The following information was obtained from the December 27 issue of the Texas Register. Public Notices HHSC intend to submit Transmittal Number 13-055 to the Texas State Plan for Medical Assistance to establish home telemonitoring services as a benefit of the Texas Medicaid program. HHSC also intends to submit to CMS a request for an amendment to DBMD waiver program to update unduplicated count and point-in-time limits, change the name from consumer directed services agencies to … [Read more...] about TX Register Updates: ACA Implementation, Base Wages
Risk Reduction and the Internal Investigation Policy
An essential element of an effective health care compliance plan is the internal investigations policy. Actions by employees, acting in the course and scope of their employment, can subject corporations to civil and criminal liability. Detecting, investigating and remedying such situations are crucial given the regulatory environment under which health care companies operate. The conduct of the investigation itself can exacerbate the situation. Employees subjected to discipline may … [Read more...] about Risk Reduction and the Internal Investigation Policy
DADS News Alert: Five Star Preview Reports
-- From the news alert page: The Five Star Preview Reports were available beginning December 11th. To access these reports, select the Certification and Survey Provider Enhanced Reports (CASPER) Reporting link located at the top of your MDS State Welcome page. For Texas, this web page is at: https://158.73.90.242:81/home.html (Staff might get a warning message, but should be able to select "proceed"). Once in the CASPER Reporting system, click on the 'Folders' button and access the Five … [Read more...] about DADS News Alert: Five Star Preview Reports
PL/IL: FAQs and Payment Rates
DADS released one provider letter and one information letter. ICF/IID (Replaces PL 12-23): DADS gathered FAQs from providers and other stakeholders to share the questions and answers with all surveyors and providers. The FAQs addressed in this letter (PDF)include statutory and regulatory references: • medication administration (page 19); • Registered Nurse delegation (page 22); and • reporting allegations of abuse, neglect or exploitation to the Texas Department of Family and … [Read more...] about PL/IL: FAQs and Payment Rates
TX Register Updates: Medical Board Changes
The following information was obtained from the December 20 issue of the Texas Register. Public Notices HHSC intends to submit an amendment to the Texas State Plan for Medical Assistance to update the fee schedules in the current state plan by adjusting or implementing fees for: 2014 Annual Healthcare Common Procedure Coding System Update; Ambulance Services; Case Management for Children and Pregnant Women; Clinical Diagnostic Laboratory Services; Dental Services; Durable … [Read more...] about TX Register Updates: Medical Board Changes
LTC News: MedPAC Calls for SNF Cuts
-- "The House of Representatives passed a 3-month patch late Thursday to stabilize physicians' Medicare payments -- delaying dramatic cuts scheduled for 2014 -- while Congress works on a permanent repeal of Medicare's sustainable growth rate (SGR) payment formula." - MedPageToday -- "Long-term care providers have lambasted the current [outpatient therapy payment] system, which requires Medicare contractors to manually review claims in excess of a set annual amount. Providers and government … [Read more...] about LTC News: MedPAC Calls for SNF Cuts
DADS News Alerts: PPECC Draft
-- The completed draft version of the 40 TAC Chapter 15, Licensing Standards for Prescribed Pediatric Extended Care Centers (PPECC) has been posted to the PPECC page. See the news alert page for more information. -- DADS Regulatory Services announced a new web site from your Facility Surveyor/ Liaisons. -- CMS released version 1.14.0 of the MDS 3.0 data submission specifications and version 1.12.0 of the MDS 3.0 item sets. For more information about these and other entries, see … [Read more...] about DADS News Alerts: PPECC Draft
ILs: New Service Codes
DADS released two information letters. CLASS CMA, CLASS CDA, and FMSA: DADS informed these providers that it has established new service codes for each of the six services that constitute specialized therapies and habilitation when provided through the CDA option. (Letter) Additionally, DADS will offer employment assistance through the CLASS program and add supported employment as a service that may be provided through the CDS option, effective February 1, 2014. (Letter) … [Read more...] about ILs: New Service Codes
TX Register Update: Medical Assistance Payment
The following information was obtained from the December 13 issue of the Texas Register. HHSC intends to submit to an amendment to the Texas State Plan for Medical Assistance to ensure that to the extent a third-party commercial payment exceeds the Medicaid allowable cost for a service provided to a recipient and for which reimbursement wasn't paid under the medical assistance program, the payment isn't considered a medical assistance payment. See the Texas Register for more information. … [Read more...] about TX Register Update: Medical Assistance Payment
Alerts and News: Court Decision, STAR+PLUS Mistake
-- HHSC adopted amendments to §9.553, Definitions; §9.555, Definitions of TxHmL program service components; §9.567, Process for Enrollment; §9.578, Program Provider Certification Principles: Service Delivery; and §9.583, TxHmL program principles for local authorities, in Subchapter N, TxHmL Program, Chapter 9, Intellectual Disability Services--Medicaid State Operating Agency Responsibilities. -- From the news alert page: Some DADS waiver clients were enrolled in STAR+PLUS or got STAR+PLUS … [Read more...] about Alerts and News: Court Decision, STAR+PLUS Mistake
