Many nursing homes have hired Certified Nurse Aides with criminal histories legally. Using data from the federal Centers for Medicare and Medicaid Services, it has been discovered that the patient abuse rate in Texas nursing homes is nearly four times the national average. 25% of the state's 1,200 long-term care centers have been cited for serious standard deficiencies- According to reports by the AARPIn Texas, there are many nurse aides in nursing facilities that have criminal … [Read more...] about Abuse & poor quality care rate in Texas nursing homes is nearly four times the national average
(CMS) requires that Medicare-certified home health agencies (HHAs) meet the Medicare Conditions of Participation (CoPs)
Provider Letter 17-35 DADS released the latest Provider Letter 17-35 – Determination of Separate Entities which replaces PL 01-46 & PL 02-05 for Medicare Certified Home and Community Support Service Agencies. The letter details that the Centers for Medicare and Medicaid Services (CMS) requires that Medicare-certified home health agencies (HHAs) meet the Medicare Conditions of Participation (CoPs) for all clients being served by the agency, regardless of a client’s payment source. The … [Read more...] about (CMS) requires that Medicare-certified home health agencies (HHAs) meet the Medicare Conditions of Participation (CoPs)
Participant Surveys in the DBMD Program Receiving Licensed Assisted Living
Information Letter No. 17-24 DADS has published its latest information letter directed to Deaf Blind with Multiple Disabilities (DBMD) Program Providers. The letter outlines the Texas Health and Human Services Commission requirements for the DBMD program providers to perform certain activities related to participant surveys in the DBMD Program and to complete a provider survey. HHSC will schedule face-to-face visits with these people to survey them about the services they receive and their … [Read more...] about Participant Surveys in the DBMD Program Receiving Licensed Assisted Living
Amended ICF rules for Individuals with an Intellectual Disability or Related Conditions
HHSC has adopted amendments regarding a change of ownership in 40 TAC Chapter 90, Intermediate Care Facilities for Individuals with an Intellectual Disabitlity or Related Conditions, that went into effect on October 11, 2017. The adopted rules:Revise requirements related to a change of ownership of a license holder for an intermediate care facility for individuals with an intellectual disability or related conditions (ICF/IID);require a license holder that does not undergo a change of ownership … [Read more...] about Amended ICF rules for Individuals with an Intellectual Disability or Related Conditions
Changes to HCS Handbook Regarding Results of Residential Visit
Information Letter No. 17-23 – The Texas Health and Human Services Commission (HHSC) is making changes to the HCS Handbook, Section 14411. The handbook revisions pertain to results from a residential visit described in rule at Title 40, Texas Administrative Code, §9.171(j).The changes will explain how a score from a residential visit is calculated• Clarify when evidence of correction is required after a residential visit• Clarify when HHSC takes follow-up action after a residential visit• … [Read more...] about Changes to HCS Handbook Regarding Results of Residential Visit
HHSC Requires Providers to Immediately Redo all Nurse Aide Registry Status Searches
Provider Letter No. 17-24 All Providers who used the Nurse Aide Registry(NAR) from June 14, 2017, through August 3, 2017 are now required by HHSC to recheck the status searches due to an error by contractor Pearson Vue which placed ineligible nurse aides on “Active” status and mailed these ineligible individuals an invalid certificate. This error also caused 50 inaccurate event-based emails to be sent to 19 individual candidates. If a search result now shows that a nurse aide is not in … [Read more...] about HHSC Requires Providers to Immediately Redo all Nurse Aide Registry Status Searches
Billing for Preadmission Screening and Resident Review Assessments and Services
Information Letter No. 17-20 - Addressed to Nursing Facility Providers on how to bill for Therapies, Customized Manual Wheel Chairs (CMWC) and Durable Medical Equipment (DME) reimbursed through the Preadmission Screening and Resident Review (PASRR) program at HHSC. Nursing facility providers must review the resident’s Medicaid Eligibility and Service Authorization Verification (MESAV) to verify a service authorization has beencreated and to determine which service code was used. Nursing facility … [Read more...] about Billing for Preadmission Screening and Resident Review Assessments and Services
Temporary Extension of Medicaid for Certain Intellectual Developmental Disability Waiver Program Recipients
Information Letter No. 17-19DADS has published the latest information letter regarding Temporary Extension of Medicaid for Certain Intellectual Developmental Disability Waiver Program Recipients Who Lose Supplemental Security Income and Medicaid. With a denial of SSI, Medicaid is automatically ended. This letter is for informational purposes regarding a process change affecting certain individuals receiving waiver services and does not affect the providers’ or local intellectual developmental … [Read more...] about Temporary Extension of Medicaid for Certain Intellectual Developmental Disability Waiver Program Recipients
Fiscal Year 2017 Cutoff Dates for Fee-for-Service Year-end Closeout Processing
Information Letter No. 17-17This is a reminder that, with the fiscal year change, any claims for services performed in fiscal year 2015 (September 1, 2014 to August 31, 2015) that TMHP receives after Noon, Tuesday, August 8, 2017, will become miscellaneous claims and cannot be paid through the standard Claims Management System payment process. Fiscal Year 2015 Miscellaneous Fee-for-Service (FFS) Claims Cutoff:Noon, Tuesday, August 8, 2017Fiscal Year 2017 FFS Claims Processing Cutoff: Noon, … [Read more...] about Fiscal Year 2017 Cutoff Dates for Fee-for-Service Year-end Closeout Processing
Updated Preferred Provider Arrangement for All Managed Care Organizations
MCO Preferred Provider Memorandum In the latest memo update for all managed care organization starting in Fiscal year 2018, HSS is providing Guidance on Preferred Provider Arrangements and Network Access Requirements. The Medicaid and CHIP managed care contracts, including the Uniform Managed Care Contract (UMCC), will require that managed care organizations (MCOs) continue to transition provider payment methodologies from volume based payment approaches to quality-based alternative payment … [Read more...] about Updated Preferred Provider Arrangement for All Managed Care Organizations
