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Information Letters: Transfer Process, Cost Ceiling Adjustment, and Retroactive Payment Procedures

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In a July 30 letter to Home and Community-Based Services (HCS) Providers, the Texas Department Aging and Disability Services notified them about the process and forms to be used for transferring individuals receiving services in the HCS program. Attached to the letter is a four-page document outlining the process, which you may download here. In a July 31 information letter, DADS notified Deaf-Blind with Multiple Disabilities Program Providers about a cost ceiling adjustment for Intermediate … [Read more...] about Information Letters: Transfer Process, Cost Ceiling Adjustment, and Retroactive Payment Procedures

Medicare News: Anemia Treatment, Off-Label Use Issue

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Earlier this week, the Centers for Medicare and Medicaid Services (CMS) announced that it will limit Medicare coverage for anemia medications in cancer patients. CMS will cover medications to treat anemia caused by chemotherapy but won’t cover medications for anemia caused by cancer. (Kaiser Network) Roger M. Perlmutter, a physician and spokesman for the drug company Amgen said, "The coverage restrictions placed on the FDA-approved indication have no scientific basis and are incompatible … [Read more...] about Medicare News: Anemia Treatment, Off-Label Use Issue

CMS To Increase Medicare Payments for Skilled Nursing Care

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The Centers for Medicare and Medicaid Services (CMS) announced an increase in Medicare payments for beneficiaries using skilled nursing facility care for fiscal year 2008. (Source) The 3.3 percent increase translates into about $690 million for beneficiaries recovering from “serious health problems” who need skilled nursing and rehabilitation care. Acting CMS Administrator Herb Kuhn said, "These new payment rates reflect our commitment to improving the quality of care in the long-term … [Read more...] about CMS To Increase Medicare Payments for Skilled Nursing Care

Texas Register Updates: Public Hearing and Intent to Submit Notices

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The Texas Department of Health and Human Services (HHSC) issued a correction to a notice of a public hearing on proposed Medicaid payment rates for Home and Community-based Services and Texas Home Living waiver programs, which appeared in the July 20 Texas Register. The hearing date has been changed from August 7, 2007, at 9:00 a.m. to August 14, 2007, at 3:30 p.m. The scope of the hearing has been expanded to include proposed rates for the Consolidated Waiver Program - Supported Employment, … [Read more...] about Texas Register Updates: Public Hearing and Intent to Submit Notices

Information Letters: Verification of Nurse Licensure, Calculation Error, and New Retro Rate Adjustment

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In a letter dated July 19, the Texas Department of Aging and Disability Services (DADS) informed Nursing Facilities, Community Based Alternatives, Home and Community Support Services Agencies, Hospice Providers, Program of All Inclusive Care for the Elderly Providers, and Consolidated Waiver Program Providers that beginning August 12, the Texas Medicaid & Healthcare Partnership (TMHP) will verify nurse licensure with the Texas Board of Nursing (TBON) for both the Director of Nurses (DON) and … [Read more...] about Information Letters: Verification of Nurse Licensure, Calculation Error, and New Retro Rate Adjustment

House Blocks Medicare Inpatient Hospital Reimbursement Reduction

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Last week, the U.S. House of Representatives approved an amendment to block a rule proposed by the Centers for Medicare and Medicaid Services (CMS) that would have reduced Medicare inpatient hospital reimbursements in FY 2008 by 2.4 percent. (Kaiser Network) CMS apparently anticipates that hospitals will bill Medicare for services that reimburse at higher rates "in response to changes that would link payments with the severity of the illnesses of patients." The proposed rule to reduce … [Read more...] about House Blocks Medicare Inpatient Hospital Reimbursement Reduction

Texas Register Updates: Mental Retardation Authority Rules, Survey Process

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The Texas Health and Human Services Commission (HHSC) proposed amendments to §§2.101 - 2.103 and 2.105 - 2.112, and the repeal of §§2.104 and 2.113 - 2.115, Chapter 2, Mental Retardation Authority Responsibilities, Subchapter C, Charges for Community Services. From the Texas Register: Because they originated at the Texas Department of Mental Health and Mental Retardation, the rules in Chapter 2, Subchapter C, currently contain references to both mental health and mental retardation … [Read more...] about Texas Register Updates: Mental Retardation Authority Rules, Survey Process

Information Letters: Claims Processing Changes, Avoiding Misc. Claims

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In a letter dated July 16, the Department of Aging and Disability Services (DADS) informed Nursing Facilities about procedural changes in the Provider Claims Service Unit. It will now take 7-10 business days to process requests, whether the request has been submitted by telephone or e-mail. For more information, download the letter here. In a letter dated July 17, DADS reminded Nursing Facilities, Community Services Providers, Therapy Providers, and ICF/MR Service Groups 5 & 6 Providers to … [Read more...] about Information Letters: Claims Processing Changes, Avoiding Misc. Claims

Information Letters: PMAB Training, Promoting Independence Initiative, Etc.

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In a letter dated July 6, the Department of Aging and Disability Services (DADS) informed Home and Community-based Services Program Providers, Texas Home Living Program Providers, and Executive Directors of Mental Retardation Authorities that the Prevention and Management of Aggressive Behavior (PMAB) training curriculum owned by the state of Texas is not available to train employees of private providers. PMAB training is available for personnel working on state mental retardation facilities … [Read more...] about Information Letters: PMAB Training, Promoting Independence Initiative, Etc.