Last month, we blogged about Texas hospitals facing more Medicaid reimbursement cuts on top of the expected 10 percent. Providers were concerned about a measure that would have changed the payment method for hospitals: they would be reimbursed for Medicaid patients according to the average rate in the state, as opposed to their current unique rate system. The Texas Tribune recently reported that in addition to other proposed reductions, hospitals may see a 23-percent payment cut in trauma … [Read more...] about Texas Hospitals Ask for Less Painful Budget Cuts
TX Register Updates: Reimbursement Changes
The following information was obtained from the May 13 issue of the Texas Register: HHSC intends to submit amendments to the Texas State Plan for Medical Assistance, which would modify the reimbursement methodologies as a result of Medicaid fee changes for Physicians and Certain Other Practitioners and Chemical Dependency Treatment Facilities. HHSC intends to submit intends to submit amendments to the Texas State Plan for Medical Assistance, which would modify the reimbursement … [Read more...] about TX Register Updates: Reimbursement Changes
News Alerts: Employee Misconduct, June 8 Meeting
Residents must sign the form in the 3.0 RAI Manual when admitted to an NF or SNF. DADS drafted rules about employee training in DADS State Supported Living Centers, which would consolidate the rules into a single subchapter, delete outdated agency names and references, improve the readability of the language, and increase congruence between rules, policies, regulatory requirements, and the Settlement Agreement. DADS recently announced enhancements to the Employee Misconduct Registry. … [Read more...] about News Alerts: Employee Misconduct, June 8 Meeting
ILs: Billing Deadlines, Hospice Documentation
DADS released two information letters: All LTC providers: The American Recovery and Reinvestment Act of 2009 expires on June 30, 2011. DADS encourages providers to bill as often to ensure that claims for services provided but not yet billed are received by June 30. Other dates: TMHP no later than noon Monday, June 27, 2011; CARE system, no later than noon Friday, June 24, 2011. (Letter) Medicaid hospice: DADS informed these providers that effective July 1, 2011, DADS will require … [Read more...] about ILs: Billing Deadlines, Hospice Documentation
TX Register Updates: Consultant, Civil Rights Rules
The following was obtained from the May 6 issue of the Texas Register: Public Notices HHSC seeks a consultant to perform Managed Care Organization (MCO) Management Information System (MIS) and Operations Readiness and Assessment Reviews ("Readiness Reviews") on MCOs selected as a result of the MCMCS RFP and the Dental RFP as well as on currently contracted MCOs pursuant to this RFP. Point of contact: Elizabeth Ward Procurement Manager, Enterprise Contracts and Procurement Health and … [Read more...] about TX Register Updates: Consultant, Civil Rights Rules
ILs: MFP Options, Screening Employees/Contractors
DADS released four information letters: NFs: Written documentation of admission and discharge is required from NFs for an individual to access MDCP services through the Money Follows the Person option. An individual may be eligible to access MDCP services if he/she completes either an NF stay no fewer than 30 consecutive days or a limited NF stay if the individual is determined to be too medically fragile to complete a 30-day stay. (Letter) CBA HCSSA and CWP HCSSA: Unless … [Read more...] about ILs: MFP Options, Screening Employees/Contractors
TX Register Updates: May 17 Hearing, RFPs
The following information was obtained from the April 29 issue of the Texas Register: Public Hearings and Notices HHSC will hold a hearing to receive public comments on Medicaid payment rates for the following: 17-Alpha Hydroxyprogesterone Caproate; Diabetic Equipment and Supplies; Incontinence Supplies; Medicaid Calendar Fee Reviews; Mobility Aids; Otology and Audiometry Services; Substance Use Disorder Services; and Surgical Procedures. The hearing will be held on May 17, 2011, at … [Read more...] about TX Register Updates: May 17 Hearing, RFPs
Note About House and Senate Bills
On the Garlo Ward blog, we alert providers to recently introduced House and Senate bills. As you know, the legislative process tends to be slow; it may take months for the legislature to refer, debate, and vote on a bill. That’s why it’s important for providers to check on relevant bills periodically for status updates. This link will bring up posts that point to bills as introduced. Some of these bills have gone through committee. Be sure to check each post for bills that affect you. … [Read more...] about Note About House and Senate Bills
Providers Could See Performance-Based Medicaid Payment
Last week, the state Senate unanimously passed a bill that would change payment rates for Medicaid and the State Child Health Insurance Program from procedure-based to performance-based. The purported goal is to raise quality of care while reducing costs. An excerpt: That bill also gives the Health and Human Services Commission the authority to try out various performance-based payment models through pilot programs. One potential pilot program, which already has raised some antitrust concerns, … [Read more...] about Providers Could See Performance-Based Medicaid Payment
IL Letters: PACE, Form H3087 Error
DADS released three information letters: PACE providers: DADS reminded these providers to use the applicant's/participant's physical address when completing all documentation for Medicaid. The PACE site's address should not be used on these forms. (Letter) DADS clarified the date to be used as the "End Date" when completing the PACE SAS Registration Form used for data entry into the Service Authorization System (SAS) (Letter): "The client may voluntarily disenroll from Programs of … [Read more...] about IL Letters: PACE, Form H3087 Error
