California is attempted to solve a budget deficit by cutting programs, and in-home care workers would have received a $2 hourly wage cut beginning July 1. A federal judge blocked the wage cut. In-home care workers in California will maintain their present wage level. (Source) The salary cut would have saved the state $98 million in 2009 and 2010. In other provider news, the Supreme Court ruled that California's Medicaid providers may challenge the state's proposed cuts to provider fees, … [Read more...] about Rulings Favor California Providers
Child Health Program Bills Introduced
The Texas House and Senate introduced bills related to the child health plan program: Senate Bill 6 and House Bill 11. Among other things, the bills would change family income eligibility levels. Earlier this month, we reported that the Texas Senate had approved a bill to increase enrollment in the State Children's Health Insurance Program, raising the income eligibility limits from $44,000 to $66,000 for a family of four. An additional 80,000 uninsured children would be covered. … [Read more...] about Child Health Program Bills Introduced
Texas Register Updates: Medicaid Rates, Texas Medical Board Changes
The following information was obtained from the June 19 issue of the Texas Register: Public Hearings and Notices The Texas Health and Human Services Commission (HHSC) will hold a public hearing on July 15, 2009, at 1:30 p.m., to receive comment on proposed Medicaid payment rates for Early and Periodic Screening, Diagnosis, and Treatment Personal Care Services for Type of Service (TOS) 1, Ambulance Services, and Certified Nurse Midwife services in a birthing center for types of service … [Read more...] about Texas Register Updates: Medicaid Rates, Texas Medical Board Changes
Obtacles to Keeping the Medically Fragile at Home
The State claims that it does not force those who age out of the children's health care plan into institutional care. It looks to me that the State certainly does do that and in a recent case, it appears that a young man died because of it. AUSTIN – Toby Simmons' disabilities were so severe that he couldn't breathe or swallow without help. For the first two decades of his life, he received around-the-clock nursing care in his foster mother's home. But when he turned 21 and aged out … [Read more...] about Obtacles to Keeping the Medically Fragile at Home
Medical Homes in Texas
The Houston Chronicle published a feature story about medical homes, which provide "personal and coordinated care" for seniors. Personal doctors coordinate the care seniors receive and manage it from a central location, and patients have more access to doctors and medical records. Medical home coordinator Dr. Trevor Rabie said, "Many patients feel that if they go to a specialist or sub-specialist for each aspect of their medical care, that they're actually improving their medical care. But … [Read more...] about Medical Homes in Texas
Pharmaceutical Industry Agrees to Cut Drug Costs
The Wall Street Journal reports that the pharmaceutical industry has agreed to cut the cost of Medicare drugs to prevent larger cuts President Barack Obama may impose to fund his health care reform plan. Under the cost-cutting plan, the drug industry would pay for half the Medicare drug's price when it's not covered by the gap under Part D. Over 10 years, pharmaceutical companies will sacrifice $80 billion by covering a larger share of brand-name prescription drug costs. The health care … [Read more...] about Pharmaceutical Industry Agrees to Cut Drug Costs
Information Letters: R&S Report Updates, Form 2032, Etc.
The Texas Department of Aging and Disability Services (DADS) issued six information letters: TMHP Remittance and Status (R&S) Report Information In a letter to DADS Long Term Care Services and Supports providers, DADS emphasized the importance and usefulness of the TMHP (R&S) Report: "Providers that do not reconcile their R&S Reports may be billing incorrectly, which can result in audits and penalties. Providers should ensure not only that all billing is accurate, but also that any … [Read more...] about Information Letters: R&S Report Updates, Form 2032, Etc.
Inappropriately Placed Residents and Adminstrative Penalties
Following a survey, DADS assessed an administrative penalty against an assisted living facility for “having three inappropriately placed residents.†Our firm appealed this holding on behalf of the facility under the premise that the regulations forbid the Department from assessing administrative penalties for “inappropriate placement.†We filed a Motion for Summary Disposition asking the ALJ to delete the penalty and DADS filed a similar Motion requesting the Court to uphold the … [Read more...] about Inappropriately Placed Residents and Adminstrative Penalties
Mental Health Parity Act Effective Date Delayed Until January 2010
New requirements for employee health care plans originally scheduled to go into effect next month now have been delayed for at least a few more months. Congress has deferred the effective date of the Mental Health Parity and Addiction Equity Act (MHPA) until January 2010. The MHPA does not require health insurance plans to provide mental health or addiction disorder benefits if they do not do so already. However, for group health plans that do choose to provide mental health and/or substance use … [Read more...] about Mental Health Parity Act Effective Date Delayed Until January 2010
Texas Register Updates: Changes to Physicians Assistants Section, Etc.
The following information was obtained from the June 12 issue of the Texas Register: Public Hearings The Texas Health and Human Services Commission (HHSC) will hold a public hearing on July 1, 2009, at 9 a.m. to receive public comment on rate increases for the Community Based Alternatives waiver program, the Community Living Assistance and Support Services waiver program, the Deaf-Blind with Multiple Disabilities waiver program, and others. The hearing will be held in the Lone Star … [Read more...] about Texas Register Updates: Changes to Physicians Assistants Section, Etc.
