DADS released one information and two provider letters. Assistant Living Facilities: The legislature has made changes to the process of removing an inappropriately placed resident. An excerpt: An inappropriately placed resident is a resident who was appropriate when admitted to the ALF, but whose condition has changed. All residents must be appropriate for the ALF licensure type when admitted to the facility. After admission, if the resident’s condition changes, the resident may no longer … [Read more...] about IL and PLs: Inappropriately Placed Residents
Medicare/Medicaid News Around the Web
MedPAC, a group that advises Congress on Medicare, recommends an overhaul in the way skilled nursing homes are reimbursed. "Congress also should direct HHS to cut payments to skilled nursing facilities with relatively high risk-adjusted rehospitalization rates for their Medicare-covered skilled nursing facility stays." - McKnight's Raising the age of Medicare eligibility. "Medicare provides health insurance to almost everyone who is 65 or older. If the eligibility age was raised above 65, … [Read more...] about Medicare/Medicaid News Around the Web
DADS News Alerts: Rescinded ‘Your Texas Benefits’ Letter
DADS released several news alerts. An excerpt: -- DADS and the Board of Nursing will delay full implementation of the pilot program for the HCS and TxHmL waiver programs and all ICF/ID with capacities of 13 or fewer beds until March 1, 2012. -- Providers with a Quality Improvement Evaluation System account to submit MDS data or view CASPER reports should now update their account and follow the process to ensure they continue to receive critical CMS alerts. -- Revised forms 4116-MHM-AA … [Read more...] about DADS News Alerts: Rescinded ‘Your Texas Benefits’ Letter
ILs and PLs: COLA Delay, ICF/ID Changes
DADS released three information and three provider letters: Community Care for the Aged and Disabled RC providers, CBA, AL/RC, and AFC: CMS recently announced a 3.6 percent COLA increase in federal benefits. Because of late receipt of this news, HHSC will not implement the increase until February 1, 2012. (Letter) NF, ICF, HCS, and TxHmL: HHSC will delay the COLA increase in Retirement, Survivors and Disability Insurance, Supplemental Security Income, and Medicare Part A and B … [Read more...] about ILs and PLs: COLA Delay, ICF/ID Changes
TX Register Updates: Medical and Nursing Board Changes
The following information was obtained from the January 6 issue of the Texas Register: Public Hearing HHSC will hold a public hearing on January 18, 2012, at 9 a.m. to receive comment on proposed payment rates for the Medicaid Biennial Calendar Fee Review - Therapy Services provided by CORF/ORF. The hearing will be held in the Brown Heatly Building Public Hearing Room at 4900 North Lamar Boulevard, Austin. For more information, see the Texas Register. Proposed Rules The Texas Medical … [Read more...] about TX Register Updates: Medical and Nursing Board Changes
Medicaid Cuts in Texas
If you treat a patient who receives both Medicare and Medicaid, your reimbursement will be limited. Earlier this year, lawmakers eliminated the Medicaid co-pay to save money in the state budget. As a result, providers might turn away more Medicaid and Medicare patients. An excerpt from the Dallas Morning News: "Doctors have to make the difficult decision whether to continue to treat these patients even though it doesn't make any financial sense,” said Steve Levine, a spokesman for the Texas … [Read more...] about Medicaid Cuts in Texas
ILs and PL: Cost Reporting, 1915(c) Waiver
DADS released eight information letters and one provider letter. CLASS CSAs, CLASS DSAs, and CDSAs: Effective January 1, 2012, a CMA and DSA can bill for pre-enrollment assessment activities on the same day. (Letter) ICF/MRs: DADS issued this letter to guide providers on using video surveillance cameras to monitor common areas. An excerpt: There is no state rule or federal requirement that specifically addresses the use of video surveillance cameras in ICFs/ID; however, 42 Code of … [Read more...] about ILs and PL: Cost Reporting, 1915(c) Waiver
TX Register Updates: Plan B, MRA Changes
The following information was obtained from the December 30 issue of the Texas Register: Proposed Rules HHSC proposed new §351.507, adverse licensing, listing, or registration decisions by HHS agencies, in Chapter 351, Coordinated Planning and Delivery of Health and Human Services. The changes would permit agencies that license or regulate certain specified entities to consider adverse licensing decisions made by other HHS licensing agencies when considering a license application or … [Read more...] about TX Register Updates: Plan B, MRA Changes
Medicaid Funding Deficits for Nursing Facilities
The American Health Care Association (AHCA) has released a report that announced not-so-good news regarding Medicaid reimbursement. Such a study is no surprise, given state budget shortfalls and a health care law that will add millions more Americans to the Medicaid rolls. Medicaid payments to nursing facilities are about to get lower. An excerpt from McKnight's: Eljay [which conducted the study on AHCA's behalf] on analysts and AHCA state affiliates attribute the shortfall to a … [Read more...] about Medicaid Funding Deficits for Nursing Facilities
TX Register Updates: Managed Medicaid Care Expansion
The following information was obtained from the December 23 issue of the Texas Register. Proposed Rules HHSC proposed rules for several sections of the code: Medicaid Managed Care – HHSC proposed to amend, repeal, and add new rules to several subsections to Chapter 353, Medicaid Managed Care. An excerpt: The amendments and repeals are also proposed to delete references to the Integrated Care Management (ICM) program. ICM was a Texas Medicaid managed care program designed to address the … [Read more...] about TX Register Updates: Managed Medicaid Care Expansion
