In 2016, CMS rolled out a pre-claim review demonstration which was stopped by stakeholders with the aid of Congress. The initiative was to require that claims be sent in earlier in the claims process. CMS has revived the initiative with some modifications. Policy experts believe that stakeholders will not be able to stop the new version of the pre-claim review. The April 2018 report of the Government Accountability Office was probably the death knell for the efforts of opponents. … [Read more...] about Pre-Claim Review for Home Health Agencies Back on the Table
Provider Letter: Feeding Assistance Rules for Nursing Facilities
Provider Letter PL 18-17 (NF) This letter addresses feeding assistance care for nursing home residents and staffing requirements to implement rules. HHSC and Long Term Care Regulatory (LTCR) determined that the topic of feeding assistance required an updated and consolidated communication to providers. The letter details: Policy Details & Provider Responsibilities: A paid feeding assistant is an individual who meets the requirements specified in the Texas Administrative Code who is … [Read more...] about Provider Letter: Feeding Assistance Rules for Nursing Facilities
High-Tech Healthcare and Telemedicine are the Fastest Growing Initiatives in Healthcare
Patient care and value is at the forefront of many healthcare discussions in the industry. Physicians and nurses providing comfort, companionship, connection and support is considered to be just as important as providing actual medicinal treatments. Better care in relation to providing tele-medicine and high tech care in the healthcare system are the top of growing initiatives that put the patient first especially in nursing homes and hospice and palliative care facilities. According to … [Read more...] about High-Tech Healthcare and Telemedicine are the Fastest Growing Initiatives in Healthcare
CMS authorizes increase of $340 million in Hospice payments for FY 2019
Many families and health care providers are debating whether the Centers for Medicare and Medicaid Services, which runs Medicare (CMS) and Congress are doing enough to implement processes to protect patients and their families from hospice providers who may be exploiting the service. Recently, CMS finalized a $340 Million/ 1.8 percent increase in Hospice payments for Medicare Hospice providers. According to reports, the Office of Inspector General (OIG) at HHS synthesized 10 years of … [Read more...] about CMS authorizes increase of $340 million in Hospice payments for FY 2019
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
Daily Care Service Authorization Necessary for the (PASRR) Specialized Services Authorization
Information Letter No. 18-07 - Addressed to Nursing Providers. Nursing Facility (NF) providers MUST ensure that a designated resident has a valid Daily Care service authorization reflected on the Medicaid Eligibility Service Authorization Verification (MESAV) at the significant steps in the submission and approval process for NF Specialized Services. The letter addresses how to minimize billing issues. NF staff must ensure all appropriate and necessary forms and assessment submissions have … [Read more...] about Daily Care Service Authorization Necessary for the (PASRR) Specialized Services Authorization
Healthcare concerns looms as Nursing provider shortage facing country intensifies
News reports have indicated that the Texas's large population of older residents, healthcare systems and assisted living facilities (ALF) could be impacted due to a nursing provider (NP) shortage facing the entire country. Central Texas and the Texas Panhandle are largely affected by the shortage of nurses. According to a Nursing Shortage Factsheet : The U.S. is projected to experience a shortage of Registered Nurses (RNs) that is expected to intensify as Baby Boomers age and the need for … [Read more...] about Healthcare concerns looms as Nursing provider shortage facing country intensifies
Proposed rule addresses healthcare providers’ right regarding patients care for religious or moral reasons
A Proposed Rule by the Health and Human Services Department is purported to give healthcare providers sweeping discretion to refuse patients care for religious or moral reasons. The rule, Protecting Statutory Conscience Rights in Health Care; Delegations of Authority, explains that since the U.S. has a long history of providing conscience-based protections for individuals and entities with objections to certain activities based on religious belief and moral convictions, they propose to revise … [Read more...] about Proposed rule addresses healthcare providers’ right regarding patients care for religious or moral reasons
CMS proposed adding non-skilled in-home care as a supplemental benefit to Medicare Advantage plans in 2019.
CMS is adding flexibility to their expansion of benefits by redefining health-related supplemental benefits to include services that increase health and improve quality of life, including coverage of non-skilled in-home supports and more. Hospice care and palliative care are considered as well as supplemental benefits down the road. Benefits will only be available to some of the participants of Medicare Advantage plans. These benefits will not be extended to original Medicare. Supplemental … [Read more...] about CMS proposed adding non-skilled in-home care as a supplemental benefit to Medicare Advantage plans in 2019.
Cost Report Training Information For Service Providers
Information Letter No. 18-01 - Cost report training is required every other year for the odd-year cost report in order for the preparer to be qualified to complete both that odd-year cost report and the following even-year cost report. Upon successful completion of either an Initial or Refresher Cost Report Training webinar, preparers who have previously completed cost report training for that same program will be awarded credit for completing the webinar and will be able to submit a 2017 cost … [Read more...] about Cost Report Training Information For Service Providers