***Providers and others can search issues of the Texas Register going back to 1976.*** The following information was obtained from the September 21 issue of the Texas Register. Public Notices HHSC adopted new per diem reimbursement rates for FY 2013, effective September 1, 2012: Pediatric Care Facility Special Reimbursement: $226.66 Large State-Operated ICF/IID Services, Large State-Operated ICF/IID Facilities - Medicaid Only clients: Adopted interim daily rate: $656.00 Large … [Read more...] about TX Register Updates: Texas Medical Board Changes
ILs and S&CC Memos: Respite, ICD-10-CM
DADS issued two information letters, and several Federal Survey and Certification letters of interest to nursing facilities. MDCP: DADS clarified that respite can occur in places other than the individual's residence. An excerpt: Respite provided in these settings should not be confused with out-of-home respite which is provided in the following licensed and/or contracted settings: • special care facilities • licensed day care facilities • hospitals • nursing facilities • camps … [Read more...] about ILs and S&CC Memos: Respite, ICD-10-CM
TX Register Updates: 9/18 Hearing, Nursing Changes
The following information was obtained from the August 24 issue of Texas Register. Public Notices and Hearing HHSC intends to submit an amendment to the Texas State Plan for Medical Assistance, which would delete obsolete and outdated information in the reimbursement methodology for case management for blind and visually impaired children. HHSC intends to submit an amendment to comply with Chapter 536 of Texas Government Code, which requires the agency to convert hospital reimbursement … [Read more...] about TX Register Updates: 9/18 Hearing, Nursing Changes
Court Rejects Challenge to Physicians-Owned Hospital Provision
The health care reform law, which the U.S. Supreme Court upheld in June, contains a provision that limits the construction of new physician-owned hospitals and the expansion of existing ones. MedPage Today reports on a ruling that is considered a set-back for these hospitals. A physician-owned hospital in the state, the Texas Spine & Joint Hospital in Tyler, stopped expansion plans after the health care law was passed. Physician Hospitals of America and other plaintiffs challenged the law in … [Read more...] about Court Rejects Challenge to Physicians-Owned Hospital Provision
Non-payment for “Never Events”: Coming to a Long-Term Care Provider Near You
Since October 2008, the Centers for Medicare and Medicaid Services ("CMS") have not paid hospitals for certain hospital-acquired conditions. That is, CMS will not pay for certain conditions that were not present in the patient upon admission. The conditions are, as designated by CMS, conditions that are: (a) high cost or high volume or both, (b) result in the assignment of a case to a DRG that has a higher payment when present as a secondary diagnosis, and (c) could reasonably have been … [Read more...] about Non-payment for “Never Events”: Coming to a Long-Term Care Provider Near You
TX Register Updates: Dual Eligibles, TANF, and SNAP
The following information was obtained from the April 20 issue of the Texas Register. Proposed Rules HHSC proposes to amend §354.1143, Coordination of Medicaid with Medicare Parts A, B, and C, which would authorize HHSC to make higher cost-sharing payments for dual eligibles for certain services if HHSC determines it's necessary to ensure adequate access or that it would be more cost-effective. For details, see the Texas Register. HHSC also proposed to amend §355.8065, Disproportionate … [Read more...] about TX Register Updates: Dual Eligibles, TANF, and SNAP
OIG Launches Compliance 101 Website
On March 5, 2005, the Office of the Inspector General ("OIG") launched its Compliance 101 website. The website contains links to guidance and educational training materials for health care providers, practitioners and suppliers. The site contains segment-specific compliance guidance for nursing facilities, ambulance suppliers, physician practices, etc. Although the materials are from 1998-2008, the compliance program guidance is still relevant and details the high-risk areas for each health … [Read more...] about OIG Launches Compliance 101 Website
Medicare Cuts for Nursing Homes, Skilled Nursing
According to the Hill, nursing homes will see an 11 percent cut in reimbursements based on a "recapture" of extra payments. An excerpt: The American Health Care Association, which represents nursing homes, said the cut endangers thousands of jobs as well as the quality of nursing-home care. "This will threaten our ability to provide quality care to America’s seniors ... At such a critical time, while we already face drastic cuts to Medicaid at the state level and a fragile economic recovery, … [Read more...] about Medicare Cuts for Nursing Homes, Skilled Nursing
The True Impact of the “Never Events” Designation
Dr. Rich at the Covert Rationing Blog explains: The “never events” initiative – just as the Feds insist to us – is aimed at changing physicians’ behavior. But quite predictably, that behavioral change will not be in the arena of quality improvement (since no amount of quality improvement can stop “never events” that are inevitable). Rather, the behavioral change will be in the arena of risk avoidance. Read the whole thing. It explains a lot about the nature of the "Central Authority" … [Read more...] about The True Impact of the “Never Events” Designation