Late last month, there was a disturbing article in The New York Times regarding Medicaid and the protection of a spouse's income and assets when the Medicaid beneficiary lives at home rather than in a nursing home. According to the article, one state Health Department spokesman said the following: “They’re saying if you put your spouse in a nursing home, you’re going to get to keep more income than if you keep your spouse out of a nursing home,†said Mark L. Kissinger, deputy … [Read more...] about Medicaid and Protection of Spouse’s Income and Assets
HHS: Medicare Part D Beneficiaries Overcharged
According to a report released by the U.S. Department of Health and Human Services Office of the Inspector General, private insurers under Medicare Part D have overcharged beneficiaries and taxpayers by billions of dollars since the program began in 2006. (Kaiser Network) An estimated 80 percent of private insurance companies owe Medicare $4.4 billion. The Centers for Medicare and Medicaid Services (CMS) has not conducted audits it should have performed in 2006. Consequently, CMS doesn't know … [Read more...] about HHS: Medicare Part D Beneficiaries Overcharged
Information Letters: PACE and Hospice Provider Updates, Etc.
The Texas Department of Aging and Disability Services (DADS) released three new information letters: Community Services Medical Necessity (MN) and Level of Care (LOC) Assessment for PACE Participants Residing in Nursing Facilities (NFs) DADS served notice to PACE providers about MN/LOC assessments and billing for participants whose permanent residence is a Medicaid NF. PACE submits assessments to the Texas Medicaid Healthcare Partnership every year, and the organization is responsible … [Read more...] about Information Letters: PACE and Hospice Provider Updates, Etc.
More Doctors E-Prescribing
To eliminate medication errors caused by misreading handwritten prescriptions and other purposes, the Centers for Medicare and Medicaid Services (CMS) introduced an electronic prescribing system. To encourage doctors to use the system, CMS allowed them to earn a payment of two percent of the total allowed Medicare charges during 2009 and another two percent incentive payment for successfully reporting measures under the Physician Quality Reporting Initiative. It looks like the incentives are … [Read more...] about More Doctors E-Prescribing
Medicaid Enrollment Climbs During Recession
As expected, Medicaid enrollment grew by 5-10 percent in several states in the past year because of the recession. (Kaiser Network) Sixteen of the 40 states that responded to a New York Times survey reported at least a 5 percent increase in Medicaid enrollment in the past year. States also reported an increase in State Children's Insurance Program (SCHIP) enrollment. Consequently, states experienced a large number of people trying to enroll, swamping social services agencies. States may … [Read more...] about Medicaid Enrollment Climbs During Recession
SCHIP Bill Would Bar New Physician-Owned Hospitals
Last week, the U.S. House of Representatives approved a bill that would reauthorize and expand the State Children’s Health Insurance Program (SCHIP). The measure, which passed by a vote of 289 to 139, would expand coverage for children from families with incomes of up to three times the federal poverty. Such an expansion would cover three million more children. The Kaiser Network reported yesterday that the House version of the SCHIP bill would prohibit the construction of new … [Read more...] about SCHIP Bill Would Bar New Physician-Owned Hospitals
Texas Register Updates: Repeal of Fair Hearing Rules, Texas Medical Board Rule Changes
The following information was obtained from the January 9 and January 16 issues of the Texas Register: Public Hearing The Texas Health and Human Services Commission (HHSC) will hold a public hearing on January 30, 2009, at 10:00 a.m. to receive public comment on the proposed interim per diem Medicaid reimbursement rate for small, state-operated Intermediate Care Facilities for Persons with Mental Retardation operated by DADS. The hearing will be held in the Piney Woods Conference Room of … [Read more...] about Texas Register Updates: Repeal of Fair Hearing Rules, Texas Medical Board Rule Changes
Information Letters: Co-Payment Chart Changes, Hurricane Ike Costs, Etc.
The Texas Department of Aging and Disability Services (DADS) released eight information letters: Effective December 1, 2008 -- Change in the Texas Administrative Code (TAC), Title 40, Chapter 44, Consumer Managed Personal Attendant Services (CMPAS), Relating to the Co-payment Chart DADS notified CMPAS providers about a TAC change, effective December 1, 2008. The change removes the previously attached co-payment chart from 40 TAC, Chapter 44 and replaces it with a statement to locate … [Read more...] about Information Letters: Co-Payment Chart Changes, Hurricane Ike Costs, Etc.
Congress Reauthorizes and Expands SCHIP
Earlier this week, the U.S. House of Representatives approved a bill that would reauthorize and expand the State Children's Health Insurance Program (SCHIP). The Kaiser Network reports that the measure passed by a vote of 289 to 139. Children from families with incomes of up to three times the federal poverty level would qualify for SCHIP, a move that likely would cover three million more children. Under the bill, SCHIP would be extended for four-and-a-half years and cost $57.3 million, a … [Read more...] about Congress Reauthorizes and Expands SCHIP
California Supreme Court Bars Balance Billing
Emergency department doctors and hospitals in California can no longer directly bill insured patients for charges HMOs refuse to pay. Last week, the state's highest court barred balance billing and contended that ER doctors and HMOs must iron out their disagreements. The responsibility should not fall on patients. (Source) In a press release, Governor Arnold Schwarzenegger wrote: "This ruling will protect Californians who have done the right thing by obtaining insurance, but then later … [Read more...] about California Supreme Court Bars Balance Billing
