TEXAS STATE MEDICAID FRAUD CONTROL UNIT: 2013 ONSITE REVIEW OIG oversees the activities of all Medicaid Fraud Control Units (MFCUs or Units). As part of this oversight, OIG conducts periodic reviews of all Units and prepares public reports based on these reviews. The reviews assess Unit performance in accordance with the 12 MFCU performance standards and monitor Unit compliance with Federal grant requirements. For fiscal years (FYs) 2010 through 2012, the Texas Unit reported recoveries of … [Read more...] about TEXAS STATE MEDICAID FRAUD CONTROL UNIT: 2013 ONSITE REVIEW
OK Hospice facing fraud counts
An Oklahoma hospice and two of its managers are facing fraud charges and possible prison time for Medicare fraud. The two administrators are charged with 39 counts of Medicare fraud, and the hospice is “accused of concealing the true medical conditions of hospice patients in order to pass a Medicare audit and obtain federal money.” (KFOR-TV, 4/17, kfor.com/2014/04/17/hospice-managers-charged-with-medicare-fraud-for-falsifying-records/) … [Read more...] about OK Hospice facing fraud counts
Employee Misconduct Registry
DADS will be proposing changes to 40 Texas Administrative Code (TAC) Chapter 93 Employee Misconduct Registry. The proposed changes are the result of House Bill 2683 which addresses individuals who utilize Consumer Directed Services and the proposed 40 TAC Chapter 15 Prescribed Pediatric Extended Care Facilities (PPECC). DADS is seeking stakeholder input on a set of draft rules. Hospice providers are required to comply with Chapter 93 as referenced under Chapter 97 Home and … [Read more...] about Employee Misconduct Registry
Upcoming DADS region 4/5 meetings
DADS issued the following Two Provider Alerts or Bulletins: Region 4/5 HCSSA Provider Meeting in Lufkin THIS MEETING IS LIMITED TO PROVIDERS LOCATED IN REGION 4/5 The meeting for Region 4/5 is on Wednesday, May 21, 2014 from 1 p.m. - 4 p.m at: Angelina College. Room 104. 3500 South 1st Street. Lufkin, TX 75902 To register: https://www.surveymonkey.com/s/2014LufkinHCSSA Region 4/5 HCSSA Provider Meeting in Tyler THIS MEETING IS LIMITED TO PROVIDERS LOCATED IN REGION 4/5 … [Read more...] about Upcoming DADS region 4/5 meetings
Proposed HHSC amendments seek to update Medicaid reimbursement
PART 15. TEXAS HEALTH AND HUMAN SERVICES COMMISSION CHAPTER 355. REIMBURSEMENT RATES. HHSC proposes to amend §355.7001, concerning Reimbursement Methodology for Telemedicine and §355.8085, concerning Reimbursement Methodology for Physicians; and proposes the repeal of §355.8081, concerning Reimbursement Methodology for Laboratory and X-ray Services, Radiation Therapy, Physical Therapists' Services, Physician Services, Podiatry Services, Chiropractic Services, Optometric Services, Ambulance … [Read more...] about Proposed HHSC amendments seek to update Medicaid reimbursement
CMS proposes adoption of updated Life Safety Code
CMS proposes adoption of updated Life Safety Code CMS announced a proposed rule on the adoption of updated life safety code (LSC) that CMS would use in its ongoing work to ensure the health and safety of all patients, family and staff in every provider and supplier setting. The updated code contains new provisions that are vital to the health and safety of all patients and staff -- CMS intends to adopt the National Fire Protection Association’s (NFPA) 2012 editions of the (LSC) and the … [Read more...] about CMS proposes adoption of updated Life Safety Code
1 TAC §354.1060 proposed amendment – billing for substitute physicians
Texas Health and Human Services Commission (HHSC) proposes to amend §354.1060 concerning Authorized Physician Services. HHSC proposes to amend §354.1060 and §354.1062 to comply with the federal Medicaid statute by clarifying the timeframes related to when a physician may bill for services performed by a substitute physician. A substitute physician provides services in place of another physician under either a reciprocal or locum tenens arrangement. In addition, the proposed amendments … [Read more...] about 1 TAC §354.1060 proposed amendment – billing for substitute physicians
Hospice quality data reporting starts in July of 2014.
Hospice quality data reporting starts in July of 2014. A new federal “system of records” database will collect quality data from hospice organizations. Collection of data is required under the ACA. For more information on the Hospice Item Set System, see the article on Health Data Management. Details appeared in The Federal Register on 4/8. (Health Data Management, 4/7, www.healthdatamanagement.com/news/Hospice-Quality-Data-Reporting-Starts-in-July-2014-47749-1.html; The Federal Register, … [Read more...] about Hospice quality data reporting starts in July of 2014.
DADS Budget Video Conference on 4/17 @ 3:00
Budget Video Conference April 17 at 3 p.m. Do you have a suggestion for what DADS should include in its budget request to the Legislature? If so, you can present your ideas at the Texas Department of Aging and Disability Service's (DADS) budget video conference at 3 p.m. (Central time) April 17. Please visit the DADS website for more information. … [Read more...] about DADS Budget Video Conference on 4/17 @ 3:00
DADS Recruiting New PIAC Members
DADS is currently accepting applications to become a member of the Promoting Independence Advisory Committee (PIAC). The deadline is May 1. DADS and HHSC are accepting applications for PIAC members from: - Advocates for individuals with disabilities, - Advocates for people with intellectual or developmental disabilities (IDD) or their family members - Home health care providers - IDD service providers - Nursing home providers For more information visit http://www.dads.state.tx.us … [Read more...] about DADS Recruiting New PIAC Members
