DADS released three information and two provider letters: CBA and HCSSA (revised letter): DADS case managers will add a dental buffer up to a maximum of $400 to each CBA initial ISP and annual reassessment, unless the amount of the buffer will cause the ISP to exceed the cost limit, effective April 19. (Letter) AFC, ALF, CBA, CLASS, CMPAS, DBMD, HDM, MDCP, PACE, TAS, and other providers: An excerpt on how to check for LTC claim payment information: Personal Needs Allowance … [Read more...] about ILs/PLs: LTC Payment, DFPS Investigations
TX Register Updates: Contract Awards, Medicare Billing Prohibition
The following information was obtained from the April 13 Texas Register: Public Notices HHSC announced several contract awards. See the Texas Register for a listing of the companies. HHSC intends to submit transmittal number 12-010, which would convert the reimbursement methodology for non-emergency medical transportation services from fee-for-service to full risk capitation in the following designated counties: Collin, Dallas, Denton, Ellis, Hood, Hunt, Johnson, Kaufman, Navarro, … [Read more...] about TX Register Updates: Contract Awards, Medicare Billing Prohibition
OIG Launches Compliance 101 Website
On March 5, 2005, the Office of the Inspector General ("OIG") launched its Compliance 101 website. The website contains links to guidance and educational training materials for health care providers, practitioners and suppliers. The site contains segment-specific compliance guidance for nursing facilities, ambulance suppliers, physician practices, etc. Although the materials are from 1998-2008, the compliance program guidance is still relevant and details the high-risk areas for each health … [Read more...] about OIG Launches Compliance 101 Website
Provider News Around the Web
Kaiser Health News reports on an study with expected findings: when times are hard, hospitals expand into affluent areas. In other words, hospitals seek more private-injured individuals. They also buy private practices in those areas and build more emergency services. The Texas Tribune reports that lawmakers will include drug reimbursements in the expanding Medicaid managed care, which they believe will save over $100 million. Included in the story is an interactive map that shows access … [Read more...] about Provider News Around the Web
DADS News Alerts: MDS, Provider Meetings
DADS has issued about over a dozen news alerts since March 28. An excerpt beginning on the second page: -- DADS reminded providers that when a nursing home or swing bed facility completes an MDS 3.0 "discharge assessment-return anticipated", and the resident does not return to the facility within 30 days, no further action is required. -- Case management for children and pregnant women is a Texas Medicaid benefit for eligible children birth to age 20 with a health condition or health … [Read more...] about DADS News Alerts: MDS, Provider Meetings
TX Register Updates: Employee Vaccines, SSLC Staff Training
The following information was obtained from the April 6 issue of the Texas Register: Public Notices HHSC intends to submit to CMS a request for MDCP and CBA waiver program renewals. HHSC also intends to submit transmittal number 12-007, which would add tobacco cessation counseling services for pregnant women, and transmittal number 12-001, which would update the Medicaid State Plan section titled "Section One - Single State Agency Organization" to include current information on agency … [Read more...] about TX Register Updates: Employee Vaccines, SSLC Staff Training
Primary Care, Medicaid News
The shortage of primary care physicians and primary care in general has been widely reported. According to the Texas Tribune, for example, the federal government has declared Harris County a primary care physician shortage zone. The health care reform law will result in millions more Texans on the Medicaid rolls. Who will treat them? CMS announced a program to alleviate some of the pressure. The initiative will provide funds to hospitals to increase training for advanced practice registered … [Read more...] about Primary Care, Medicaid News
ILs/PL: Rule Reminders for HCS and TxHmL
DADS released three information letters and one provider letter: NFs: DADS notified NFs that the compliance date for the Automated External Defibrillator Requirement has been extended to September 1, 2014. (Letter) HCS and TxHmL: DADS rules require these providers to include in an individual's implementation plan a list outcomes and to document the progress or lack of progress toward the outcomes. Completing sample logs in the billing guidelines might not fulfill this requirement. … [Read more...] about ILs/PL: Rule Reminders for HCS and TxHmL
TX Register Updates: May 15 Medicaid Payment Hearing
The following information was obtained from the March 30 issue of the Texas Register: HHSC will hold a public hearing on May 15, 2012, at 1:30 p.m., to receive comment on proposed Medicaid payment rates for third quarter 2011 Healthcare Common Procedure Coding System; Durable Medical Equipment, Prosthetics, Orthotics, and Supplies - "E Codes"; Doctor of Dentistry Services in an Ambulatory Surgical Center/Hospital Ambulatory Surgical Center, Evoked Response Tests and Neuromuscular Procedures, … [Read more...] about TX Register Updates: May 15 Medicaid Payment Hearing
Protecting Your Business Against Solicitation is More Important Now Than Ever
The Department of Aging and Disability Services (“DADS”) recently initiated the repeal of administrative code sections prohibiting solicitation of another provider’s community services contracts. Prior to January 2012, 40 Texas Administration Code §49.19, entitled “Advertising and Solicitation of Clients,” prohibited certain activities related to a provider's soliciting prospective clients from other providers. The repeal became effective January 25, 2012. DADS previously noted in Information … [Read more...] about Protecting Your Business Against Solicitation is More Important Now Than Ever
