In April of this year, the Alabama Supreme Court, in Tennessee Health Management, Inc. v. Carol J. Rousseau Johnson, as personal representative of the estate of Dolores J. Rousseau, deceased (CV-08-900469) held that a nursing home resident “passively permitted” her daughter to sign an pre-admission arbitration agreement on her behalf. As a result, the woman’s estate was forced to settle its dispute with the nursing home through arbitration. Dolores J. Rousseau was admitted to Millennium … [Read more...] about Alabama Supreme Court Upholds Arbitration Agreement Signed by Nursing Home Resident’s Daughter
Information Letter and Alerts: MDCP, NF Computer-Based Training
DADS release on information letter and news alerts: MDCP: DADS informed these providers that during the development of the Individual Plan of Care, the service initiation date will be negotiated before the provider receives a service authorization form as indicated in 40 TAC, Chapter 50, §51.217(b). An excerpt: When the initial service initiation date has been agreed upon by all required parties, the case manager will send the provider the appropriate service authorization form, either … [Read more...] about Information Letter and Alerts: MDCP, NF Computer-Based Training
Provider and Information Letters: ICF/MR, HCSSA, NFs, Assisted Living
DADS released seven new provider letters and one information letter. DADS informed the following providers that in addition to an initial Nurse Aide Registry and the Employee Misconduct Registry search, they must search both registries every year for unlicensed employees and volunteers whose duties include face-to-face contact with clients, effective September 1, and document and keep a record of the searches: Adult Day Care Assisted Living … [Read more...] about Provider and Information Letters: ICF/MR, HCSSA, NFs, Assisted Living
Information Letters: NFs, ICFs/MR, CLASS, and DBMD
DADS released three new information letters: Per diem payment rates NFs and hospice directors, effective September 1, 2010, can be found here. Per diem payment rates for ICFs/MR, effective September 1, 2010, can be found here. CLASS and DBMD providers: DADS informed these providers that effective September 1, 2010, it will not allow providers to be paid for more than 24 hours of service in a 24-hour day. Claims submitted for more than 24-hour units in a … [Read more...] about Information Letters: NFs, ICFs/MR, CLASS, and DBMD
Information Letter: For Nursing Facilities
Two updates for NFs: The definition of "licensed health professional" has been moved to 40 TAC §19.101(56), from 40 TAC §19.101(57); The DADS Paid Feeding Assistant Training curriculum is available on the Regulatory Services Credentialing web page at the following url: http://www.dads.state.tx.us/providers/NF/credentialing/NATCEP/feedingassistant.pdf (98-page PDF) … [Read more...] about Information Letter: For Nursing Facilities
Information Letters: Hospice and Nursing Facilities
DADS released three information letters: Hospice: Hospice providers are responsible for know the Medicare and Medicaid eligibility for a hospice client. An excerpt: The DADS rule for Medicaid Hospice Payments and Limitations at 40 TAC §30.60(h) states: (h) Third-party resources. Medicaid pays only after all third-party resources have been used. In accordance with 40 TAC §30.60(h), it is the responsibility of the hospice provider to be aware of a client’s eligibility for Medicare … [Read more...] about Information Letters: Hospice and Nursing Facilities
Information Letters: Claims Processing Cut-Offs, STAR+PLUS Expansion
DADS released five information letters: HCS and TxHmL waiver claims processing cutoff dates: FY 2008 Miscellaneous Claims at NOON Friday, August 6, 2010 FY 210 Claims Processing Cutoff: NOON Friday, August 20, 2010 ICF/MR Community/State (Service Group 5) providers claims processing cutoff dates: FY 2008 Miscellaneous Claims Cutoff: NOON Monday, August 9, 2010 FY 2010 FY10 Claims Processing Cutoff: NOON Monday, August 23, 2010 Community Services, NFs, and ICF/MR Service Group 6 … [Read more...] about Information Letters: Claims Processing Cut-Offs, STAR+PLUS Expansion
Texas Register Updates: Reimbursement Rate Hearings
DADS adopted new reimbursement rates for the following: Nursing Facility Payment Rates for State Veterans Homes Non-State Operated ICF/MR Nursing Facilities HHSC announced a contract award to the Public Consulting Group, total value $50,000 plus contingency fee. For more information, see the Texas Register. HHSC will hold a public hearing on August 17, 2010, at 1:30 p.m., to receive comment on proposed Medicaid payment rate for the following (all take place in Lone Star … [Read more...] about Texas Register Updates: Reimbursement Rate Hearings
NFs and Hospice providers:
DADS released two information letters: NFs and Hospice providers: DADS offered guidelines and instructions to manage the most common errors that result in NF and Hospice claim rejections and denials. An excerpt: "Providers are encouraged to review and share this information with their billing staff to reduce errors and maximize efficiency. "During the first three quarters of the state Fiscal Year (FY) 2010 (September 2009 through May 2010), the Claims Management System (CMS) … [Read more...] about NFs and Hospice providers:
Texas Register Updates: Texas Medical Board, Nursing Facilities
The following information was obtained from the July 16 issue of the Texas Register: Public Hearing and Notice HHSC will hold a public hearing on August 2, 2010, at 1:30 p.m., to receive comment on proposed Medicaid payments for Case Management for Children and Pregnant Women, to be held in the Lone Star Conference Room of HHSC, Braker Center, Building H, located at 11209 Metric Boulevard, Austin, Texas. Send written comments to the attention of Rate Analysis, HHSC, Rate Analysis, Mail … [Read more...] about Texas Register Updates: Texas Medical Board, Nursing Facilities
