A couple weeks ago, we blogged about a new CMS rule that will raise Medicaid payment rates for primary care physicians. The American Academy of Family Physicians (AAFP) released a statement supporting the new rule but wants only primary care physicians, and not subspecialists (general internal medicine, pediatric medicine, etc.), to benefit. An excerpt: In the proposed rule, CMS says it is interested in ensuring primary care physicians receive the benefit of the increased payment, a goal shared … [Read more...] about Physicians Group Opposes Increased Rates for Subspecialists
TX Register Updates: Proposed NorthSTAR Waiver Changes
The following information was obtained from the June 8 Texas Register: HHSC intends to submit transmittal number 12-024 to the Texas State Plan for Medical Assistance, which would clarify the orthotic and prosthetic services available to Medicaid EPSDT eligible recipients under 21 by moving coverage information to the EPSDT Services section of the state plan. HHSC intends to submit an amendment that would modify the reimbursement methodology in the State Plan for non-state operated ICF/MR … [Read more...] about TX Register Updates: Proposed NorthSTAR Waiver Changes
Health Care Reform and the Supreme Court
Long term care providers await the U.S. Supreme Court's decision on whether President Barack Obama's health care reform law is unconstitutional. Texas is one of the states that filed suit against the federal government challenging the law. The key issue is the law's individual mandate, which would require individuals to purchase health care insurance or face fines. The Physicians Hospital of America, which represents doctors, are concerned about the law's restriction on expanding or building new … [Read more...] about Health Care Reform and the Supreme Court
IL/News Alerts: Behavioral Health Facility, Vaccinations
HSC, TxHml, and LA: An excerpt of what DADS expects from providers when an individual receiving waiver services is admitted to a state hospital or other behavioral health facility for psychiatric stabilization: A Home and Community-based Services (HCS) or Texas Home Living Program (TxHmL) program provider is responsible for placing an individual who is admitted to a state hospital or inpatient behavioral health facility on suspension from waiver services for the duration of the individual's … [Read more...] about IL/News Alerts: Behavioral Health Facility, Vaccinations
TX Register Updates: Correction, Hearing
The following information was obtained from the June 1 issue of the Texas Register: A correction: The Texas Health and Human Services Commission (HHSC) proposed an amendment to 1 TAC §370.4, concerning definitions, in the May 4, 2012, issue of the Texas Register (37 TexReg 3283). On page 3286, new language in the definition of "dental home", renumbered from paragraph (29) to (30), was inadvertently shown without underlining, making the text appear to be existing language. The corrected … [Read more...] about TX Register Updates: Correction, Hearing
DADS News Alerts: Cultural Change Initiative, NF meeting
-- As part of the cultural change initiative, DADS will host four symposia in 2012. Registration information will be available a month before each event: Lubbock – Wednesday, August 22, Holiday Inn Lubbock - Hotel and Towers Dallas – Friday, August 24, Westin Park Central San Antonio – Tuesday, November 13, Sheraton Gunter Hotel Houston – Thursday, November 15, Houston Marriott Westchase -- DADS issued an alert to providers and other qualified entities to become a residential … [Read more...] about DADS News Alerts: Cultural Change Initiative, NF meeting
More Money for Primary Care Physicians?
Earlier this month, CMS reported on a new rule that purportedly would increase Medicaid payments to primary care physicians. Secretary [Kathleen] Sebelius also announced today that, in 2011, over 150,000 primary care providers nationwide received almost $560 million in higher Medicare payments because of the Affordable Care Act. This is another way the Affordable Care Act rewards doctors, nurse practitioners, physician assistants, and other primary care providers who are central to our health … [Read more...] about More Money for Primary Care Physicians?
ILs: Death Reporting, UMR Expansion
DADS released five information letters. DBMD: DADS informed these providers of death reporting requirement changes within the DBMD program. An excerpt: Effective June 1, 2012, providers must report to DADS, deaths of all individuals enrolled in the DBMD program. Within 24 hours after learning of the death of an individual, DBMD providers must complete DADS form 8493 "Notification to DADS Regarding a Death in the Home and Community-based Services (HCS), Texas Home Living (TxHml) and Deaf … [Read more...] about ILs: Death Reporting, UMR Expansion
TX Register Updates: Employee and Resident Vaccinations
The following information was obtained from the May 25 issue of the Texas Register: On DADS' Behalf HHSC adopted amendments to §19.101, Definitions, and §19.1601, Infection Control, in Chapter 19, Nursing Facility Requirements for Licensure and Medicaid Certification. The new rules require NFs to develop policies for employee and contractor vaccinations to protect residents from vaccine-preventable diseases. See the Texas Register for details. HHSC adopted amendments to §90.3, … [Read more...] about TX Register Updates: Employee and Resident Vaccinations
DADS News Alerts: EDS Pilot Survey, STAR Medicaid Managed Care
-- DADS is conducting an EDS Pilot it Regions 6, 2/9, and 7 to test the usefulness of submitting referral documents by e-mail between DADS and providers. If you're in one of these regions, please complete the attached survey by May 25, 2012: https://www.surveymonkey.com/s/EDS_Pilot_Survey -- DADS notified all CLASS CMAs and DSAs of updated Form 3660 - CLASS Request for Adaptive Aids, Medical Supplies, Minor Home Modifications or Dental Services/Sedation. -- DADS will hold the next Adult … [Read more...] about DADS News Alerts: EDS Pilot Survey, STAR Medicaid Managed Care
