In skilled nursing facilities, in accordance with CMS manual guidance, CMS will only make payment for covered post-hospital extended care services if a physician makes the required certification and, where applicable, the required re-certification regarding the services furnished. Skilled nursing facilities are responsible for obtaining the required physician certification and recertification statements. Such certification must clearly note that that post-hospital inpatient extended … [Read more...] about Certification and Recertification by Physicians for Extended Care Services
Rise of Accountable Care Organizations Changing the Landscape of Accreditation
According to a recent article in Modern Healthcare, increasing consolidation in the healthcare sector and changes in reimbursement methodologies, such as the payment structure for accountable care organizations ("ACOs") is leading to changes in accreditation standards. John Burke, the CEO and President of Accreditation Association for Ambulatory Health Care, stated, "The movement to accountable care organizations and other recent trends has led to more health systems reabsorbing primary-care … [Read more...] about Rise of Accountable Care Organizations Changing the Landscape of Accreditation
Court Rejects Challenge to Physicians-Owned Hospital Provision
The health care reform law, which the U.S. Supreme Court upheld in June, contains a provision that limits the construction of new physician-owned hospitals and the expansion of existing ones. MedPage Today reports on a ruling that is considered a set-back for these hospitals. A physician-owned hospital in the state, the Texas Spine & Joint Hospital in Tyler, stopped expansion plans after the health care law was passed. Physician Hospitals of America and other plaintiffs challenged the law in … [Read more...] about Court Rejects Challenge to Physicians-Owned Hospital Provision
IL/PL and News Alerts: West Nile Virus, Upcoming Sessions
DADS released an information letter and a provider letter: Most providers, including ADC, AL, CMPAS, DBMD, Hospice, NF, and TxHmL: DADS alerted these providers to increased incident rates of the West Nile virus in Texas, its symptoms, and how to avoid it. (Letter) ICF/IID: DADS attached the answers to frequently asked questions from providers and stakeholders. An excerpt: Criminal History Checks Q: I conduct searches and review the criminal history reports of all job applicants. … [Read more...] about IL/PL and News Alerts: West Nile Virus, Upcoming Sessions
TX Register Updates: 8/28 Hearings, ICF/ID Supp. Payments
The following information was obtained in the August 17 issue of the Texas Register. Public Hearings HHSC will hold a public hearing on August 28, 2012, to receive comments on the proposed amendments to §354.1252 and new §354.1253 under Texas Administrative Code, Title 1, Chapter 354, Subchapter A, Division 16 concerning Certified Nurse Midwife Services: Conditions for Participation; and Licensed Midwife: Conditions for Participation. The hearing will take place from 10-11 a.m. On the … [Read more...] about TX Register Updates: 8/28 Hearings, ICF/ID Supp. Payments
Skilled NF Pay-for-Performance, Home Care Growth
In 2009, we blogged about CMS's cash incentive program to improve quality of care in nursing homes. CMS asked Arizona, Mississippi, New York, and Wisconsin to participate. Facilities with the highest scores as well as the greatest performance would receive performance payment. McKnight's reports that after four years, results are mixed (apparently Mississippi chose not to participate). CMS released a report about the program's first-year results. An excerpt: Although the demonstration is … [Read more...] about Skilled NF Pay-for-Performance, Home Care Growth
DADS News Alerts: Upcoming Webinars, Form 2002
A sample of recent DADS news alerts: -- Form 2002, Reporting Reasonable Suspicion of a Crime, is available. -- Registration is open for the DADS Culture Change Initiative: Symposium 2012. You may register here. Lubbock: Wednesday, Aug. 22, Holiday Inn Lubbock - Hotel and Towers Dallas: Friday, Aug. 24, Westin Park Central San Antonio: Tuesday, Nov. 13, Henry B. Gonzales Convention Center Houston: Thursday, Nov. 15, Hilton Houston Southwest -- DADS updated the MDS portion of … [Read more...] about DADS News Alerts: Upcoming Webinars, Form 2002
TX Register Updates: 9/13 Hearing, Board of Nursing Changes
The following information was obtained from the August 10 issue of the Texas Register. Public Hearings and Notices HHSC will hold a public hearing on Thursday, September 13, 2012, at 1:30 p.m., to receive comment on proposed Medicaid payment rates for Licensed Midwife Services in a Birthing Center; and primary care services and vaccine administration services provided by physicians and other practitioners as a result of the Affordable Care Act. The hearing will take place in the Lone Star … [Read more...] about TX Register Updates: 9/13 Hearing, Board of Nursing Changes
Federal Insurance Exchanges, New CMS Rule
Although Governor Rick Perry said Texas won't expand Medicaid or set up a state insurance exchange to accommodate the Affordable Care Act, the federal government might set up exchanges for states that don't set up their own. From the Associated Press: The law envisioned that states would run the new markets, or exchanges, with federal control as a fallback only. But the fallback now looks as if it will become the standard option in about half the states , at least initially. It would happen … [Read more...] about Federal Insurance Exchanges, New CMS Rule
ILs: FY13 Cutoffs, PASRR Changes
DADS released four information letters: AFC, ALFs, CBA, CMPAS, DBMD, FC, ICF/ID, PACE, and others: • Fiscal Year (FY) 2010 Miscellaneous Claims Cutoff: NOON Wednesday, August 8, 2012 • FY12 Claims Processing Cutoff: NOON Thursday, August 23, 2012 (Letter) Community/State (Service Group 5) ICF/IID: • Fiscal Year (FY) 2010 Miscellaneous Claims Cutoff: NOON Wednesday, August 8, 2012 • FY12 Claims Processing Cutoff: NOON Thursday, August 23, 2012 (Letter) HSC and TxHmL: • Fiscal Year (FY) … [Read more...] about ILs: FY13 Cutoffs, PASRR Changes
