The Department of Health and Human Services has notified nursing facilities that in some cases, Medicaid is improperly billed and therefore pays for the date of death that occurs during a Medicare Part A skilled nursing facility stay in error. This determination was made after a review of the Texas Medicaid Long Term Care payments for individuals with Medicare and Medicaid coverage. In some cases, however, Medicaid does pay for date of death if the patient falls under a certain … [Read more...] about Provider Letter: Payment Disallowed for Date of Death During a Medicare Co-insurance Stay
Medicaid Report and Issue Brief
Last month, a federal advisory panel called the Medicaid Commission released a report with recommendations to prevent Medicaid from going bankrupt. Once again, it’s all about the baby boomers, and once again, Republicans and Democrats are split on the issue. (The Kaiser Network) The Bush administration wants to implement changes intended to save money in the long run, while the new Democratic Congress likely will resist the recommended changes. The report has not been posted … [Read more...] about Medicaid Report and Issue Brief
‘Cultural Transformation’ in the Long Term Care Industry
I’ve blogged about the impending retirement of waves of baby boomers before. It’s a hot topic in the health care industry, which will need to adjust to the influx of Americans who’ll need long term, and sometimes specialized care. A bipartisan committee called The National Commission for Quality Long-Term Care, co-chaired by former U.S. Sen. Bob Kerrey and former House Speaker Newt Gingrich, will release a report that will guide the industry and help it prepare for new patients and new … [Read more...] about ‘Cultural Transformation’ in the Long Term Care Industry
Provider Letters: Billing Requirements, Immunizations, and CMS Alert
In a letter dated November 2, the Texas Department of Aging and Disability Services (DADS) informed nursing facilities and community services providers that third-party billers are required to enter into a contract with the Texas Health and Human Services Commission before claims can be submitted to the Texas Medicaid HealthCare Partnership, effective June 30, 2007. This is an effort to combat fraud. You may download the letter here. DADS informed home and community support services … [Read more...] about Provider Letters: Billing Requirements, Immunizations, and CMS Alert
Texas Register Updates
On behalf of the Texas Department of Aging and Disability Services, the Texas Health and Human Services Commission (HHSC) has adopted an amendment to §9.178 in Chapter 9, Subchapter D, which restores text inadvertently replaced with incorrect text during previous adoption of an amendment. For more information, see the relevant section of the Texas Register. HHSC announced its intent to submit Transmittal Number 06-030, Amendment Number 748, to the Texas State Plan for Medical Assistance. … [Read more...] about Texas Register Updates
Medicaid News Roundup
In an effort to recoup money paid in Medicaid services, Tennessee’s Medicaid program will increase its efforts to go after beneficiaries’ estates. (Kaiser Network) As more retiring baby boomers start receiving Medicaid services, I suspect more states will follow Tennessee’s lead. In other Medicaid news, a radio program called Marketplace Morning Report examined Missouri’s Medicaid program and found that it went from being one of the best in the country to one of the worse. Over … [Read more...] about Medicaid News Roundup
Automatic Medicaid Enrollment of U.S.-Born Babies of Illegal Aliens Ends
Last week, President George W. Bush announced that U.S.-born babies of illegal aliens no longer will be automatically enrolled in Medicaid. Under the new policy, which took effect this past July, illegal aliens will be required to prove their baby’s citizenship. (Kaiser Network) Leslie Norwalk, acting administrator of the Centers for Medicare and Medicaid Services, told the New York Times, “When emergency Medicaid pays for a birth, the child is not automatically deemed eligible. But the … [Read more...] about Automatic Medicaid Enrollment of U.S.-Born Babies of Illegal Aliens Ends
Texas Comptroller To Lawmakers: End Accenture Contract
Carole Keeton Strayhorn, Texas Comptroller, chastised the Texas Health and Human Services Commission for its $800 million contract with Accenture, a group that administers Medicaid enrollment and other social services. Citing mismanagement, Stayhorn says the contract “must be ended.†According to the Houston Chronicle, Accenture’s call centers experience computer glitches and lost and backlogged applications. Strayhorn, who is running for governor, asked lawmakers to transfer project … [Read more...] about Texas Comptroller To Lawmakers: End Accenture Contract
Hearing on Proposed Provider Reimbursement Rates
The Texas Health and Human Services Commission (HHSC) announced in the October 20 Texas Register that there will be a public hearing for comments on proposed interim Medicaid reimbursement rates that will apply to large, state-operated Intermediate Care Facilities for Persons with Mental Retardation. Included are state schools operated by the Texas Department of Aging and Disability Services. The hearing will be held on Monday, November 6, 2006, at 2:00 p.m. in the Lone Star Conference Room … [Read more...] about Hearing on Proposed Provider Reimbursement Rates
CMS Computer System Leaves Medical Records At Risk
According to a new Government Accountability Office (GAO) report, the computer system at the Centers for Medicare and Medicaid Services (CMS)has weaknesses that could result in unauthorized disclosures of medical records. (Source) Former CMS administrator Mark McClellan, who left his position last weekend, told the Associated Press that the GAO didn’t find evidence of compromised records, and that "we appreciate GAO's assistance in identifying important opportunities for the contractor to … [Read more...] about CMS Computer System Leaves Medical Records At Risk