A new Centers for Medicare & Medicaid Services (CMS) Press release details the proposed additional rule to address risk adjustment program for the 2018 benefit year. The rule would give payers the ability to receive 2018 risk adjustment payments by resolving legal contentions of the program’s operation and give CMS the ability to issue risk adjustment payments without interruptions for the current plan year. According to reports the risk adjustment payments also reimburse health insurers … [Read more...] about Proposed Rule for Permanent Risk Adjustment Program for 2018
New Web-based Licensure System – Texas Unified Licensure Information Portal (TULIP)
Provider Letter : PL 18-15 - Texas Unified License Information Portal (TULIP) is a new web-based licensure system designed specifically for licensed long-term care providers it will begin on Sept 4, 2018. All licensure applications will be electronic, including those for initial licenses, renewals and changes of ownership. The provider letter out lines important dates and information related to TULIP’s benefits and features, as well as instructions for making a successful transition to … [Read more...] about New Web-based Licensure System – Texas Unified Licensure Information Portal (TULIP)
Palliative Care and Hospice Education and Training Act goes to Senate For Approval, May Become Law
Palliative and hospice care can improve both the quality of care and quality of life for patients who are terminally ill and their families. Now the Senate has the decision to follow the U.S. House of Representatives, which has unanimously approved a bill that would help doctors and other healthcare professional elevate their skills in providing hospice and palliative care. The H.R.1676 - Palliative Care and Hospice Education and Training Act would also increase palliative care research and … [Read more...] about Palliative Care and Hospice Education and Training Act goes to Senate For Approval, May Become Law
New CMS payment system for skilled nursing facilities reimburses providers for care not volume
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?
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
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
