DADS released 12 information letters. CBA HCSSA: HCSSAs must follow the procedures listed in the letter when the DADS case manager notifies them that an applicant's initial medical necessity determination assessment has expired, effective August 1, 2013. (Letter) DADS reminded providers that the adopted rules that include limits on the amount of certain services an individual may receive and a process for DADS to grant an exception to those limits expire on August 31, 2013. … [Read more...] about ILs: FY13 Cutoff Notice, Service Limits Expiration
TX Register Updates: THTQIP, A/N/E Changes
The following information was obtained from the July 26 issue of the Texas Register. Public Notices HHSC intends to submit to CMS a request to amend the Texas Healthcare Transformation and Quality Improvement Program (THTQIP) to remove the policy that allows a managed care organization to request disenrollment for beneficiaries dependent on a ventilator or diagnosed with End Stage Renal Disease. HHSC intends to submit to CMS a request to amend the THTQIP to include the … [Read more...] about TX Register Updates: THTQIP, A/N/E Changes
TX Register Updates: 8/20 Hearing, Nursing Rule Review
The following information was obtained from the July 19 issue of the Texas Register. HHSC will hold a public hearing on Tuesday, August 20, 2013, at 1:30 p.m., to receive comment on proposed Medicaid payment rates for Audiometric Services, rates for first and second quarter 2013 Healthcare Common Procedure Coding System updates, Medicaid Biennial Calendar Fee Review, Outpatient Behavioral Health Services, Physician-Administered Drug – Fluarix, Physician-Administered Drug - Hydroxyprogesterone … [Read more...] about TX Register Updates: 8/20 Hearing, Nursing Rule Review
DADS News Alerts: New Appendix, Stakeholder Meeting Documents
-- On July 8, 2013, DADS added a new appendix to several provider manuals, titled Medicaid for the Elderly and People with Disabilities. -- Documents from the June 21, 2013, HCSSA stakeholder meeting (in PDF): Agenda Draft of Information Letter: Notification when there are Service Delivery Plan Variances New Employment Services for Individuals Receiving DADS Services Draft Handbook Appendix -- Electronic Visit Verification -- DADS will host five regional conferences for IDD … [Read more...] about DADS News Alerts: New Appendix, Stakeholder Meeting Documents
IL, PL, and New S&C and S&CC Letters
DADS released an information letter and a provider letter. NF, Hospice, and ICF/IID: DADS alerted providers about new forms of valid verification they can use to determine the liability of Comprehensive Insurance Policies and instructions for filing Medicaid claims. (Letter) AL and NF: The Texas Health and Safety Code requires all ALFs and NFs to register with the Texas Information Referral Network – 211. Form 1085 is attached. (Letter) DADS has added new Federal Survey and … [Read more...] about IL, PL, and New S&C and S&CC Letters
TX Register Updates: July Public Forums
The following information was obtained from the July 12 issue of the Texas Register. HHSC's Medical Transportation Program will host public forums to hear feedback about the delivery of Non-Emergency Medical Transportation services through Managed Transportation Organizations and proposed regional maps. For more information, contact LeShawn Manus, Medical Transportation Program, 1106 Clayton Lane, Austin, Texas 78723, phone (512) 706-4900, fax: (512) 706-4999, or e-mail … [Read more...] about TX Register Updates: July Public Forums
RUG Reviews: Signing Documents Provided by the Reviewers
http://www.youtube.com/watch?v=gAJV7FsoXkg During the exit interview of a RUG review, you will be asked to sign and initial documents. It is very important that you understand what you are initialing or signing. Carefully review the document that you are asked to sign and ask questions if you don’t understand it before you sign or initial. These documents create a record that may become relevant in a Reconsideration or Appeal. Let us discuss the details by first reviewing the … [Read more...] about RUG Reviews: Signing Documents Provided by the Reviewers
Texas NF Court Victory, Mandate Delay
-- "A Texas nursing home has triumphed in a lawsuit that claimed it had retaliated against a facility resident when family members complained about her care...The family filed allegations of negligent hiring, supervision, management, and retention of employees; breach of fiduciary duty; breach of contract; and retaliation. Per the state's Medical Liability Act requirement, it had to first file an expert report on the resident's care. The courts found the expert report deficient, crumbling much … [Read more...] about Texas NF Court Victory, Mandate Delay
IL and News Alerts: 9/16 Meeting, Claims Submissions
DADS released one information letter. AFC, AL, CAS, CBA, CLASS, CDA, CMPAS, DAHS, DBMD, ERS, FC, HDM, Hospice, Non-State (Service Group 6) ICF/IID, LA, MDCP, NF, and PHC: DADS reminded providers to submit claims for any unbilled services promptly to prepare for the August 31, 2013, end of the state fiscal year. (Letter) -- DADS adopted amendments to and repealed sections of 40 TAC, Chapter 41, The Consumer Directed Services. See the news alert page for details. -- The DADS Center … [Read more...] about IL and News Alerts: 9/16 Meeting, Claims Submissions
TX Register Updates: 7/19 Hearing, Revised Hearing Notice
The following information was obtained from the July 5 issue of the Texas Register. Public Hearings and Notices HHSC will hold a hearing on Friday, July 19, 2013, at 1:30 p.m. to receive comment on proposed Medicaid payment rates for hospital outpatient imaging services, hospital outpatient reimbursement, and hospital inpatient reimbursement. The hearing will be held in the Public Hearing Room, Winters Building, located at 701 W. 51st Street, Austin. Revised Hearing Notice: [HHSC] is … [Read more...] about TX Register Updates: 7/19 Hearing, Revised Hearing Notice
