Regulation of the Patient-Physician Relationship
In July 2012, the American College of Physicians ("ACP") published a lengthy Statement of Principles on the Role of Governments in Regulating the Patient-Physician Relationship. The statement discusses proposed or adopted legislation and regulations governing medical practice and how those mandates interfere, or have the potential to interfere, with appropriate clinical practice. The statement notes that a particular concern are laws and regulations that require physicians to provide care not … [Read more...] about Physicians Speak Out on Government Regulation of the Patient-Physician Relationship
Certification and Recertification by Physicians for Extended Care Services
In skilled nursing facilities, in accordance with CMS manual guidance, CMS will only make payment for covered post-hospital extended care services if a physician makes the required certification and, where applicable, the required re-certification regarding the services furnished. Skilled nursing facilities are responsible for obtaining the required physician certification and recertification statements. Such certification must clearly note that that post-hospital inpatient extended … [Read more...] about Certification and Recertification by Physicians for Extended Care Services
Rise of Accountable Care Organizations Changing the Landscape of Accreditation
According to a recent article in Modern Healthcare, increasing consolidation in the healthcare sector and changes in reimbursement methodologies, such as the payment structure for accountable care organizations ("ACOs") is leading to changes in accreditation standards. John Burke, the CEO and President of Accreditation Association for Ambulatory Health Care, stated, "The movement to accountable care organizations and other recent trends has led to more health systems reabsorbing primary-care … [Read more...] about Rise of Accountable Care Organizations Changing the Landscape of Accreditation
Court Rejects Challenge to Physicians-Owned Hospital Provision
The health care reform law, which the U.S. Supreme Court upheld in June, contains a provision that limits the construction of new physician-owned hospitals and the expansion of existing ones. MedPage Today reports on a ruling that is considered a set-back for these hospitals. A physician-owned hospital in the state, the Texas Spine & Joint Hospital in Tyler, stopped expansion plans after the health care law was passed. Physician Hospitals of America and other plaintiffs challenged the law in … [Read more...] about Court Rejects Challenge to Physicians-Owned Hospital Provision
