PACE: DADS alerted PACE providers to a procedural change for processing TMHP MN/LOC denials based on "Timer expired and form sent to Denial Inventory" or "Form was sent to Denial Inventory after 21 days expired." An excerpt: Since the reason for these MNLOC denials is lack of supporting documentation submitted by the provider, the Department of Aging and Disability Services has determined this Chapter 60 rule does not apply to these situations. Therefore, effective immediately, the MN/LOC … [Read more...] about IL/News Alerts: TMHP MN/LOC Denial Change
Texas Medicaid Chief on Supreme Court Decision
As we blogged last week, Government Rick Perry went on record to say Texas will not expand Medicaid to accommodate the Affordable Care Act. He also said the state won't set up insurance exchanges. Bill Millwee, the director of the Texas Medicaid and Children's Health Insurance programs, agreed that the new law will be financially difficult for the state, as uninsured individuals not enrolled in Medicaid are required enroll in some kind of coverage by 2014. Millwee, who is retiring in August, … [Read more...] about Texas Medicaid Chief on Supreme Court Decision
TX Register Updates: Continuing Ed for Tick-borne Disease Treatment
The following information was obtained from the July 13 issue of the Texas Register: Public Notices The Texas Medical Board adopted new 22 TAC §§198.1 - 198.3 in the June 29, 2012, issue of the Texas Register (37 TexReg 4929). On page 4929, the name of the chapter, "Unlicensed Practice," is incorrect and reflects the old topic of Chapter 198 rules. The correct name of the new chapter is "Standards for Use of Investigational Agents." HHSC intends to submit transmittal number 12-028 to the … [Read more...] about TX Register Updates: Continuing Ed for Tick-borne Disease Treatment
Gov. Rick Perry: No Obamacare In Texas
Rick Perry: No Obamacare In Texas Governor Rick Perry, an opponent of the Affordable Care Act, said he will not expand Medicaid to implement the new law nor set up state insurance exchanges. An excerpt: "I will not be party to socializing healthcare and bankrupting my state in direct contradiction to our Constitution and our founding principles of limited government. "I stand proudly with the growing chorus of governors who reject the Obamacare power grab. Neither a "state" exchange nor … [Read more...] about Gov. Rick Perry: No Obamacare In Texas
PL/News Alerts: Alzheimer’s, July 11 Seminar
ALF: DADS clarified the requirements for using locking devices in Alzheimer's facilities or an Alzheimer's unit. An excerpt: The ALF licensing rule at 40 TAC §92.61(b)(4)(A) requires small Type A & B ALF and large Type A ALF buildings and structures to be in compliance with the 1988 edition of the Life Safety Code, National Fire Protection Association (NFPA) 101, Chapter 21 for Residential Board and Care Occupancies. The following directives must be met for small Type A and B ALFs and … [Read more...] about PL/News Alerts: Alzheimer’s, July 11 Seminar
TX Register Updates: Medicaid Hearings, NF License Changes
The following information was obtained from in the July 6 issue of the Texas Register. Public Hearings On July 23, 2012, at 1:30 p.m., HHSC will hold a public hearing to receive comments on proposed amendments to the administrative rule at 1 TAC §355.8052, which governs the payment methodology for Medicaid inpatient hospital reimbursement. On August 15, 2012, at 1:30 p.m., HHSC will hold a public hearing to receive comment on proposed Medicaid payment rates for Computed Tomography and … [Read more...] about TX Register Updates: Medicaid Hearings, NF License Changes
ILs: Revised Form 3071, Claims Billing Closeout
DADS released four information letters. HCS, TxHmL, CLASS, DBMD, ICF/ID, and Local Authorities: DADS providers should no longer refer individuals already employed and want assistance with job maintenance to the DARS, DRS, or DBS, effective the date of the letter. Provider should seek approval through the individual's service plan to provide SE or other services needed to maintain an individual's employment. Medicaid Hospice: Effective July 1, 2012, hospice providers must use the … [Read more...] about ILs: Revised Form 3071, Claims Billing Closeout
TX Register Updates: July 18 Hearings, DAHS Changes
The following information was obtained from the July 29 issue of the Texas Register. Public Hearings HHSC will hold a public hearing on July 18, 2012, at 1 p.m. to receive comment on proposed payment rates DAHS in the CBA and MDCP waiver programs. At 2 p.m., HHSC will hear public comment on proposed rates under foster care redesign for Single Source Continuum Contractors that provide services in the 24-Hour Residential Child Care program. The hearings will be held in the Lone Star … [Read more...] about TX Register Updates: July 18 Hearings, DAHS Changes
Kaiser Webcast, Supreme Court Aftermath
Kaiser News Network posted a video webcast about the U.S. Supreme Court's decision to uphold the health care reform law. What does the court decision mean for Texas? From the Texas Tribune: In the wake of Thursday's U.S. Supreme Court ruling upholding federal health reform, Texas has two big choices to make: whether to accept federal funds to expand Medicaid, and whether to roll out a consumer marketplace for comparing and purchasing insurance coverage. While the Supreme Court found the … [Read more...] about Kaiser Webcast, Supreme Court Aftermath
Individual Mandate Survives as Tax
The U.S. Supreme Court has upheld the Affordable Care Act and ruled the law's most controversial portion, the individual mandate, unconstitutional. The Obama administration created the individual mandate as a fine to be imposed on individuals who didn't have health insurance. The court held this requirement unconstitutional, but artfully contended that the government has the power to tax individuals. In that regard, the mandate survives as a tax. "Because the Constitution permits such a tax, … [Read more...] about Individual Mandate Survives as Tax
