DADS has issued Provider Letter 11-11 outlining changes for requirements to informal review requests for cost reports, effective September 1, 2011. Beginning September 1, if a provider submits an informal review request that does not meet the requirements of 1 TAC §355.110(c)(1)(B) the request will not be accepted. Under 1 TAC §355.110(c)(1)(B), a provider must submit the following with its request for informal review: A concise statement of the specific actions or determinations … [Read more...] about Requirements for Informal Review Requests will be Enforced Beginning September 1, 2011
TX Register Updates: Oct. Hearings, Nursing & Physician Changes
The following information was obtained from the October 7 issue of the Texas Register: Public Hearings and Notice HHSC will hold a public hearing on October 27, 2011, at 9 a.m. to receive public comment on proposed rates for Hospice routine home, continuous home, inpatient respite, and general inpatient care, to be held in the Lone Star Conference Room. HHSC intends to submit transmittal number 11-055 to the Texas State Plan for Medical Assistance, which would establish the Recovery … [Read more...] about TX Register Updates: Oct. Hearings, Nursing & Physician Changes
ILs and PLs: Meds/Unlicensed Person, EVV
DADS released three provider and five information letters: Licensed ICFs: Effective immediately, an unlicensed person may adminster medication to a client without the requirement that an RN delegate or oversee each administration if various conditions are met, including if the meds are administered for a stable or predictable condition. (Letter) ALFs: SB 7, 82nd Legislature, First Called Session, 2011, amended Section 247.002 of the code and revised the definition of an ALF to … [Read more...] about ILs and PLs: Meds/Unlicensed Person, EVV
TX Register Updates: CDS Option Hearing, Corrected Notices
The following information was obtained from the September 30 issue of the Texas Register: Public Hearing and Notices HHSC intends to renew the consultant contract for Information Technology Negotiation Support Services to continue services to provide information, advice, and assistance in various proposals IT negotiations. HHSC will hold a public hearing on Tuesday, October 18, 2011, at 9 a.m. to receive public comment on proposed CDS option payment rates for employment assistance and … [Read more...] about TX Register Updates: CDS Option Hearing, Corrected Notices
PL and News Alerts: ANE Reporting, Nursing Training Sessions
DADS released a provider letter and posted several news alerts: Assisted Living: The legislature added Section 247.007 to the HSC, which requires all assisted living facilities to comply with requirements for reporting and investigating ANE. (Letter) -- DADS has revised Form 3626, Request for an Exception of Service Limit, to address frequent questions from CLASS providers on how to accurately calculate service amounts. -- DADS will host a webinar on the proposed new contract and … [Read more...] about PL and News Alerts: ANE Reporting, Nursing Training Sessions
TX Register Updates: STD Coverage, Cost Finding
The following information was obtained from the September 23 issue of the Texas Register: Public Notice HHSC intends to submit to CMS a request for extension for renewal of the Women's Health Program demonstration waiver to add treatment of sexually transmitted diseases to coverage. See the Texas Register for more information. Adopted Rules HHSC adopted amendments to §355.457, Cost Finding Methodology, which establishes the cost finding methodology for the ICF/MR program. HHSC also … [Read more...] about TX Register Updates: STD Coverage, Cost Finding
ILs and PL: AFC Clients, Mortality Review
DADS released two provider and three information letters. Licensed Type C ALs: DADS will conduct a two-year review of licensed Type C assisted living facilities that no longer serve adult foster care (AFC) clients, effective September 14, 2011, which replaces the assessment completed by the AFC contract specialist when the services were provided to those clients. Use Form 1123, Review of Assisted Living Facility Type C. (Letter) HCSSAs: Attached to this letter is a five-page document … [Read more...] about ILs and PL: AFC Clients, Mortality Review
ILs and PL: Weather-Related Closures, New Service Limits
DADS released one provider and six information letters: Adult Day Care, AL, HCSSAs, ICFs/MR, and NFs: CMS and DADS don't consider inclement weather-related or emergency state office closures to be state or federal holidays. Please submit any TAC- or federal code-required reports or other documents within the specified time frame, regardless closures. (Letter) CLASS Case Management and DSAs, HCS, CWP, and CDSAs: DADS will end the CWP on December 31, 2011, because it is no longer cost … [Read more...] about ILs and PL: Weather-Related Closures, New Service Limits
TX Register Updates: Medical Board Fees, Cease and Desist Orders
The following was obtained from the September 9 issue of the Texas Register: Public Notices HHSC adopted new per diem payment rates for the non-state operated ICF/MR, which can be found here. HHSC also intends to submit amendments to the Texas State Plan for Medical Assistance to modify the reimbursement methodologies as a result of Medicaid fee adjustments for: Durable Medical Equipment Prosthetics, Orthotics, and Supplies; Early Periodic Screening, Diagnosis and Treatment; Physicians and … [Read more...] about TX Register Updates: Medical Board Fees, Cease and Desist Orders
ILs: Hospice Rates, Criminal Checks
DADS released three information letters. Medicaid Hospice: HHCS approved new payment rates for Medicaid hospice room and board for recipients living in a NF or ICF/MR, effective September 1, 2011. You can access the new rates at the HHCS Rate Analysis web page. (Letter) CBA AL/RC, CBA HCSSA, CLASS CMA and DSA, DAHS, DBMD, HCS, ICF/MR, NF, PHC, AL/RC, and TxHmL: HHSC adopted amendments to its Cost Determination Process rules governing the Informal Reviews and Formal Appeals at 1 TAC … [Read more...] about ILs: Hospice Rates, Criminal Checks
