The following information was obtained from the December 12 issue of the Texas Register: The Texas Health and Human Services Commission (HHSC) intends to submit an amendment to the Texas State Plan for Medical Assistance, under Title XIX of the Social Security Act, which would comply with the Centers for Medicaid and Medicare Services final rule to further align the Medicaid definition of "outpatient services" to the Medicare definition. For information on obtaining a copy of the proposed … [Read more...] about Texas Register Updates: Outpatient Services Rule Alignment
Medicare News: MedPAC and Part D
The Medicare Payment Advisory Commission (MedPAC) has recommended that hospitals receive full market basket Medicare payment increases in fiscal year 2010. (Kaiser Network) Among the proposals is a 1.6 percent payment increase recommendation for long term care hospitals based on quality of care delivered. A final vote will come in January. MedPAC advises Congress on Medicare issues. In other Medicare news, Kaiser reports that close to 133,000 beneficiaries in Tennessee have not taken … [Read more...] about Medicare News: MedPAC and Part D
DADS Alerts: CMS Revises Hospice Conditions of Participation; Christmas Schedule
The Centers for Medicare and Medicaid Services recently revised the existing Hospice Conditions of Participation. Effective December 2, 2008, hospices must meet the revised conditions of participation (CoPs), found at 42 Code of Federal Regulations, Part 418, to participate in Medicare and Medicaid programs. Download a PDF copy of the revised CoPs. For more information, see alert #306. Please see the DADS alert about its Christmas/New Year Processing Schedule. DADS staff will conduct … [Read more...] about DADS Alerts: CMS Revises Hospice Conditions of Participation; Christmas Schedule
Information Letters: Ventilators and Tracheostomies Reimbursements, Etc.
The Department of Aging and Disability Services (DADS) released seven information letters: DADS Supplemental Reimbursement for Ventilators and Tracheostomies In a letter to Nursing Facility (NF) providers, DADS reminded them about the reimbursement rules at Texas Administrative Code, Title 1, Part 15, Chapter 355, §355.307(b)(3)(F) and(G), which states that qualifying ventilator-dependent residents and qualifying children with tracheostomies requiring daily care may receive a … [Read more...] about Information Letters: Ventilators and Tracheostomies Reimbursements, Etc.
HCS & TxHML Providers–access to Child Abuse & Neglect Reporting System (Screen employees)
DADS is making Client Abuse and Neglect Reporting System (CANRS) available to HCS and TxHmL providers to allow providers to conduct pre-employment screenings of employees in order to find confirmed allegations of abuse, neglect and exploitation while employed at State Schools, State Hospitals, and State Centers.†The provider letter gives instructions on how such providers may gain access to this database. Providers will be able to simply enter the social security number of a potential (or … [Read more...] about HCS & TxHML Providers–access to Child Abuse & Neglect Reporting System (Screen employees)
Texas Register Updates: Hearing Aid Services Changes, Etc.
The following information was obtained from the November 28 issue of the Texas Register: Adopted Rules The Texas Health and Human Services Commission (HHSC) adopted amendments to §354.1231, Benefits and Limitations; §354.1233, Requirements for Hearing Aid Services; and §354.1235, Requirements for Provider Participation, in Title 1, Part 15. The new rules better align Medicaid rules with current hearing aid technology and standards of care and clarify the rule content. See the relevant … [Read more...] about Texas Register Updates: Hearing Aid Services Changes, Etc.
Higher Co-pays for Medicaid Beneficiaries; Doctors May Drop Vaccinations
President George W. Bush implemented a new Medicaid law in 2006 that will allow states to charge premiums and higher co-payments to Medicaid beneficiaries. (Kaiser Network) Close to 13 million beneficiaries will be faced with paying new or higher co-pays. Consequently, some of these beneficiaries will delay certain care or avoid care. Under the new law, Medicaid is expected to save $1.4 billion for the federal government and $1.1 billion for the states over five years. An excerpt: The … [Read more...] about Higher Co-pays for Medicaid Beneficiaries; Doctors May Drop Vaccinations
Texas Register Updates: Pilot Program Rules, RFP
The following information was found in the November 21 issue of the Texas Register: Adopted Rules The Texas Health and Human Services Commission (HHSC) adopted new §§2.301 - 2.303, 2.305, 2.307, 2.309, 2.311, 2.313, and 2.315, and the repeal of §§2.351 - 2.373, in Chapter 2, Mental Retardation Authority Responsibilities, to establish rules governing the role and responsibilities of a mental retardation authority. HHSC also adopted new §§16.1 - 16.4 in Chapter 16, Pilot Program to … [Read more...] about Texas Register Updates: Pilot Program Rules, RFP
Information and Provider Letters: Change in Look-Back Periods, Etc.
The Texas Department of Aging and Disability Services (DADS) issued one provider and three information letters: Community Services Medical Necessity (MN) and Level of Care Assessment (LOC) -- Resource Utilization Group Value "BC1" DADS notified Home and Community Support Services Agencies for Community-Based Alternatives, Consolidated Waiver Program, Integrated Care Management, and Program for the All Inclusive Care for the Elderly that it implemented a recent change in look-back … [Read more...] about Information and Provider Letters: Change in Look-Back Periods, Etc.
Medicaid Pays for Unapproved Drugs; Errors in Eligibility System
From 2004 to 2007, Medicaid paid almost $198 million for over 100 unapproved prescription drugs. (Source) Although the drugs have been on the market for decades, they haven't been assessed by the Food and Drug Administration (FDA) for safety or effectiveness. About two percent of drugs sold in the United States have not been approved by the FDA. The agency developed tighter restrictions on drugs in the 1960s. Critics say the FDA must compile a complete list of unapproved drugs, so that … [Read more...] about Medicaid Pays for Unapproved Drugs; Errors in Eligibility System
