DADS released four information letters: Screen 573 allows ICFs/MR to monitor compliance with RLO. The screen's new function is to identify individuals in each queried component code that have not received a RLO due to being a new admission. These individuals will show as "Not Found" on Screen 573. A vendor will place a hold on payments to facilities until all reviews are updated and completed. (Letter) HCS, MRAs, and CDSAs: DADS implemented in CARE new nursing categories and new rates for … [Read more...] about Information Letters: ICF/MR, HCS, CDSAs, DBMD
Texas Register Updates: Higher FY Expenditures
The following information was obtained from the September 25 Texas Register: HHSC will submit amendments to the Texas State Plan for Medical Assistance, which would modify reimbursement methodologies for Physicians and Certain Other Practitioners, and Durable Medical Equipment. The changes may result in an additional aggregate expenditure of $17,784,701 for FY 2010. HHSC will submit an amendment that would provide for higher levels of managed care savings in the PACE program, and may … [Read more...] about Texas Register Updates: Higher FY Expenditures
Texas Register Updates: Medical Board, Board of Nursing
The following information was obtained from the September 18 issue of the Texas Register: Public Notices HHSC adopted new Medicaid per diem rates for Non-State Operated ICF/MR Services by Level of Need and Facility Size. The rates are found here. See the relevant section of the Texas Register for more information. Emergency Rules The Texas Board adopted an emergency repeal of §180.1, concerning Rehabilitation Orders, and added new sections to Chapter 180, concerning Texas Physician … [Read more...] about Texas Register Updates: Medical Board, Board of Nursing
DADS Letters: CBA, AL/RC, CLASS, DAHS, PHC, and Other
DADS released two information letters: To CBA, AL/RC, CLASS, DAHS, PHC, and other providers: HHSC approved a rate increase for these providers as a result of the federal minimum wage increase. See this web page at HHSC for details. (Letter) The CLASS waiver program received new rates on September 1. Claims received after this date automatically will be paid at the new rate, except claims submitted by a CDSA. IPCs already submitted for individuals participating in the agency option for all … [Read more...] about DADS Letters: CBA, AL/RC, CLASS, DAHS, PHC, and Other
State Medicaid, Health Care Issues
Last month we wrote about how some primary care physicians are dealing with the growing costs of health care by charging fees to provide personalized, or concierge, care. These efforts involve reducing the number of patients and charging remaining patients about $2,000 a year for services that include annual physicals, 24/7 access by phone and e-mail, same-day/next-day appointments, and a CD containing personal medical information. The Kaiser Network rounds up links to news articles about the … [Read more...] about State Medicaid, Health Care Issues
Provider and Information Letters: ICFs/MR, Assisted Living, NFs
DADS issued three provider and three information letters last week: DADS notified ICFs/MR providers of amendments to Section 252.122 of the Health and Safety Code, Section 261.109 of the Family Code, Section 48.052 of the Human Resources Code, and Section 22.04 of the Penal Code, which added new language. Example (new language in bold): "Notification of duty to report abuse, neglect and exploitation. Each facility shall require each employee of the facility, as a condition of employment … [Read more...] about Provider and Information Letters: ICFs/MR, Assisted Living, NFs
Texas Register Updates: CBA, CWP, CLASS, Nursing
The following information was obtained from the August 28 issue of Texas Register: Public Hearing and Notices HHSC will hold a public hearing on September 18, 2009, at 9:30 a.m. to receive public comment on proposed Medicaid payment rates for Personal Care III services in the CBA waiver program, CWP, and CLASS, in the Lone Star Conference Room HHSC. Send written comments up to 5 p.m. the day of the hearing to Meisha Scott to fax (512) 491-1998, e-mail at meisha.scott@hhsc.state.tx.us, or … [Read more...] about Texas Register Updates: CBA, CWP, CLASS, Nursing
Rising Costs Affect Medicaid Expansion and Primary Care Physicians
The question in the health care reform debate is not whether Medicaid and providers will be affected by changes, but rather how they will be affected. The goal of Barack Obama's health care reform plan is to reduce the number of uninsured Americans. Doing so will cost money. The News-Leader reports that under the president's plan, uninsured people with low incomes would be covered by Medicaid. Lawmakers have grappled over expanding Medicaid for years, and the debate will only grow louder if … [Read more...] about Rising Costs Affect Medicaid Expansion and Primary Care Physicians
Provider and Information Letters: ICFs/MR, HSC, TxHml
According to the code, the examining physician determines the severity of injuries in ICF/MR facilities. In a provider letter, DADS informed ICFs/MR that an examining PA and APN may also determine severity of injuries if delegated by an examining physician. Download the letter here. DADS is removing the cost limitation for Augmentative Communication Devices (ACDs) for residents in the DADS ICF/MR program. These providers may request an ACD for a Medicaid-eligible resident in the ICF/MR … [Read more...] about Provider and Information Letters: ICFs/MR, HSC, TxHml
Texas Register Updates: Contract Award, Reimbursement Rate Changes
The following information was obtained from the August 21 issue of Texas Register: Public Notices and Hearings DADS awarded a contract (total value $227,599) to Bailit Health Purchasing, Inc., to provide the procurement, implementation, and evaluation of the health home pilot project for children on Medicaid. For a list of per diem reimbursement rates DADS proposed for non-state ICF/MR providers, see this chart. HHSC will hold a public hearing on September 1, 2009, at 1:30 p.m., … [Read more...] about Texas Register Updates: Contract Award, Reimbursement Rate Changes
