The following bills (which may affect long term care providers) were recently introduced in the 82nd Legislative Session: HB 637: Relating to certain treatment by a physical therapist. HB 680: Relating to a physician's response to a complaint filed with the Texas Medical Board. Proposed Rules HHSC proposes to amend §371.1647, concerning notice of sanction; and new §371.1709, concerning recoupment of overpayments pursuant to audit, in Chapter 371, Medicaid and Other Health and Human … [Read more...] about House Bills, TX Register Updates
Why Should You Have a Compliance Program?
The Patient Protection and Affordable Care Act ("PPACA") mandates in Sections 6102 and 6401 that a broad range of providers, suppliers, and physicians adopt compliance and ethics programs. By March 23, 2013, skilled nursing facilities and other nursing facilities must have “in operation” a compliance and ethics program that meets the PPACA’s criteria. Although the PPACA's requirements for nursing facilities are specific, the PPACA also contains broad compliance program requirements for all other … [Read more...] about Why Should You Have a Compliance Program?
Background Checks for Nursing Homes and Assisted Living Facility Employees
Many nursing homes and assisted living facilities may be unsure whether they are required to conduct background checks for independent contractors with direct client contact (such as dieticians and medical directors). The question arises because there appears to be a conflict between the Texas Health and Safety Code and a DADS handbook. Under Texas Health and Safety Code Section 250.002, nursing homes and assisted living facilities are required to conduct criminal background checks ONLY on … [Read more...] about Background Checks for Nursing Homes and Assisted Living Facility Employees
Information/Provider Letters: Diagnostic Codes, Wall-Mounted Objects
DADS released one information and one provider letter: Nursing Administrators and Minimum Data Set Coordinators: DADS provided clarification about submission of Preadmission Screening and Resident Review and the Minimum Data Set forms. For example, the term "mental retardation" has been replaced by "intellectual disability." See the approved diagnostic codes for more information (PDF). (Letter) Free-Standing Hospice Facilities, ICFs/MR, and NFs: DADS issued a letter to notify … [Read more...] about Information/Provider Letters: Diagnostic Codes, Wall-Mounted Objects
Medicare Seeks to Reward High Quality of Care
Last week, CMS proposed a rule to reward hospitals based on high quality of patient care, a requirement under the health care reform law. Under "value-based purchasing," high-performing hospitals will receive higher Medicare payments. "Today's proposal is a huge leap forward in improving the quality and safety of America’s hospitals for both Medicare beneficiaries and all Americans," CMS administrator Donald Berwick said. "The hospital value-based purchasing program will reward hospitals for … [Read more...] about Medicare Seeks to Reward High Quality of Care
TX Register Updates: Correction, Rate Hearings
The following information was obtained from the January 7 issue of the Texas Register: Public Notices and Hearings HHSC issued a correction for an error in the December 24, 2010, published under, "Notice of Public Hearing on Proposed Medicaid Payment Rates." The correction: "Hearing. The Texas Health and Human Services Commission will conduct a public hearing on January 7, 2011, at 11:00 a.m. to receive public comment on payment rate reductions for the non-state operated Intermediate Care … [Read more...] about TX Register Updates: Correction, Rate Hearings
Hospice Program Contacts, Webinar Dates
DADS released contact information for the Texas Medicaid Hospice program. Download the letter for more information. Registration is open for the Second CLASS External Stakeholder Quarterly Webinar, to be held on Monday, January 10, 2011, from 10-11 a.m. You may register here and find the agenda and other information here. Registration is open for the First Quarterly Webinar for HCS/TxHmL External Stakeholders, to be held on Thursday, January 20, 2011 from 10 a.m.-12:00 p.m. You may … [Read more...] about Hospice Program Contacts, Webinar Dates
Information/Provider Letters: Rate Changes, Cost Reporting
DADS released one provider and nine information letters. Adult Day Care and Assisted Living: DADS will require all ADC and AL facilities to submit Form 3725, Licensure Change of Ownership Affidavit, as part of the change of ownership notification process, effective January 1, 2011. (Letter) CBA, CLASS, MDCP, PHC, CAS, FC, and CDSA: DADS informed these providers that the electronic visit verification system is expected to be fully operational in Region 9 by March 1, 2011. … [Read more...] about Information/Provider Letters: Rate Changes, Cost Reporting
TX Register Updates: TxHmL Waiver, Verification System
The following information was obtained from the December 31 issue of the Texas Register: Public Notice HHSC intends to submit to CMS an amendment to the TxHmL waiver, which would implement an optional program that offers additional funds to providers to pass on to community support staff through salaries, wages, benefits, and mileage. For details, see the Texas Register. Adopted Rules HHSC adopted new §354.1261, Benefits and Limitations, and new §354.1262, Conditions for … [Read more...] about TX Register Updates: TxHmL Waiver, Verification System
Association of American Physicians and Surgeons Challenges PECOS
In August 2010, the Association of American Physicians and Surgeons ("AAPS") filed an amended complaint asking the court to vacate HHS regulations requiring non-Medicare providers to enroll with Medicare, to appear in the Provider Enrollment, Chain and Ownership System ("PECOS"), or to obtain a National Provider Identifier ("NPI"). A copy of AAPS' full amended complaint is available here. AAPS argues that the ability of non-Medicare enrolled physicians to order or refer for services provided … [Read more...] about Association of American Physicians and Surgeons Challenges PECOS
