CMS new Patient-Driven Payment Model (PDPM) will be implemented on Oct. 1, 2019. CMS finalized the Patient-Driven Payment Model for skilled nursing facilities (SNF), which will link Medicare payments to value and care, rather than volume/ fee-for-service care. The rule according to news reports “would reduce documentation standards around patient assessments, saving facilities approximately $2 billion over 10 years," and would "give a $975 million collective raise next year to post-acute care … [Read more...] about New CMS payment system for skilled nursing facilities reimburses providers for care not volume
Trump Signs Electronic Visit Verification (EVV) Into Law
With no opposition from the House or Senate, the U.S. Senate unanimously approved legislation of the H.R.6042 bill delay the nationwide deadline for electronic visit verification (EVV) or ( in-home health service bill) in Medicaid-reimbursed personal care services until 2020. President Donald Trump signed Rep. Brett Guthrie’s health care bill into law on July 30th. According to news reports, the 21st Century Cures Act, initially signed into law in 2016 under the Obama Administration, … [Read more...] about Trump Signs Electronic Visit Verification (EVV) Into Law
Three Federal Health Privacy Rules including HIPPA to be reformed by HHS
U.S. Health Insurance Portability and Accountability Act of 1996 (HIPAA) laws let providers share certain private information with patient family members and outside groups in emergencies; and now the U.S. Department of Health and Human Services (HHS) secretary Alex Azar confirmed that HHS will undertake an effort to reform federal health privacy rules, stating that "In the coming months, under the leadership of my deputy secretary, Eric Hargan, HHS will be releasing requests for information … [Read more...] about Three Federal Health Privacy Rules including HIPPA to be reformed by HHS
HHS facesbbacklash & concerns over proposed changes by the Trump administration to Title X Program
The U.S. Department of Health and Human Services (HHS) and the Trump administration published a series of proposed changes to the regulations governing the Title X family planning program. Title X, enacted in 1970, is the only federal grant program dedicated solely to providing individuals with comprehensive family planning and related preventive health services gives access to fundamental health care possible for 4 million low-income, uninsured, and underserved Americans each … [Read more...] about HHS facesbbacklash & concerns over proposed changes by the Trump administration to Title X Program
Who has the greatest impact on high healthcare costs?
In a new NEJM Catalyst Buzz Survey, the question of who is the biggest driver of high healthcare costs brings physicians, healthplans, pharmacuetical & bio-tech companies under scrutiny. Doctors who have been blamed for the inflated cost of US healthcare due to expensive recommendations or overtreating patients have maintained that even though the discussion needs to be had with patients about healthcare costs, they have no power to determine the price of a drug or new healthcare … [Read more...] about Who has the greatest impact on high healthcare costs?
Annual Mandatory Training for Assisted Living Facility Manager
Long-Term Care Regulatory Provider Letter PL 18-12 (ALF) - Texas Health and Safety Code, Section 247.066(h) directs the Health and Human Services Commission (HHSC), to require that facility managers complete an annual training on aging in place and retaliation. The ALF rule is found at Texas Administrative Code, Title 40, Part 1, §92.41(f)(6). HHSC has developed a web-based training that meets this requirement. The creation of this course was required by House Bill (HB) 2109, … [Read more...] about Annual Mandatory Training for Assisted Living Facility Manager
Technical Memoranda (TM) concerning prescribed Life Safety Code (LSC) standards for ALFs
Provider Letter 18-11 - Technical Memoranda (TM) concerning prescribed Life Safety Code (LSC) standards for ALFs to be responsible for reviewing the LSC TM and complying with the guidance provided therein. The LSC is a set of fire protection requirements designed to provide a reasonable degree of safety at Assisted Living Facilities. It covers construction, protection, and operational features designed to provide safety from fire, smoke, and panic. According to the letter and 2.0 Policy … [Read more...] about Technical Memoranda (TM) concerning prescribed Life Safety Code (LSC) standards for ALFs
PPAT Notice-Proposed Changes to the ICF/IID Administrative Penalties Rules
HHSC published the proposed changes mandated by House Bill (H.B.) 2025 to the ICF/IID rules which calls for changes to rules governing administrative penalties, license terms and related policies in various programs including the ICF/IID program, DAHS, ALFs, NFs and Pediatric Extended Care Facilities. HB 2025 is the act relating to the regulation of certain long-term care facilities, including facilities that provide care to persons with Alzheimer ’s disease or related disorders; authorizing an … [Read more...] about PPAT Notice-Proposed Changes to the ICF/IID Administrative Penalties Rules
Preparing for the Upcoming Fiscal Year 2018 Fee-for-Service Claims Billing Closeout
Information Letter No. 18-06 : This letter addresses preparation for the August 31, 2018, end of fiscal year closeout. Providers must promptly submit claims to be paid by the Health and Human Services Commission (HHSC) for any unbilled services. Any problems associated with the claims are resolved within the 12-month filing limitation. The letter directly addresses the following: Adult Foster Care Providers Assisted Living Facilities Community Attendant Services Providers Community … [Read more...] about Preparing for the Upcoming Fiscal Year 2018 Fee-for-Service Claims Billing Closeout
Guidelines Regarding Plans of Correction Associated with a PASRR Violation
Provider Letter 18-09 (NF) - This letter addressed Long-Term Care Regulations by HHSC. Nursing facilities (NFs) must comply with both state and federal requirements related to Preadmission Screening and Resident Review (PASRR). This includes coordinating Level I screening and Level II evaluation assessments, participating in interdisciplinary team meetings (IDTs), and providing necessary specialized services for individuals with intellectual disabilities (ID), developmental disabilities (DD) or … [Read more...] about Guidelines Regarding Plans of Correction Associated with a PASRR Violation
