Some time ago, I wrote about Harvey Silverglate's book Three Felonies A Day: How the Feds Target the Innocent. The book's premise is that there is virtually no adult in this country who has not violated a federal criminal law because of the incredible number of laws and the vagueness and breadth of them. Moreover, almost every Federal regulation carries criminal consequences either directly or through piggy-backing with a statute.This should be of particular concern to health providers … [Read more...] about Three Felonies A Day Redux
IL/News Alerts: DBMD Provider Requirements
DADS released an information letter and several news alerts. CMPAS: As a follow-up to IL 11-119 from October 21, DADS includes additional information specific to CMPAS providers. An excerpt: Individuals eligible for Supplemental Security Income (SSI) or SSI-related Medicaid and receiving CMPAS will be enrolled in the STAR+PLUS program effective March 1, 2012. However, individuals receiving CMPAS at the time of the expansion whose spouses are their paid attendants may choose to remain in … [Read more...] about IL/News Alerts: DBMD Provider Requirements
TX Register Updates: Texas Medical Board Changes
The following information was obtained from the December 9 issue of the Texas Register. Public Notice HHSC announced the renewal of a contract with Software Contract Solutions, Inc. to provide a resource for investigating all facets of information technology software issues that impact price, cost savings measures, risk exposure, and overall total cost of ownership. The renewal's value will not exceed $950,000. See the Texas Register for more information. Adopted Rules The Texas … [Read more...] about TX Register Updates: Texas Medical Board Changes
IL/News Alerts: Electronic Submission, December Webinars
AFC, AL/RC, CAS, CBA, CDS, DAHS, ERS, FC, HDM, MDCP, and PHC: DADS will participate in the Electronic Document Submission Pilot, which entails transmitting documents between DADS case manages and providers/CDSAs. The program begins on December 19, 2011 and will continue for six months. (Letter) -- DADS will implement a new service code in the CLASS program for DSA full and partial pre-enrollment assessment activities and eliminate service code 40A for DSA billing of partial pre-enrollment … [Read more...] about IL/News Alerts: Electronic Submission, December Webinars
Medicare/Medicaid News
CMS expands competitive bidding in Medicare. "The first phase of the program was successfully implemented for nine product categories in nine areas of the country on Jan. 1, 2011. To date, CMS monitoring data have shown a successful implementation with no changes in beneficiary health status. Today, CMS released the detailed schedule for Round 2 bidding. Registration will begin on December 5, and the 60-day supplier bidding period will begin in late January of 2012. " - CMS Medicare to … [Read more...] about Medicare/Medicaid News
IL/ News Alerts: HDM Changes, 12/8 Survey Deadline
Title XIX and Title XX Home Delivered Meals (HDM): DADS made three changes to the HDM Contract Compliance and Fiscal Monitoring Tool. An excerpt: Meal Delivery within the Required Timeframes An HDM provider or subcontractor performing meal delivery must monitor each meal delivery route annually to verify meals are delivered within the required timeframes. Documentation of monitoring must include the route name/number, the date of the monitoring, and the times of the first and last meal … [Read more...] about IL/ News Alerts: HDM Changes, 12/8 Survey Deadline
TX Register Updates: Call for Comments, Repealed Rule
The following information was obtained from the December 2 issue of the Texas Register: Public Notice HHSC has put out a call for public comments on its estimate and methodology for determining the TANF Program caseload reduction credit for FY 2012 beginning December 2 and ending December 16. See the Texas Register for details. Proposed Repeal HHSC proposed to repeal §354.1865, Number-of-prescriptions Limit, because the information is obsolete. For details, see the Texas Register. … [Read more...] about TX Register Updates: Call for Comments, Repealed Rule
DADS News Alerts: Revised CLASS Manual
DADS posted a number of news alerts since November 16. A selection: -- DADS posted new and revised information to the CLASS Provider Manual in HTML format. -- CMS is transitioning from the CMSNet connectivity method used to submit OASIS data from AT&T to Verizon. An excerpt: Texas is scheduled to convert from AT&T to Verizon the week beginning January 3, 2012. This transition will affect your h@ login ID and will make it easier to connect. This will not affect your login ID for … [Read more...] about DADS News Alerts: Revised CLASS Manual
TX Register Updates: Nursing, Medical Board Changes
The following information was obtained from the November 25 issue of the Texas Register: Public Notices HHSC intends to submit to CMS a request to amend the Non-Emergency Medical Transportation waiver program, which would add Colorado, Erath, Palo Pinto, and Somerville counties to the waiver to realign the counties in the full-risk broker model areas that impact the waiver. Jasper, Newton, Polk, San Jacinto, and Tyler counties will be removed. Adopted reimbursement rates for large, … [Read more...] about TX Register Updates: Nursing, Medical Board Changes
TX Providers Criticize Proposed Reduced Medicaid Rates
Reduced reimbursement rates are a common occurrence for most providers. As lawmakers seek to make up budget shortfalls, they tend to target the rates at which providers are paid. One of the unintended consequences is people of lower income levels are impacted the most, as physicians reduce Medicaid patients or stop taking them altogether. An excerpt from the Fort Worth Star-Telegram: Therapists stand to lose millions of dollars as Medicaid reimbursement rates for their services are … [Read more...] about TX Providers Criticize Proposed Reduced Medicaid Rates
