The Texas Department of Aging and Disability Services has released HCSSA Houston Roundtable Questions and Answers, a table of questions and answers that resulted from two Regulatory Services staff meetings in Houston, Texas, last year. Topics include Licensing, Training, Coordination of Care, Survey Questions, Administrative Issues, OASIS, and General Questions. For more information, download the letter and 26-page Q&A table here. … [Read more...] about Provider Letter: HCSSA Houston Roundtable Q&A
Payment Reforms for Inpatient Hospital Services
In an effort to improve the accuracy of payment under the acute care hospital inpatient prospective payment system and give hospitals incentives to improve quality, the Centers for Medicare and Medicaid Services (CMS) proposed a new rule. From the press release: Medicare’s inpatient rates for operating expenses will increase by 3.3 percent in FY 2008 for those hospitals that report quality data to CMS. Overall, the proposed rule is estimated to increase payments to more than 3,500 acute … [Read more...] about Payment Reforms for Inpatient Hospital Services
States To Share $30 Million For Health Insurance Counseling
All 50 states, the District of Columbia, Puerto Rico, Guam, the Virgin Islands will share $30 million in grant money to provide health insurance counseling services to Medicare beneficiaries, according to the Centers for Medicare and Medicaid Services. The State Health Insurance Assistance Programs, or SHIPs, will help beneficiaries figure out which insurance coverage is best for them. The program should be quite helpful for Medicare Part D enrollees. Under SHIPs, counseling will be more … [Read more...] about States To Share $30 Million For Health Insurance Counseling
CMS Publishes Physician-Related Updates
The Centers for Medicare and Medicaid Services (CMS) has provided incentives for physicians to report quality data. As the process may be too expensive for smaller practices, CMS implemented a three-year pilot program that will pay 800 small- or medium-sized practices in Arkansas, California, Massachusetts, and Utah to report quality care data for Medicare patients with chronic conditions. I blogged about this program last year, though it may not be the same one discussed in this press … [Read more...] about CMS Publishes Physician-Related Updates
Texas Register: CCAD Age Requirement, ICM Program
The Texas Health and Human Services Commission (HHSC) has proposed a rule that will impose an age requirement for Community Care for Aged and Disabled (CCAD) services. Currently, there is no age requirement. In response to the settlement agreement in a case titled, Alberto N., et al, vs. Albert Hawkins and James Hine (PDF), HHSC will make available personal care services for people under 21. After this program goes into effect, the Texas Department of Aging and Disability Services will offer … [Read more...] about Texas Register: CCAD Age Requirement, ICM Program
Congress Debates Medicare Part D Drug Price Negotiating
Congressional discussions about the government negotiating Medicare Part D drug prices is ongoing. Although President George W. Bush has threatened to veto legislation allowing the government to negotiate prescription drug prices, lawmakers are moving forward. The House of Representatives passed a measure that would require the secretary of the Department of Health and Human Services to barter with drug companies over Medicare Part D drug prices. (UPI) The Senate version of the bill is … [Read more...] about Congress Debates Medicare Part D Drug Price Negotiating
Medicare Advantage Payment Rates To Increase
The Centers for Medicare and Medicaid Services (CMS) announced that payment rates for Medicare Advantage plans will increase by 3.5 percent in 2008. (CQ Health Beat News) Medicare Advantage plans offer beneficiaries the traditional fee-for-service program with the option to receive Medicare through private insurance plans like health maintenance organizations and preferred provider plans. CMS also announced updates to Medicare Part D. The new annual percentage increase used for updating … [Read more...] about Medicare Advantage Payment Rates To Increase
Provider Letters: STAR+PLUS, Monthly Service Fees Updates, Etc.
In a March 29 letter to Primary Home Care and Day Activity and Health Services providers, the Texas Department of Aging and Disability Services (DADS) wanted to make sure these providers were aware that they can bill DADS for PHC or DAHS services provided to consumers in counties covered by the STAR+PLUS program in rare cases. Consumers living in STAR+PLUS program coverage areas began receiving services from a Health Maintenance Organization on March 1. For more information, including what … [Read more...] about Provider Letters: STAR+PLUS, Monthly Service Fees Updates, Etc.
Funds for Kidney Patients Under Medicare Part D
Medicare Part D recipients who are qualified kidney dialysis patients will have extra assistance getting bone disease Medicare Part D prescription drugs. (Medical News Today) The American Kidney Fund (AKF) may give eligible patients up to $2,000 a year in drug assistance funds. These grants will help cover “donut hole†costs for recipients caught in the coverage gap. AKF CEO LaVerne A. Burton said, “Because they take so many prescription medications, many dialysis patients have … [Read more...] about Funds for Kidney Patients Under Medicare Part D
Provider Letters: DAHS Billing Policy, ICM, Etc.
In a provider letter to Day Activity and Health Services (DAHS) Providers dated March 30, the Texas Department of Aging and Disability Services (DADS) offered a clarification of the DAHS billing policy. An excerpt: 40 Texas Administrative Code, §49.41(c)(1)(A) states that “a provider agency is entitled to payment if the services are authorized by DHS (DADS) in writing...†The consumer’s case manager determines the number of units of service the consumer is authorized to receive, with … [Read more...] about Provider Letters: DAHS Billing Policy, ICM, Etc.
