In a provider letter dated December 1, the Texas Department of Aging and Disability Services (DADS) notified home health agencies seeking Medicare certification that DADS will no longer schedule initial Medicare certification surveys, per a directive by the Centers for Medicare and Medicaid Services. From the letter: Background Over the last five years, Texas has experienced unprecedented growth in the number of HHAs seeking certification. The five-state CMS Region 6 (Texas, New … [Read more...] about Provider Letter: Medicare Certification Alert for HCSSAs
‘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
Medicare Part D Open Enrollment
Open enrollment for Medicare Part D, the new prescription drug program, began last Wednesday and will end on December 31. Current beneficiaries may switch plans and first-timers may sign up for new plans. For more information, visit the Medicare.gov web page. … [Read more...] about Medicare Part D Open Enrollment
Industry vs. State: California Seeks to Control Drug Prices
Effective January 2007, the state of California will be authorized to seek drug discounts up of up to 60 percent for California residents receiving benefits from Medicare Part D. Drug companies are “alarmed,†of course. From the Kaiser Network: Although state officials say the measure is voluntary, the law also includes language that permits California in 2010 to remove from its Medicaid formulary treatments sold by companies that do not comply with the law. According to the Globe, … [Read more...] about Industry vs. State: California Seeks to Control Drug Prices
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
Party-Line Medicare Battles Continue
The new majority party in Congress didn’t wait long before it starting pulling rank. Under the current Medicare law, passed in 2003, the federal government is prohibited from negotiating drug prices or establishing a list of preferred drugs. Soon-to-be House Speaker Nancy Pelosi says the Democrats will try to repeal the ban straight out of the starting gate. (Kaiser Network) So much for Republicans’ efforts to partially privatize the system. One of the concerns about the government … [Read more...] about Party-Line Medicare Battles Continue
Medicare News Roundup
The Centers for Medicare and Medicaid Services (CMS) has made a series of announcements about Medicare: 1. Payment rates for home health services will increase by 3.3 percent for 2007. The acting administrator for CMS said this increase will “reward home health agencies who continue to report quality data and also provides beneficiaries with access to more affordable oxygen equipment.†(Source) 2. CMS also announced a final rule for Medicare payments for hospital outpatient services … [Read more...] about Medicare News Roundup
More Money for Doctors Reporting Quality of Care Data
Physicians who provide care to Medicare patients with chronic conditions will have an incentive to do more paperwork. The Kaiser Network reports that the Centers for Medicare and Medicaid Services will begin a three-year pilot program that will pay physicians to report quality of care data. An excerpt: The three-year program will begin next year in 800 small- or medium-sized practices in Arkansas, California, Massachusetts and Utah. During the first year, physicians will be paid for … [Read more...] about More Money for Doctors Reporting Quality of Care Data
CMS Offers Online Tools to Help Medicare Part D Beneficiaries
Medicare Part D beneficiaries with questions about the prescription drug program can now access more information online. At the Centers for Medicare and Medicaid Services (CMS) web site, a tool called the "Drug Plan Finder" should contain information about all available drug plans, according to the Kaiser Network. Users can compare plans across states and learn how to lower costs during gaps in coverage. Kaiser also reports that CMS released an analysis of prescription drug plan savings: … [Read more...] about CMS Offers Online Tools to Help Medicare Part D Beneficiaries
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