Last week, the Senate debated whether to reduce the age eligibility for Medicare from 65 to 55. Leading the charge against the expansion was Senator Joe Lieberman. The proposal was defeated. The American Hospital Association and the Federation of American Hospitals opposed expanding Medicare, and the groups lobbied lawmakers reluctant to vote for it. Lobbyists and lawmakers who opposed the buy-in were concerned an expansion would exacerbate provider shortages in states with low reimbursement … [Read more...] about Providers Fought Medicare Buy-In
Information and Provider Letters: Under-21 Individuals, Etc.
DADS released one provider and eight information letters. CLASS program and CDSAs for CLASS: DADS changed a policy for these providers. Individuals under the age of 21 may receive Personal Care Services from Medicaid Children's Services administered through the Department of State Health Services while receiving services through the CLASS program. (Letter) ICFs/MR: These providers must submit DADS discharges within 3 days after the effective date of discharge. Discharges are … [Read more...] about Information and Provider Letters: Under-21 Individuals, Etc.
Information Letters: NFs, ICFs/MR, HCSSAs, Etc.
DADS released six information letters, including three for nursing facilities. NFs: DADS reminded NFs that Texas Government Code section 531.153 requires that providers develop a permanency plan for an individual under age 22 who resides in an institution. Section 531.154 also requires a nursing facility to notify, within three days of a child's admission to the facility: DADS, the community resource coordination group, the local office of Early Childhood Intervention, and the local school … [Read more...] about Information Letters: NFs, ICFs/MR, HCSSAs, Etc.
HIPAA Update
New rules increase penalties substantially and allow self-assessment for reporting. See the details here. … [Read more...] about HIPAA Update
Information Letters: New Hospice Rates, Employment Svcs Training
DADS released two information letters. Medicaid Hospice Providers: HHSC recently approved rate changes for the Medicaid Hospice Program for Federal Fiscal Year 2010, effective October 1, 2009. See new rates on this web page. The adjustment will be retroactive, so providers don't have to do anything, unless repayment fails. In that case, they'll need to re-bill the denied claims. (Letter) ICF/MR: DADS announced the Employment Services Training and Technical Assistance Initiative. The … [Read more...] about Information Letters: New Hospice Rates, Employment Svcs Training
Texas Register Updates: Board of Nursing Penalties, Sanctions, and Fines
The following information was obtained from the December 4 issue of the Texas Register: Public Notices HHSC intends to submit amendments, effective January 1, 2010, that will modify the reimbursement methodologies in the Texas Medicaid State Plan as a result of Medicaid fee changes for Physicians and Certain Other Practitioners and Durable Medical Equipment, Prosthetics, Orthotics and Supplies. HHSC also will submit amendments, effective February 1, 2010, that will modify the … [Read more...] about Texas Register Updates: Board of Nursing Penalties, Sanctions, and Fines
Information Letters: SPW Consumer Transfers, Allowable Hours
DADS issued two information letters. CBA, ICMW, HCSSAs, and STAR+PLUS Waiver (SPW) Consumers Transferring into the CBA and ICMW Programs: Some providers are concerned about documentation requirements for SPW consumers transferring into the CBA or ICMW programs. After consulting with HHSC, DADS confirmed that a STAR+PLUS HMO transfer packet for SPW consumers contains the necessary supporting documentation to justify the services authorized on the SPW ISP, even if the documentation isn't … [Read more...] about Information Letters: SPW Consumer Transfers, Allowable Hours
Information Letter: HCS/MRA Case Management Transition
DADS issued an information letter to HCS providers regarding the transition of case management from HCS providers to MRAs. DADS included several attachments, including a letter alerting providers to the transition, information letter #09-165 requiring HCS providers to distribute the letter to all individuals, legally authorized representatives, and actively involved family members and friends, and instructions on how to register for e-mail updates from DADS. (Letter) … [Read more...] about Information Letter: HCS/MRA Case Management Transition
Texas Register Updates: Contract Award, Nursing and Medical Boards
The following information was obtained from the November 27 Texas Register: Public Notices HHSC awarded contact #529-10-0021-00001 to Software Contract Solutions, Inc., to provide a resource for investigating all facets of information technology software issues that impact price, cost savings measures, risk exposure, and overall total cost of ownership. The total value of the contract will not exceed $900,000. HHSC intends to submit an amendment that will extend the rate for Mental … [Read more...] about Texas Register Updates: Contract Award, Nursing and Medical Boards
House Delays Physician Payment Cut
The American Academy of Family Physicians predicts there will be 40,000 fewer family care physicians in 10 years, and 160,000 fewer by 2025. One proposed solution to the growing shortage is to increase residency positions for family doctors at teaching hospitals. To make matters worse, doctors face a 21 percent cut in Medicare payments in 2010. An internist quoted in CNN Money said if the cut went through, it would exceed his profits, and he'd have to lay off employees to stay in business. But … [Read more...] about House Delays Physician Payment Cut
