Garlo Ward, P.C.

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ILs/PL: LTC Claim Errors, Criminal History Checks

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DADS released two information letters and one provider letter: AFC, ALF, CBA, CLASS, DAHS, HDM, Hospice, ICF/ID, NF, PACE, and other providers: Last year, LTC CMS processed over 15 million claims, which included 423,185 rejected claims and 456,967 denied claims. DADS provided guidelines to deal with the most common errors that delay LTC provider claim processing and payment An excerpt: Rejected Claims A rejected claim fails initial system edits, and is returned to the provider for … [Read more...] about ILs/PL: LTC Claim Errors, Criminal History Checks

DADS News Alerts: MDS 3.0 Updates, DADS 1915(c) Training

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--  A Medical Necessity and Level of Care Item by Item Guide is scheduled for release on April 1, 2012. This is the link (PDF) to the November 2011 Item by Item Guide: . Effective April 1, 2012 it will link to the April revision. --  An MDS 3.0 RAI Manual (v1.08) Errata document labeled "MDS 3.0 RAI Manual (v1.08) Errata_March_12_2012" has been posted in the Downloads section of the MDS 3.0 Training page. --  Providers using MDS 3.0 for nursing homes and swing beds: "[M]ay ignore warning … [Read more...] about DADS News Alerts: MDS 3.0 Updates, DADS 1915(c) Training

ILs: Revised MDS 3.0, Hospice Forms

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DADS released four information letters: All contracted NFs: CMS revised the MDS 3.0 Assessments, effective April 1, 2012. Details and revisions to the RAI Manual may be found on this CMS webpage. (Letter) ADC, ADF, CAS, CLASS, DBMD, MDCP, PACE, and other providers: CMS has mandated an April 1 deadline for all transactions to be compliant with EDI Version 5010. (Letter) CBA HCSSA, MDCP, HCS, and PACE: DADS is releasing a new version of the MN/LOC 3.0 assessment, effective April … [Read more...] about ILs: Revised MDS 3.0, Hospice Forms

ILs: STAR+PLUS Managed Care Expansion

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DADS released five information letters: CBA and HCSSA: DADS notified these providers that a monitored medication dispensing unit is reimbursable as an adaptive aid in the CBA program. The policy and operations will be in place to support it on March 6, 2012. (Letter) DADS will implement a new Promoting Independence initiative to divert individuals from being admitted to an NF if they're at immediate risk, effective March 1, 2012. (Letter) HCS, TxHmL, and ICFs/ID w/ 13 or fewer … [Read more...] about ILs: STAR+PLUS Managed Care Expansion

PL & News Alerts: Vaccine-Preventable Diseases, Webinars

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DADS released one provider letter: ALFs, ICFs/ID, and NFs: DADS notified these providers of the requirement to develop and implement a policy to protect individuals they serve from vaccine-preventable diseases and to provide  information about CDC guidelines. Providers must implement the policy by September 1, 2012. This letter replaces last week's PL 12-02. (Letter) DADS released several news alerts since February 7. An excerpt: -- --  DADS hosted a webinar for HCS, TxHmL waiver … [Read more...] about PL & News Alerts: Vaccine-Preventable Diseases, Webinars

PL: Vaccine-Preventable Diseases

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ALFs, ICFs/ID, NFs: DADS notified providers of the requirement to develop and implement a policy to protect the individuals they serve from vaccine-preventable diseases. DADS included information about CDC guidelines. Providers must implement the policy by September 1, 2012. An excerpt: Vaccine-preventable diseases are defined as those diseases included in the most current recommendations of the Advisory Committee on Immunization Practices (ACIP) of the CDC. The link to ACIP Comprehensive … [Read more...] about PL: Vaccine-Preventable Diseases

DADS Alerts: Becoming DBMD Provider, DAHS Meeting

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DADS released several news alerts. An excerpt: --  DADS issued an alert to providers and other qualified entities interested in becoming a DBMD provider in Regions 1, 2, 4, 5, 8, or 9. DBMD providers must have current HCSSA licensure with at least the Licensed Home Health Services category to be eligible. Please contact Paul Straka in Community Services Contracts at DADS by phone at 512-438-3460 or email at paul.straka@dads.state.tx.us. --  DADS is postponing the Culture Change webinar … [Read more...] about DADS Alerts: Becoming DBMD Provider, DAHS Meeting

IL and PLs: Adverse Licensing, Crime Reporting

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DADS released one information and two provider letters. CLASS CSA, CLASS, DSA, HCS, TxHmL, CDA, and Local Authorities: DADS is expanding utilization management and review activities for its Medicaid community entitlement and waiver programs, effective January 1, 2012. (Letter) ADC, ALF, HCSSA, ICF/ID, and NF: Beginning March 1, 2012, if the name of an applicant or associated person is listed in a health and human services agency record of adverse licensing, DADS may deny the person's … [Read more...] about IL and PLs: Adverse Licensing, Crime Reporting

ILs and PLs: COLA Delay, ICF/ID Changes

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DADS released three information and three provider letters: Community Care for the Aged and Disabled RC providers, CBA, AL/RC, and AFC: CMS recently announced a 3.6 percent COLA increase in federal benefits. Because of late receipt of this news, HHSC will not implement the increase until February 1, 2012. (Letter) NF, ICF, HCS, and TxHmL: HHSC will delay the COLA increase in Retirement, Survivors and Disability Insurance, Supplemental Security Income, and Medicare Part A and B … [Read more...] about ILs and PLs: COLA Delay, ICF/ID Changes