The following information was obtained from the January 25 issue of the Texas Register. Proposed Rules HHSC proposed to amend §354.1634, Waiver Pool Allocation and Valuation, which removes the prohibition on a non-Medicaid provider receiving the first demonstration year payment if it is an anchor. See the Texas Register for more information. The Texas Medical Board proposed to amend §190.14, Disciplinary Sanction Guidelines, which provides that the board may suspend or revoke a … [Read more...] about TX Register Updates: Medicaid Eligibility
IL/News Alerts: 2/4 Webinar, Four-Person Residence Rule
HCS: An excerpt: The Texas Department of Aging and Disability Services (DADS) has a new rule at Texas Administrative Code, Title 40, Part 1, Chapter 9, §9.178(e)(1) regarding a four-person residence. The new rule requires each Home and Community-based Services program provider to ensure that a four-person residence is certified to be in compliance with: • the relevant portions of Chapter 32 or Chapter 33 of the National Fire Protection Association (NFPA) 101 Life Safety Code applicable to … [Read more...] about IL/News Alerts: 2/4 Webinar, Four-Person Residence Rule
House and Senate Bills: Medicaid, Nurse Lawsuits
The following recently introduced House and Senate bills could affect long term care providers: HB 593: Relating to the expansion of eligibility for medical assistance to certain persons under the federal Patient Protection and Affordable Care Act. HB 595: Relating to the repeal of certain health programs and councils, to the review of certain health programs, panels, councils, systems, foundations, centers, committees, and divisions under the Texas Sunset Act, and to the transfer of … [Read more...] about House and Senate Bills: Medicaid, Nurse Lawsuits
DADS News Alerts: 1/31 Dementia Care Call, MDS Mentor
-- December 2012 issue of The MDS Mentor -- On DADS' behalf, HHSC proposed new §98.105, Administrative Penalties, in Chapter 98, Adult Day Care and Day Activity and Health Services Requirements, which allows DADS to assess an administrative penalty against an adult day care facility that violates licensing requirements. See the Texas Register for details. -- CMS will host a National Provider Call on the "CMS National Partnership to Improve Dementia Care in Nursing Homes" on Thursday, … [Read more...] about DADS News Alerts: 1/31 Dementia Care Call, MDS Mentor
TX Register Updates: Types of Hearings, Rural Health
The following information was obtained from the January 18 issue of the Texas Register. Adopted Rules HHSC adopted an amendment to §357.17, Types of Hearings, which states that a client receiving Medicaid services through an MCO must exhaust the MCO's expedited appeals process before requesting an expedited fair hearing from HHSC unless the MCO has not sent a timely response to the request or the MCO has denied the request. HHSC adopted new §390.1, Definitions, and §390.2, Standards … [Read more...] about TX Register Updates: Types of Hearings, Rural Health
House and Senate Bills: Health Care Reform, Identification
The following long term care-related bills were recently introduced in the 83rd Legislative Session: HB 486: Relating to outsourcing a service performed by a health and human services agency to a private commercial contractor HB 459: Relating to the creation of a navigator program as described by the Patient Protection and Affordable Care Act. HB 395: Relating to the use by certain health care providers of electronically readable information from a driver's license or personal … [Read more...] about House and Senate Bills: Health Care Reform, Identification
IL/News Alerts: Cost Avoidance Project, New MOA
NF, Hospice, ICF/IID: DADS provided a status of the implementation of the Cost Avoidance Project. An excerpt: Release 1: Implemented August 2012 This release implemented new operations processes for validating insurance information on file for Long Term Care (LTC) individuals at Texas Medicaid & Healthcare Partnership (TMHP). This release provides phone support to providers requiring assistance with Other Insurance (OI) information on file for individuals in their facilities. Release … [Read more...] about IL/News Alerts: Cost Avoidance Project, New MOA
TX Register Updates: Notice Correction, Medical Board Changes
The following information appeared in the January 11 issue of the Texas Register. Public Notice Correction HHSC published a correction to an intent to submit an amendment to the Texas State Plan for Medical Assistance. An excerpt: The announcement incorrectly described the fiscal impact of the proposed state plan amendment. The correct fiscal impact is as follows: The proposed amendment is estimated to result in an additional annual aggregate expenditure of $21,300,000 for the … [Read more...] about TX Register Updates: Notice Correction, Medical Board Changes
State Insurance Exchanges Approved
CMS reports that the U.S. Department of Health and Human Services (HHS) has conditionally approved health insurances exchanges in California, Hawaii, Idaho, Nevada, New Mexico, Vermont, and Utah. "States across the country are working to implement the health care law and build a marketplace that works for their residents,” Secretary Kathleen Sebelius said. "In ten months, consumers in all fifty states will have access to a new marketplace where they will be able to easily purchase affordable, … [Read more...] about State Insurance Exchanges Approved
NURSING FACILITY COMPLIANCE PROGRAM: AUDITING OR THE ART OF FINDING OUT IF YOUR POLICIES WORK
The deadline for having your compliance plan in place is rapidly approaching on March 13, 2013. Having a compliance plan in place will be of no real benefit if you are not focusing on effectiveness. As part of the compliance program enforcement under the Affordable Care Act (ACA) starting in March of 2013, the Office of the Inspector General (OIG) and The Center for Medicare Services (CMS) state that a reliable audit and monitoring system are key elements to a effective compliance program. … [Read more...] about NURSING FACILITY COMPLIANCE PROGRAM: AUDITING OR THE ART OF FINDING OUT IF YOUR POLICIES WORK
