ATTENTION HCS & TxHmL Providers: CMS has directed HHSC to eliminate the current monthly Administration and Operations Fee (Adm & Op fee) and replace with a methodology that allocates these expenses across all HCS services. How will this directive impact you? It means that the current monthly "admin& op" fee used to reimburse providers for these admin and operations expenses ($938.62 per consumer per month or approximately $11,263 per annum) is being removed and these … [Read more...] about Proposed Changes to §335.723—So long flat rates…hello “weighted methodologiesâ€
Never Talk to the Police
I've been wanting to post this video for a while. With the ramping up of fraud investigations and investigations of abuse and neglect, there is a chance that some of you might be subjected to an investigation by law enforcement. Additionally, there are investigators in the AG's office whose background is law enforcement. This is a great video about how these people work and why you should jealously guard your 5th Amendment rights. Here is part 2. … [Read more...] about Never Talk to the Police
Information Letters: Hearing Cancellation, Physician’s Signature
The Department of Aging and Disability Services (DADS) issued two information letters: Public Hearing Regarding Proposed Rates for the Home and Community-based Services, Texas Home Living, and Consolidated Waiver waiver programs -- Revised DADS informed all HCS, TxHmL, and CWP waiver programs about the cancellation of a public hearing initially scheduled for July 24, 2009, at 2:30 p.m. See the letter for more information. Mental Retardation/Related Conditions (MR/RC) … [Read more...] about Information Letters: Hearing Cancellation, Physician’s Signature
Texas Register Updates: Licensure Applications and Registrations Changes, Etc.
The following information was obtained from the July 10 Texas Register: Public Hearing The Texas Health and Human Services Commission (HHSC) will hold a public hearing on July 24, 2009, at 1 p.m. to receive public comment on proposed rates for Professional Services in Home and Community-Based Services waivers. The hearing will take place in the Lone Star Conference Room of the Health and Human Services Commission, Braker Center, Building H, located at 11209 Metric Boulevard, Austin, Texas. … [Read more...] about Texas Register Updates: Licensure Applications and Registrations Changes, Etc.
Medicare Fraud Strike Force in Texas
According to the Houston Chronicle, there's a federal Medicare fraud strike force on the loose in Texas. The article highlights a number of Houston-area clinics committing Medicare fraud. Medicare fraud in the U.S. last year totaled $2.35 billion. There were 575 health fraud criminal actions and 342 civil actions filed. The task force has reduced identification of Medicare fraud from months to days, thanks to improved technology. Justice Department spokeswoman Melissa Schwartz said, "There … [Read more...] about Medicare Fraud Strike Force in Texas
Information and Provider Letters: Critical Incident Reporting
The Texas Department of Aging and Disability Services (DADS) released three information letters and one provider letter: Resident Choice of Health Professionals DADS reminded Assisted Living Facilities (ALFs) and Home and Community Support Services Agencies of a resident's right to choose and contract with his or her own health care professionals. According to DADS, ALFs must specify in the facility resident admission agreement any requirements the facility imposes on non-facility … [Read more...] about Information and Provider Letters: Critical Incident Reporting
Texas Register Updates: New Contract Award, Etc.
The following information was obtained from the July 3 issue of the Texas Register: Public Notices The Texas Health and Human Services Commission (HHSC) announced a contract award valued at $259,690 to Navigant Consulting, Inc., to provide consulting and application development services to HHSC to design and develop a risk-based contract performance management/monitoring tool for the Texas Medicaid/Children with Special Health Care Needs Claims Processing, Primary Care Case Management, and … [Read more...] about Texas Register Updates: New Contract Award, Etc.
Extending Medicare Drug Coverage May Lower Other Costs
A recent study showed that extending Medicare Part D coverage to Medicare enrollees who previously had limited or no drug coverage may result in lowering other medical costs. (Source) According to the study, prescription drug spending for newly enrolled beneficiaries without previous coverage rose by $41 a month, $27 a month for those who'd had a $150 quarterly cap, and $13 a month for who'd had a $350 cap. The study also found that spending for other forms of medical care for the … [Read more...] about Extending Medicare Drug Coverage May Lower Other Costs
Information Letters/Announcement: HCS and TxHmL Stakeholder Meeting, Etc.
The Department of Aging and Disability Services (DADS) announced that the next quarterly stakeholder meeting for the Home and Community-Based Services (HCS) and Texas Home Living (TxHmL) waiver programs will be held on July 23, 2009, in the Public Hearing Room at DADS state office, Winters Building, 701 West 51st Street, Austin, Texas. Providers may register here. Contact Mary Valente at mary.valente@dads.state.tx.us for more information. DADS released two information letters: Amended … [Read more...] about Information Letters/Announcement: HCS and TxHmL Stakeholder Meeting, Etc.
Texas Register Updates: State-owned Veterans Nursing Facility Payment Rates, Etc.
The following information was obtained from the June 26 issue of the Texas Register: Public Notices and Hearings The Texas Health and Human Services Commission (HHSC) adopted the following per day payment rates for the state-owned veterans nursing facilities for fiscal year (FY) 2009, effective September 1, 2008: Big Spring, $133.00; Bonham, $133.00; Floresville, $133.00; Temple, $133.00; McAllen, $133.00; El Paso, $133.00 and Amarillo, $133.00. Effective March 1, 2009 the rates adopted … [Read more...] about Texas Register Updates: State-owned Veterans Nursing Facility Payment Rates, Etc.
