On behalf of the Texas Department of Aging and Disability Services (DADS), the Texas Health and Human Services Commission adopted amendments that would allow an individual receiving services through the Home and Community-based Services Program to participate in the consumer directed services option (CDS), which is "a service delivery option in which an individual or legally authorized representative (LAR) employs and retains service providers and directs the delivery of program … [Read more...] about Texas Register: Consumer Directed Services
Is Medicaid Proof-of-Citizenship Law Backfiring?
According to a new report from the Center on Budget and Policy Priorities (CBPP), the new Medicaid proof-of-citizenship law is having unintended consequences. Last year, Congress passed a law requiring Medicaid beneficiaries and applicants to prove U.S. citizenship before receiving care. The law was intended to curb fraud in the Medicaid program and prevent illegal aliens, who are not legally authorized to be in the country, from receiving care through the program. But according to the … [Read more...] about Is Medicaid Proof-of-Citizenship Law Backfiring?
More Medicare Part D Fall-Out for Pharmacists
Last year I blogged about a group of Texas pharmacists (independent operators) lobbying the White House for reimbursement for Medicare Part D prescription drugs. (See Texas Pharmacists Lobby White House) The pharmacists were not receiving sufficient reimbursement to make up for the millions of dollars worth of drugs they gave to Part D patients for free, in part because Part D was new and confusing, and patients who needed medications couldn’t afford to wait for approval. To make … [Read more...] about More Medicare Part D Fall-Out for Pharmacists
Texas Register: Adopted and Proposed Reimbursement Rates
The Texas Health and Human Services Commission (HHSC) announced newly adopted interim per diem reimbursement rates for large, state-operated Intermediate Care Facilities for Persons with Mental Retardation (ICF/MR), including state schools operated by the Texas Department of Aging and Disability Services: $345.87 for Medicaid-only clients and $338.59 for dual eligibles. The public hearing was held on November 6, 2006. Mark your calendars for upcoming public hearings for proposed provider … [Read more...] about Texas Register: Adopted and Proposed Reimbursement Rates
Texas Register Updates: Reimbursement Rates for Medicaid Hospital Services
Last year, the Health and Human Services Commission (HHSC) proposed two amendments to implement a supplemental payment program to private hospitals. The Centers for Medicare and Medicaid Services approved the proposed amendments. For more information about the amendments, visit the relevant section in the January 19, 2007, Texas Register. Submit written comments within 30 days of publication in the Texas Register to Kevin Niemeyer by telephone at (512) 491-1366, by fax at (512) 491-1998, … [Read more...] about Texas Register Updates: Reimbursement Rates for Medicaid Hospital Services
Four New Provider Letters
Submission of the Hospice Election Form 3071 and Physician Certification of Terminal Illness Form 3074 The Texas Department of Aging and Disability Services (DADS) informed Medicaid hospice providers that it has updated its list of regional contacts for hospice election and certification forms to Community Services, Texas Medicaid and Healthcare Partnership, and Health and Human Services Commission Medicaid Eligibility staff. For more information, download the letter and attached list of … [Read more...] about Four New Provider Letters
Texas Register Updates: Sanctions, Health Passport, and SSI Gap
The Texas Health and Human Services Commission (HHSC) has proposed a new rule titled, “Internet Posting of Sanctions Imposed For Contractual Violations.†Among other things, the rule would outline HHSC’s authority to impose sanctions on Medicaid Managed Care Organization’s that do not comply with contractual terms. This information would be posted on HHSC’s web site. Submit written comments to the following: Gilbert Estrada, Policy Analyst Medicaid/CHIP Division Texas … [Read more...] about Texas Register Updates: Sanctions, Health Passport, and SSI Gap
National Provider Identifier
A National Provider Identifier (NPI) is a 10-digit number used to identify providers under the 1996 Health Insurance Portability and Accountability Act (HIPAA). According to the Centers for Medicare and Medicaid Services, there are only 151 days left to comply with the NPI requirement. From the site: If you are a health care provider who bills for services, you probably need an NPI. If you bill Medicare for services, you definitely need an NPI! Getting an NPI is easy. Getting an NPI is … [Read more...] about National Provider Identifier
Pharmacists Face Reduced Medicaid Reimbursements
Pharmacists may see their Medicaid reimbursements reduced if a proposed new rule becomes a reality. The Kaiser Network reports (via the New York Times) that the Bush administration proposed a rule that would save the government $8.4 billion over the next five years. This would allow the government to offer drug discounts to beneficiaries similar to those offered in the private sector. The proposed rule would limit the federal government’s share of Medicaid costs, which would reduce … [Read more...] about Pharmacists Face Reduced Medicaid Reimbursements
Provider Letter: Medicaid Estate Recovery Program
In a provider letter to nursing facilities dated December 18, the Department of Aging and Disability Services (DADS) asked these facilities for help with providing personal representative information to the Medicaid Estate Recovery Program. Although some providers fill out the personal representative information request form, others do not. From the letter: The expectation is that once the Texas Integrated Eligibility Redesign System (TIERS), the new Medicaid database, is available … [Read more...] about Provider Letter: Medicaid Estate Recovery Program