DADS released three information and two provider letters. NF, Hospice, and ICF/IID: DADS provided billing guidelines to providers for the final implementation of the Cost Avoidance Project, effective February 22, 2013. An excerpt: Because the February 22, 2013, Cost Avoidance Project implementation date falls within the month of February, providers are encouraged to separate claims for dates of service before and after February 22, 2013. Claims with dates of service prior to February 22, … [Read more...] about ILs/PLs: Cost Avoidance Project, DPS
TX Register Updates: PASRR Changes
The following information was obtained from the February 22 issue of the Texas Register. Proposed Rules HHSC proposed to amend §355.310, Reimbursement Setting Methodology--Customized Power Wheelchairs and Associated Evaluations, and new §355.748, Reimbursement Methodology for Preadmission Screening and Resident Review (PASRR) Level II Evaluations. An excerpt: The proposed changes to the PASRR program are a result of a Centers for Medicare and Medicaid Services (CMS) directive for the … [Read more...] about TX Register Updates: PASRR Changes
News Alerts/Medicaid Expansion
-- DADS updated the following information on the DADS Nursing Services web page. -- CMS staff clarified that contact precautions for influenza do NOT warrant coding in Item O0100M on the MDS. -- The State Supported Living Centers division is inviting comments on draft revised Policy #007, Psychiatry Services. Send your comments to Eric Moorad, Policy/Rules Coordinator, at eric.moorad@dads.state.tx.us or via fax at 512-438-4605 by close of business Friday, March 15, 2013. See the news … [Read more...] about News Alerts/Medicaid Expansion
House and Senate Bills: Medical Board, STAR + PLUS
The following recently introduced House and Senate bills could affect long term care providers: HB 1406: Relating to the disclosure of the calculation of out-of-network payments by the issuers of preferred provider benefit plans and by health maintenance organizations. HB 1389: Relating to clinical initiatives to improve the quality of care and cost-effectiveness of the Medicaid program. HB 1389: Relating to clinical initiatives to improve the quality of care and cost-effectiveness of … [Read more...] about House and Senate Bills: Medical Board, STAR + PLUS
ILs and News Alerts: PASRR Changes, Medicaid Buy-In
Pre-Admission Screening and Resident Review Process Changing: Local Authorities NF Administrators, MDS Coordinators, and Directors of Nursing -- DADS has modified CLASS Form 3621 and Form 3621-R. See the forms page for more information. -- DADS announced that it's now easier to apply for the Medicaid Buy-In. Download the application in PDF for more information. -- DADS has updated information on its Nursing Services web page for the LVN On-Call Operational Protocol. -- DADS … [Read more...] about ILs and News Alerts: PASRR Changes, Medicaid Buy-In
TX Register Updates: Board of Nursing Changes
The following information was obtained from the February 15 issue of the Texas Register. Proposed Rules The Texas Board of Nursing proposed an amendment to §211.7, Executive Director, which would reduce the volume of requests that must be heard by the Eligibility and Disciplinary Committee of the Board and reduce and/or eliminate the amount of time that individuals must wait to have their matters heard and decided by the Committee. The board also proposed to amend §220.2, Issuance of a … [Read more...] about TX Register Updates: Board of Nursing Changes
House and Senate Bills: STAR + PLUS, PPACA
The following recently introduced House and Senate bills could affect long term care providers: HB 1137: Relating to the use of maximum allowable cost lists under a Medicaid managed care pharmacy benefit plan. HB 1112: Relating to state assistance for certain county health care expenditures. HB 1088: Relating to consumer protection provisions applicable to Medicaid managed care contracts. HB 1066: Relating to a review process for managed care organizations participating in the STAR + … [Read more...] about House and Senate Bills: STAR + PLUS, PPACA
DADS News Alerts: MDS 3.0 Clarification, MDCP Waiver Renewal
-- An excerpt: This revised alert replaces the "Minimum Data Set (MDS) 3.0 Item A0410 Clarification" alert. On a Jan. 15, 2013 national conference call, the Centers for Medicare & Medicaid Services (CMS) staff reiterated that MDS 3.0 item A0410 must be coded correctly. Coding instructions for item A0410 are on page A-9 of the MDS 3.0 RAI Manual. In all states, item A0410 must be set to "3" (federal required submission) when a resident is in a Medicare or Medicaid certified bed, … [Read more...] about DADS News Alerts: MDS 3.0 Clarification, MDCP Waiver Renewal
TX Register Updates: 2/13 Hearing, Potentially Preventable Events
The following information was obtained from the February 8 issue of the Texas Register. Public Hearing and Notice HHSC will hold a public hearing on Wednesday, February 13, 2013, at 1:30 p.m., to receive comment on proposed Medicaid payment rates for Outpatient Behavioral Health Services. The public hearing will be held in the Lone Star Conference Room. HHSC intends to submit transmittal number 13-002 to the Texas State Plan for Medical Assistance, which would remove outdated … [Read more...] about TX Register Updates: 2/13 Hearing, Potentially Preventable Events
Bills and Provider Bundled Payments
The following recently introduced House and Senate bills could affect long term care providers: HB 913: Relating to licensing and regulation of certain facilities providing personal care to persons who are elderly or disabled. HB 914: Relating to reimbursement rates for certain therapy services provided to Medicaid recipients. HB 909: Relating to the personal needs allowance for certain Medicaid recipients who are residents of long-term care facilities. SB 337: Relating to … [Read more...] about Bills and Provider Bundled Payments
