The Centers for Medicare & Medicaid Services (CMS) issued a final rule this month for the 2018 Physician Fee Schedule and final rule with comment period for the Quality Payment Program (QPP). According to a news release by CMS, Seema Verma, Administrator of CMS explained that:“These rules move the agency in a new direction and begin to ease that burden by strengthening the patient-doctor relationship, empowering patients to realize the value of their care over volume of tests, and … [Read more...] about CMS Finalizes Policies that Reduce Provider Burden, Lower Prescription Prices
(CMS) requires that Medicare-certified home health agencies (HHAs) meet the Medicare Conditions of Participation (CoPs)
Provider Letter 17-35 DADS released the latest Provider Letter 17-35 – Determination of Separate Entities which replaces PL 01-46 & PL 02-05 for Medicare Certified Home and Community Support Service Agencies. The letter details that the Centers for Medicare and Medicaid Services (CMS) requires that Medicare-certified home health agencies (HHAs) meet the Medicare Conditions of Participation (CoPs) for all clients being served by the agency, regardless of a client’s payment source. The … [Read more...] about (CMS) requires that Medicare-certified home health agencies (HHAs) meet the Medicare Conditions of Participation (CoPs)
Texas lawmakers approve major nursing home quality reforms
According to reports, the 2017 Texas regular legislative session made vast changes affecting older Texans. Lawmakers approved several top priorities for AARP Texas including bills that, among other things, will protect seniors’ financial future, improve access to health care, and help unpaid family caregivers and their families.Also included was major nursing home quality reforms that seek to hold operators of nursing homes and other long-term care facilities more accountable when they have been … [Read more...] about Texas lawmakers approve major nursing home quality reforms
CMS cancels planned Home Health Groupings Payment Model, announces new rule
CMS announced in a rule that it would not move forward with the Home Health Groupings Model. These regulations are effective on January 1, 2018. According to CMS, this final rule updates the home health prospective payment system (HH PPS) payment rates, including the national, standardized 60-day episode payment rates, the national per-visit rates, and the non-routine medical supply (NRS) conversion factor, effective for home health episodes of care ending on or after January 1, 2018. The … [Read more...] about CMS cancels planned Home Health Groupings Payment Model, announces new rule
Report: Forecasting the growth prospect of the global long-term care market
There are more than 1,200 long-term care centers in Texas and according to the Administration on Aging, over 70 percent of people turning age 65 can expect to use some form of Long term care in their lives. Long-term care in the US has been based on but not limited to nursing homes, and facility-based long-term care that includes services such as continuing care retirement communities, assisted living, and board-and-care home. Long term care is not medical care but serves the purpose of … [Read more...] about Report: Forecasting the growth prospect of the global long-term care market
Texans to face new obstacles as Obamacare open enrollment nears with government cuts
On November 1st, the open enrollment period for the Affordable Healthcare Act (ACA) begins. The 2018 open enrollment runs from November 1st to December 15th and is a crucial time to reach a critical number of under and uninsured individuals in order to get them covered. With enrollment during that period coverage would start on January 1, 2018. This years period is shorter than the 3-month period last year and has been reduced to 6 weeks. According to reports, government cutbacks in the form of … [Read more...] about Texans to face new obstacles as Obamacare open enrollment nears with government cuts
Procedural Requirements for Requesting Additional Medicaid Beds through an Exemption
Provider Letter 2017-30 Addressed to Nursing facilities. DADS reports that to qualify for a high occupancy rate exemption and receive an allocation of additional Medicaid beds when it has high occupancy rates, a NF must demonstrate that it has had an occupancy rate of at least 90 percent for nine of the 12 months prior to the application. A NF may not rely on data for any month before a previous increase. See the provider letter for more details. Medicaid Bed Allocation Requirements for high … [Read more...] about Procedural Requirements for Requesting Additional Medicaid Beds through an Exemption
Billing for Preadmission Screening and Resident Review Assessments and Services
Information Letter No. 17-20 - Addressed to Nursing Facility Providers on how to bill for Therapies, Customized Manual Wheel Chairs (CMWC) and Durable Medical Equipment (DME) reimbursed through the Preadmission Screening and Resident Review (PASRR) program at HHSC. Nursing facility providers must review the resident’s Medicaid Eligibility and Service Authorization Verification (MESAV) to verify a service authorization has beencreated and to determine which service code was used. Nursing facility … [Read more...] about Billing for Preadmission Screening and Resident Review Assessments and Services
Temporary Extension of Medicaid for Certain Intellectual Developmental Disability Waiver Program Recipients
Information Letter No. 17-19DADS has published the latest information letter regarding Temporary Extension of Medicaid for Certain Intellectual Developmental Disability Waiver Program Recipients Who Lose Supplemental Security Income and Medicaid. With a denial of SSI, Medicaid is automatically ended. This letter is for informational purposes regarding a process change affecting certain individuals receiving waiver services and does not affect the providers’ or local intellectual developmental … [Read more...] about Temporary Extension of Medicaid for Certain Intellectual Developmental Disability Waiver Program Recipients
Why Planning for Long-Term Care Services is A MUST For Aging Individuals
Long-term care services are an important aspect of your health care plans and for that reason, it's important to inform your loved ones and providers about your health care needs for the future. In fact, most adults should plan for long-term and even palliative care as it benefits the candidate when it comes to supportive care in the form of basic living needs such as bathing, dressing, personal care, housekeeping, meal preparations and even medical help. According to news reports, research … [Read more...] about Why Planning for Long-Term Care Services is A MUST For Aging Individuals