The New York Times stated in a recent editorial that employers and Medicare beneficiaries should have access to information that the Centers for Medicare and Medicaid keep on who the best doctors are at the most affordable rates, and reported that the Department of Health and Human Services (HHS) refuses to release the data. From the article (free registration required): The conflicting perspectives were described by Robert Pear in yesterday's Times. The Business Roundtable, which … [Read more...] about Should CMS Release Provider Quality Data?
Medicaid Estate Recovery Program
In a provider letter dated April 12, 2006, the Texas Department of Aging and Disability Services (DADS) requests that Nursing Facility Providers (NF) begin giving the Medicaid Estate Recovery Plan Receipt Acknowledgement (Form 8001) to Social Security income-only NF residents. DADS implemented the Medicaid Estate Recovery Program (MERP) on March 1, 2005. From the letter: As part of this program, NFs are being asked to provide SSI only NF admissions with information regarding MERP. Under … [Read more...] about Medicaid Estate Recovery Program
New Per Diem Rates
The Texas Department of Aging and Disability Services has issued a new provider letter to nursing facility administrators and hospice directors about new per diem rates. You may download the letter here (PDF). The Texas Health and Human Services Commission has raised per diem rates for the Nursing Facility Program, the Hospice Program in Nursing Facilities, and the Swing Bed Program. The changes went into effect on January 1, 2006. The new rates can be found here. Swing Bed and other … [Read more...] about New Per Diem Rates
Assisted Living Facilities’ Ability To Restrict Residents Contracting for Health or Personal Care Services.
The Attorney General (AG) of Texas issued an important opinion on February 23rd addressed to the Texas Department of Aging and Disability Services (DADS) regarding "retirement centers" that require residents to use the centers' own home health agencies. First, the AG agreed with DADS' interpretation that an establishment, including one characterized as a retirement community, that furnishes food and shelter to four or more persons who are unrelated to the proprietor and that requires those … [Read more...] about Assisted Living Facilities’ Ability To Restrict Residents Contracting for Health or Personal Care Services.
Close Call for Medicare and Medicaid
For the time being, Medicare and Medicaid spending won't be cut. Although President George Bush proposed a $65 billion reduction in Medicaid, Medicare, and other mandatory programs, the Senate voted to exclude the provisions. Last week, the House Budget Committee also voted to exclude the cuts. As expected, both political parties are divided on the president's budget. From Medical News Today: The House resolution's entitlement savings are "well shy of what conservatives had sought, but … [Read more...] about Close Call for Medicare and Medicaid
Nursing Homes Seek Economic Stability
Nursing homes are bearing the brunt of state budget cuts and after-effects of the hurricane season. For example, Louisiana faced $70.2 million in budget cuts, but the Senate decided to exclude a provision that called for a $36 billion reduction in Medicare and Medicaid funding. The House of Representatives may choose to include the provision. From United Press International: "What we're looking to do is get the economic stability to do a better job," said Bruce Yarwood, president and … [Read more...] about Nursing Homes Seek Economic Stability
Provider Letter: More Delays in Licensure
In January, I blogged about a provider letter issued by the Texas Department of Aging and Disability Services (DADS) to Home and Community Support Services Agencies (HCSSA). At that time, DADS reported lengthy delays in processing applications for initial licensure and Medicare certification because of the number of applications received. In a new letter, DADS advises HCSSA's to expect more delays, especially in places like Region 6 (Houston Regional Office) and Region 3 (Arlington Regional … [Read more...] about Provider Letter: More Delays in Licensure
Update Medicare Coverage for Spinal Disk
Last month I blogged about an artificial spinal disk called Charite by (Johnson & Johnson). The Centers for Medicare and Medicaid Services proposed to deny coverage for the surgery, citing lack of evidence that it is "reasonable and necessary." The 30-day period for comments ended last Friday, and it appears Medicare will not cover the procedure. The final ruling is due in May. From the New York Times: The Medicare decision was based on several well-known criticisms of Charité. The … [Read more...] about Update Medicare Coverage for Spinal Disk
Market Forces Lower Prescription Drug Prices
According to Mike Leavitt, secretary of the Department of Health and Human Services, prescription drug prices have dropped, thanks to "market forces." (Medical News Today) So capitalism works? Excellent news! President Bush must have had the right idea by injecting competition into Medicare's prescription drug program, the same one that people say is confusing. According to a survey conducted by America's Health Insurance Plans, however, the plan is not so confusing after all. From the … [Read more...] about Market Forces Lower Prescription Drug Prices
Japanese Build Robots To Care For Elderly
The Japanese love gadgets. First, it was the Japanese Boyfriend pillow, and the Japanese lap pillow, Now, they are inventing Robots to care for the elderly. Regarding the Robot in the top picture, A Japanese-led research team said it had made a seeing, hearing and smelling robot that can carry human beings and is aimed at helping care for the country's growing number of elderly. Government-backed research institute Riken said the 158-centimeter (five-foot) RI-MAN humanoid … [Read more...] about Japanese Build Robots To Care For Elderly