The Centers for Medicare and Medicaid Services announced a decision to delay implementation of a proposed rule to reduce Medicaid reimbursements to pharmacies for generic prescription drugs for six months. (Kaiser Network) According to Kaiser, the rule also would require drug companies to “offer Medicaid the lowest price offered to any purchaser -- which includes any "rebates, discounts or other price concessions" offered to PBMs or mail-order pharmacies.†Like many such government … [Read more...] about Generic Drug Reimbursement Cuts Delayed for Six Months
Texas Register Updates: Reimbursement Rates; Repeal
The Texas Health and Human Services Commission (HHSC) has adopted an amendment to §355.8063, which revises the Medicaid reimbursement methodology for freestanding psychiatric inpatient hospitals. According to HHSC, it didn’t receive comments about the proposed rule during the comment period. Additionally, HHSC adopted the repeal of §§357.481 - 357.490, Formal Appeals. The agency anticipates that the repealed rules will be replaced by a new Subchapter I, §§357.481 - 357.498, Hearings … [Read more...] about Texas Register Updates: Reimbursement Rates; Repeal
Provider Letters: Evercare; Medicare Certification Surveys
This week, the Texas Department of Aging and Disability Services (DADS) released three provider letters. The first letter to community services providers, dated June 11, concerns Evercare’s notice sent to potential long term services and supports providers concerning liability insurance requirements. Evercare faxed information about its contracting and credentialing requirements concerning liability insurance. These requirements reflect DADS’s requirements; in that regard, providers … [Read more...] about Provider Letters: Evercare; Medicare Certification Surveys
DADS Alert: Personal Care Services
The Department of Aging and Disability Services (DADS) is asking providers to spread the word about changes in the delivery of personal care services (PCS). Effective September 1, 2007, Medicaid clients under 21 who need assistance with daily living or other activities because of physical, cognitive, or behavioral limitations related to their disability may be eligible for PCS through the Texas Health and Human Services Commission. Medicaid clients over 21 will still receive personal … [Read more...] about DADS Alert: Personal Care Services
Deinstitutionalizing Nursing Home Care
In 1987, Congress signed into law the Nursing Home Reform Law, which established nursing home oversight rules to improve facilities. Mary Ousley, past chair of the American Health Care Association, testified before Congress in May about the long term care profession’s experience since the Nursing Home Reform Law went into effect and the need for facilities, providers, regulators, and consumers to work together to improve nursing home care. Last year, lawmakers introduced a bill called the … [Read more...] about Deinstitutionalizing Nursing Home Care
Medicaid Spending Would Increase Under Immigration Bill
According to the Congressional Budget Office, Medicaid spending would increase by $10 billion from 2008 to 2012 and by $23 billion from 2008 to 2017, under the current immigration bill. (Kaiser Network) The bill would open the door to allowing millions of illegal aliens to become U.S. citizens. Lawmakers would need to raise taxes to compensate for Medicaid benefits paid out to these new citizens. The so-called immigration reform bill was a compromise between national Republicans and … [Read more...] about Medicaid Spending Would Increase Under Immigration Bill
Provider Letters: Complex Needs Waiver Programs, Medicare Certification
In a letter to Home and Community Support Services Agencies, Department of Aging and Disability Services (DADS) Staff, and All Other Stakeholders dated June 1, DADS announced that it is hosting half-day training sessions on “Meeting Complex Needs in Waiver Programs Registration Information.†The sessions will answer questions about licensing rules and contract requirements for accepting complex needs patients in the following 1915(c) Medicaid waiver programs: Consolidated Waiver Program, … [Read more...] about Provider Letters: Complex Needs Waiver Programs, Medicare Certification
Texas Register Updates: Reimbursement Rate Hearing Notices
The May 25 Texas Register has published a series of public notices for various reimbursement rate hearings, including one on proposed Medicaid reimbursement rates applicable for providers of Medical Dependant Children Program Camp Services, on June 11, 2007, at 10:30 a.m., at Permian Basin Conference Room of the Texas Health and Human Services Commission, Braker Center, Building H, located at 11209 Metric Blvd, Austin, Texas. Send written comments to: Kimbra Rawlings Health and Human … [Read more...] about Texas Register Updates: Reimbursement Rate Hearing Notices
Provider Letter: Clarifications on National Provider Identifiers
The Texas Department of Aging and Disability Services (DADS) issued a letter dated May 25 to home and community-based services (HCS) and Texas Home Living providers (TxHmL) clarifying issues about National Provider Identifiers (NPI) that apply only to them. By June 1, 2007, DADS must have NPI numbers for all HCS and TxHmL providers, which means these providers must apply for and obtain NPI numbers. Beginning July 1, claims that contain no NPI numbers will not be processed. Additionally, … [Read more...] about Provider Letter: Clarifications on National Provider Identifiers
Bush Proposes Medicare Reimbursement Cuts to Fund Proposals
The Bush administration seeks to cut Medicare reimbursements to hospitals, home health agencies, and skilled nursing facilities in an effort to save as much as $100 billion to fund health care proposals. (Kaiser Network) Last week, the House Ways and Means Health Subcommittee, chaired by Democrat Pete Stark, held a hearing to consider a proposal from the Bush administration “to freeze Medicare reimbursements for home health agencies and skilled nursing facilities." A health care … [Read more...] about Bush Proposes Medicare Reimbursement Cuts to Fund Proposals
