DADS released two information letters and one provider letter: AFC, ALF, CBA, CLASS, DAHS, HDM, Hospice, ICF/ID, NF, PACE, and other providers: Last year, LTC CMS processed over 15 million claims, which included 423,185 rejected claims and 456,967 denied claims. DADS provided guidelines to deal with the most common errors that delay LTC provider claim processing and payment An excerpt: Rejected Claims A rejected claim fails initial system edits, and is returned to the provider for … [Read more...] about ILs/PL: LTC Claim Errors, Criminal History Checks
TX Register Updates: Reimbursement Rates
The following information was obtained from the March 23 issue of the Texas Register: HHSC adopted amendments to §355.105, General Reporting and Documentation Requirements, Methods, and Procedures; §355.112, Attendant Compensation Rate Enhancement; §355.308, concerning Direct Care Staff Rate Component; §355.503, Reimbursement Methodology for the Community-Based Alternatives Waiver Program and the Integrated Care Management-Home and Community Support Services and Assisted Living/Residential … [Read more...] about TX Register Updates: Reimbursement Rates
DADS News Alerts: MDS 3.0 Updates, DADS 1915(c) Training
-- A Medical Necessity and Level of Care Item by Item Guide is scheduled for release on April 1, 2012. This is the link (PDF) to the November 2011 Item by Item Guide: . Effective April 1, 2012 it will link to the April revision. -- An MDS 3.0 RAI Manual (v1.08) Errata document labeled "MDS 3.0 RAI Manual (v1.08) Errata_March_12_2012" has been posted in the Downloads section of the MDS 3.0 Training page. -- Providers using MDS 3.0 for nursing homes and swing beds: "[M]ay ignore warning … [Read more...] about DADS News Alerts: MDS 3.0 Updates, DADS 1915(c) Training
ILs: Waiver Program Forms Review, EVV
DADS released two information letters: CLASS CMA, and DSA: DADS is conducting a review of all forms used across DADS waiver programs as part of an initiative to standardize and streamline. Updated versions of the forms included in the Phase IV review are available. An excerpt: Form 3599, Attendant Orientation/Supervisory Visit, and Instructions Revisions to this form include re-organization of the signature section, and updating the plan of care tasks. In addition the following … [Read more...] about ILs: Waiver Program Forms Review, EVV
TX Register Update: Medical Board Licensure
From the March 16 issue of the Texas Register: Under the Texas Medical Board, the Board of Acupuncture Examiners proposed to amend §183.4, Licensure, which would provide that applicants must demonstrate active practice within either of the two years before application, and that the Board can issue temporary licenses to remedy active practice deficiencies. See the Texas Register for details. … [Read more...] about TX Register Update: Medical Board Licensure
ILs: Revised MDS 3.0, Hospice Forms
DADS released four information letters: All contracted NFs: CMS revised the MDS 3.0 Assessments, effective April 1, 2012. Details and revisions to the RAI Manual may be found on this CMS webpage. (Letter) ADC, ADF, CAS, CLASS, DBMD, MDCP, PACE, and other providers: CMS has mandated an April 1 deadline for all transactions to be compliant with EDI Version 5010. (Letter) CBA HCSSA, MDCP, HCS, and PACE: DADS is releasing a new version of the MN/LOC 3.0 assessment, effective April … [Read more...] about ILs: Revised MDS 3.0, Hospice Forms
DADS News Alerts: 4/2 Meeting, 4/24 Webinar
-- DADS requests that HCS, TxHml, and private ICF/ID providers; State Supported Living and Community Centers, and Local Authorities assist the agency in creating a better Adult Protective Services facility investigative report. Please take this survey: http://www.surveymonkey.com/s/6MBDTQQ -- DADS Regulatory Services Division regional staff will present a home health provider meeting for regions 1, 2, and 9 on April, 2, 2012, from 1:30-4:30 p.m. at the in Lubbock at the Knipling Education … [Read more...] about DADS News Alerts: 4/2 Meeting, 4/24 Webinar
TX Register Updates: 4/29 Hearing, Medical Board Changes
The following information was obtained from the March 9 issue of the Texas Register: Public Hearing and Notices HHSC will hold a public hearing on April 19, 2012, at 2 p.m., to receive comment on proposed Medicaid payment rates for the Blind Children's Vocational Discovery and Development Program. The public hearing will be held in the Permian Basin Conference Room of HHSC, Braker Center, Building H, located at 11209 Metric Boulevard, Austin. HHSC intends to submit to CMS a request to … [Read more...] about TX Register Updates: 4/29 Hearing, Medical Board Changes
Medicaid Managed Care: Prescription Drugs
The Texas Tribune reports that prescription drugs will be a part of Medicaid managed care as it expands across the state. Pharmacists, who probably will see reimbursement cuts, object. An excerpt: “I am totally scared to death,” Louis Rumsey, a pharmacist who owns Elam Road Pharmacy in South Dallas, told a joint committee of Texas House and Senate members on Wednesday. Rumsey, who is making plans to sell the pharmacy over the managed care changes, said 85 percent of the patients he serves are … [Read more...] about Medicaid Managed Care: Prescription Drugs
IL/News Alerts: EVV, EDS Pilot Areas
CDSA and MDCP: DADS informed these providers and CDS employers using the Electronic Visit Verification System of the change in required documentation. An excerpt: This letter updates the CDS information provided in Information Letter No. 10-117 and applies only to CDSAs and CDS employers in the MDCP program who use the DADS EVV system for respite or adjunct support services provided by an attendant. CDS employers using the DADS EVV system no longer need to complete or keep a copy of DADS … [Read more...] about IL/News Alerts: EVV, EDS Pilot Areas
