The following information was obtained from the June 28 issue of the Texas Register. Public Hearings HHSC will hold a hearing on Monday, July 15, 2013, at 8:30 a.m. to receive public comment on proposed interim per diem Medicaid reimbursement rates for small and large, DADS-operated ICF/IID. HHSC will hold a hearing the same day at 10 a.m. receive public comment on proposed payment rate adjustments for the TxHmL waiver program. HHSC will hold a hearing on the same day at 1 p.m. to … [Read more...] about TX Register Updates: 7/15-16 Hearings
IL and News Alerts: 6/21, 7/23 Meetings
AFC, AL/RC, CBA HCSSA, DAHS, FMS, HDM, MDCP, Out-of-Home Respite ADC and AL/RC, PHC, and TAS: DADS notified contracted providers of changes to contract and fiscal compliance monitoring protocol in relation to negative billing. (Letter) -- (Published on the DADS site today, 6/18) DADS will hold the quarterly HCSSA stakeholder meeting this Friday, June 21, 2013, from 9 a.m. to 1 p.m. in the Public Hearing Room in the Winters Building, 701 W. 51st Street, Austin. Agenda (PDF) -- DADS will … [Read more...] about IL and News Alerts: 6/21, 7/23 Meetings
ILs/PLs: Dental Contractor, Asbestos Survey
DADS released two information and two provider letters: NF, Hospice, and ICF/IID: DADS informs providers that when billing for non-Medicare covered services, they're not required to file a claim to determine the liability of a Medicare Supplemental Insurance policy. (Letter) CLASS, CMA DSA: DADS recently contracted with contract with the University of Texas Health Science Center at San Antonio. An excerpt: As part of the expansion of Utilization Management and Review (UMR), the … [Read more...] about ILs/PLs: Dental Contractor, Asbestos Survey
ILs/PLs: Cost Avoidance Project, DPS
DADS released three information and two provider letters. NF, Hospice, and ICF/IID: DADS provided billing guidelines to providers for the final implementation of the Cost Avoidance Project, effective February 22, 2013. An excerpt: Because the February 22, 2013, Cost Avoidance Project implementation date falls within the month of February, providers are encouraged to separate claims for dates of service before and after February 22, 2013. Claims with dates of service prior to February 22, … [Read more...] about ILs/PLs: Cost Avoidance Project, DPS
IL/News Alerts: Cost Avoidance Project, New MOA
NF, Hospice, ICF/IID: DADS provided a status of the implementation of the Cost Avoidance Project. An excerpt: Release 1: Implemented August 2012 This release implemented new operations processes for validating insurance information on file for Long Term Care (LTC) individuals at Texas Medicaid & Healthcare Partnership (TMHP). This release provides phone support to providers requiring assistance with Other Insurance (OI) information on file for individuals in their facilities. Release … [Read more...] about IL/News Alerts: Cost Avoidance Project, New MOA
Medicare and Medicaid Court Decisions
Medicare recipients with chronic conditions can no longer be turned down for home health services provided by skilled nurses and therapists, according to a recent settlement between the federal government and consumer advocates. Home care and other long term care providers benefit as well. An excerpt: To receive this coverage, patients must meet specific requirements. First, a doctor must prescribe care from a nurse or therapist. Patients in skilled-nursing facilities also must demonstrate a … [Read more...] about Medicare and Medicaid Court Decisions
ILs/PL: Protecting Sensitive Personal Information
AFC, AL/RC, CBA, CLASS, DBMD, HCS, Hospice, PHC, TxHmL, and others: DADS reminded these providers and agencies of their responsibilities and requirements relating to protecting sensitive personal information received from DADS and notifying DADS of a breach of sensitive personal information. (Letter) CBA HCSSA, CLASS, DSA, NFs, and others: DADS notified these providers about the training schedule for the 2012 cost report (Letter): Online training will be available to qualified … [Read more...] about ILs/PL: Protecting Sensitive Personal Information
IL & PL: HCSSA Training
HCSSAs: Reminder: DADS provided joint training with its staff and HCSSAs this month. (Letter) Medicaid Hospice: HHSC approved rate changes for FY 13 based on CMS information. See HHSC Rate Analysis for details. (Letter) … [Read more...] about IL & PL: HCSSA Training
ILs/News Alert: Cost Avoidance Project
NF, Hospice, and ICF/IID: DADS provided a status of the Cost Avoidance Project implementation: Release 1 (August 2012), Release 2 (November 2012), and Release 3 (February 2013). (Letter) All providers: DADS alerted providers of three changes to the MESAV, effective November 2, 2012. An excerpt: 1) "Other Insurance Policies" Section A new section "Other Insurance Policies" will be added to the MESAV. Insurance policies for Long Term Care (LTC) individuals will be displayed on the … [Read more...] about ILs/News Alert: Cost Avoidance Project
IL and S&C Letters: DFP Investigations, Dementia Training
HCS and TxHmL: DADS reminds these providers of their responsibility to provide information to alleged victims of abuse, neglect or exploitation or their legally authorized representatives and service coordinators of the findings of the investigation, the program provider's corrective action in response to the investigation, etc. (Letter) State Survey Agency Directors – issued last month CMS has revised the State Operations Manual, Appendix P-Traditional Survey Protocol for Long-Term … [Read more...] about IL and S&C Letters: DFP Investigations, Dementia Training