The Texas Tribune reports that prescription drugs will be a part of Medicaid managed care as it expands across the state. Pharmacists, who probably will see reimbursement cuts, object. An excerpt: “I am totally scared to death,” Louis Rumsey, a pharmacist who owns Elam Road Pharmacy in South Dallas, told a joint committee of Texas House and Senate members on Wednesday. Rumsey, who is making plans to sell the pharmacy over the managed care changes, said 85 percent of the patients he serves are … [Read more...] about Medicaid Managed Care: Prescription Drugs
IL/News Alerts: EVV, EDS Pilot Areas
CDSA and MDCP: DADS informed these providers and CDS employers using the Electronic Visit Verification System of the change in required documentation. An excerpt: This letter updates the CDS information provided in Information Letter No. 10-117 and applies only to CDSAs and CDS employers in the MDCP program who use the DADS EVV system for respite or adjunct support services provided by an attendant. CDS employers using the DADS EVV system no longer need to complete or keep a copy of DADS … [Read more...] about IL/News Alerts: EVV, EDS Pilot Areas
TX Register Updates: New/Withdrawn Medical Board Rules
The following information was obtained from the March 2 issue of the Texas Register: Public Notices HHSC intends to submit an amendment to the Texas State Plan for Medical Assistance, which would modify the fee schedules as a result of Medicaid fee adjustments for Clinical Laboratory Services and Physicians and Other Practitioners. HHSC also intends to submit an amendment that would incorporate recent updates to the fee schedules, including adding fees for new services and modifying fees … [Read more...] about TX Register Updates: New/Withdrawn Medical Board Rules
Doctors Annoyed By ER Medicaid Cuts
Washington state is one of 43 or so that face cuts in reimbursement from emergency room visits. Beginning April 1, if patients are diagnosed with any one of 500 diagnoses, Washington's Medicaid program won't pay physicians or hospitals. An excerpt from the Wall Street Journal: Instead, the state will pay a screening fee of about $50 if the patient is in a private-plan version of Medicaid, which currently enrolls about 60% of beneficiaries and is slated to grow. Patients won't be charged. The … [Read more...] about Doctors Annoyed By ER Medicaid Cuts
ILs: STAR+PLUS Managed Care Expansion
DADS released five information letters: CBA and HCSSA: DADS notified these providers that a monitored medication dispensing unit is reimbursable as an adaptive aid in the CBA program. The policy and operations will be in place to support it on March 6, 2012. (Letter) DADS will implement a new Promoting Independence initiative to divert individuals from being admitted to an NF if they're at immediate risk, effective March 1, 2012. (Letter) HCS, TxHmL, and ICFs/ID w/ 13 or fewer … [Read more...] about ILs: STAR+PLUS Managed Care Expansion
TX Register Updates: Expanded Medicaid Managed Care
The following was obtained from the February 24 issue of the Texas Register: Adopted Rules HHSC adopted new §351.507, adverse licensing, listing, or registration decisions by HHS agencies, which authorizes each HHS agency to consider adverse decisions made by other HHS agencies when considering an application or renewal filed with that agency by another agency's licensee. See the Texas Register for details. HHSC adopted amendments to §§353.1 - 353.5, Medicaid managed care general … [Read more...] about TX Register Updates: Expanded Medicaid Managed Care
Physicians Avoid Medicare Payment Cuts
Last Friday, Congress voted to prevent a 27 percent cut in Medicare payments for physicians for 2012. The Kaiser Health Network's Jackie Judd interviewed colleague Mary Agnes Carey about the agreement. An excerpt: JACKIE JUDD: Good Day, this is Health on the Hill. I’m Jackie Judd. Breaking news from Capitol Hill where Senate and House negotiators have reached agreement on the "doc fix," so that physicians treating Medicare patients will not have payments slashed by 27 percent later this month. … [Read more...] about Physicians Avoid Medicare Payment Cuts
PL & News Alerts: Vaccine-Preventable Diseases, Webinars
DADS released one provider letter: ALFs, ICFs/ID, and NFs: DADS notified these providers of the requirement to develop and implement a policy to protect individuals they serve from vaccine-preventable diseases and to provide information about CDC guidelines. Providers must implement the policy by September 1, 2012. This letter replaces last week's PL 12-02. (Letter) DADS released several news alerts since February 7. An excerpt: -- -- DADS hosted a webinar for HCS, TxHmL waiver … [Read more...] about PL & News Alerts: Vaccine-Preventable Diseases, Webinars
TX Register Updates: CBA Waiver Changes
The following information was obtained from the February 17 issue of the Texas Register: Public Notices HHSC intends to submit an amendment that would revise the date HHSC last submitted the model supplemental rebate agreement and model program benefit agreement to CMS for approval and clarify the circumstances under which drugs may be included on the preferred drug list. HHSC intends to submit to CMS a request to amend the CBA waiver program. An excerpt: The purpose of this amendment … [Read more...] about TX Register Updates: CBA Waiver Changes
Obama’s 2013 Budget: Reduced Reimbursements
Once again providers will bear the brunt of budget cuts. The Obama administration's FY 2013 budget, released Monday, would cut spending on Medicare and Medicaid by close to $360 billion over the next 10 years, and most of the reduction is to providers and drug companies. Additionally, to compensate for ever-shrinking funds, the Obama administration proposed to raise Medicare premiums for retirees and higher-income seniors beginning in 2017. (Associated Press) The budget will become even … [Read more...] about Obama’s 2013 Budget: Reduced Reimbursements
