DADS posted a number of news alerts since October 21. A sample: -- On November 3, 2011, from 12:30-2 p.m. CT, CMS will host a National Provider Call on "Skilled Nursing Facility Prospective Payment System (PPS) Minimum Data Set (MDS) 3.0 and Resource Utilization Group-Version 4 (RUG-IV) Policies and Clarifications." Registration is required to attend this call. -- HHSC is expanding the STAR+PLUS Medicaid managed care delivery system into the Lubbock, El Paso, and Hidalgo service areas … [Read more...] about DADS News Alerts: STAR+PLUS Expansion, Work Sessions
TX Register Updates: Medicaid Hearing, Nursing Rule Review
The following information was obtained from the October 28 issue of the Texas Register: Public Hearings and Notice HHSC will hold a public hearing on November 16, 2011, at 1:30 p.m., to receive comment on proposed Medicaid payment rates for Healthcare Common Procedure Coding System updates, Medicaid Biennial Calendar Fee Review, Medicaid Policy Reviews, and Medicaid Special Reviews. The hearing will take place in HHSC's Lone Star Conference Room. See the Texas Register for details. HHSC … [Read more...] about TX Register Updates: Medicaid Hearing, Nursing Rule Review
ILs and PL: STAR+PLUS, Hospice Changes
DADS released two information letters and one provider letter: CBA, CDSA, DAHS, PHC, and CMPAS: Beginning March 1, 2012, HHSC will implement changes to CHIP services delivery, which include expanding STAR and STAR+PLUS Medicaid managed care programs to new areas and transitioning about 880,000 people currently part of the Primary Care Case Management into managed care. (Letter) Medicaid Hospice: DADS will modify the hospice physician narrative review process, effective November 1, … [Read more...] about ILs and PL: STAR+PLUS, Hospice Changes
Medicaid Around the Web
Obama administration suspends long-term care feature of health care reform. "The law that many Americans had hoped would transform the nation’s dysfunctional system of long-term care for the swelling ranks of people with disabilities and dementia quietly died this month, a victim of its own weaknesses, a toxic political environment and President Obama’s re-election campaign focus on jobs." – New York Times Some states limit Medicaid hospital coverage. "Hawaii is going even further. In April … [Read more...] about Medicaid Around the Web
TX Register Updates: Corrections, Medicaid Buy-In
The following information was obtained from the October 21 issue of the Texas Register: Public Notice DADS proposed to amend 40 TAC §92.2, Definitions, in the October 7, 2011, issue of the Texas Register and included outdated definitions for paragraph (8), "behavioral emergency" on page 6702, and paragraph (36), "personal care services" on page 6703, were erroneously included in the rule text of the proposal. Corrections: (8) Behavioral emergency--Has the meaning given in §92.41(p)(2) of … [Read more...] about TX Register Updates: Corrections, Medicaid Buy-In
DADS News Alerts: Cultural Change, PERM Webinar
A few of the most recent news updates: -- DADS will hold four webinars on cultural change in nursing facilities. The first is scheduled for Oct. 25, 2011, 10:30 to 11:30 a.m. Registration is open. Email DADSCultureChange@dads.state.tx.us with questions. -- CMS is hosting a PERM provider (PDF) education webinar/listening sessions for Medicaid and CHIP providers in Cycle 3 states: -- DADS will propose to repeal 40 TAC, Chapter 5, Subchapter I, Behavior Therapy, at the … [Read more...] about DADS News Alerts: Cultural Change, PERM Webinar
ILs and PL: EVV Requirements, Deficiencies Review
DADS released two information letters and one provider letter: CDS: HHSC will pilot an Electronic Visit Verification (EVV) System for your community-based services in DADS Region 2 (Abilene, Wichita Falls and the surrounding area) and DADS Region 4 (Longview, Tyler and the surrounding area) (Letter) Individuals receiving services from DADS: HHSC will pilot an EVV System for your community-based services in DADS Regions 2 and 4. (Letter) HCSSAs: DADS explains the Informal Review … [Read more...] about ILs and PL: EVV Requirements, Deficiencies Review
TX Register Updates: PASRR Changes, TxHmL Renewal
The following information was obtained from the October 14 issue of the Texas Register: Public Notices HHSC intends to submit an amendment to the Texas State Plan for Medical Assistance, which would add categorical determinations to the Preadmission Screening and Resident Review (PASRR) program. HHSC intends to submit an amendment that would define the PASRR Level II evaluation and identify specialized services available only to PASRR-eligible individuals. Finally, HHSC intends to … [Read more...] about TX Register Updates: PASRR Changes, TxHmL Renewal
Requirements for Informal Review Requests will be Enforced Beginning September 1, 2011
DADS has issued Provider Letter 11-11 outlining changes for requirements to informal review requests for cost reports, effective September 1, 2011. Beginning September 1, if a provider submits an informal review request that does not meet the requirements of 1 TAC §355.110(c)(1)(B) the request will not be accepted. Under 1 TAC §355.110(c)(1)(B), a provider must submit the following with its request for informal review: A concise statement of the specific actions or determinations … [Read more...] about Requirements for Informal Review Requests will be Enforced Beginning September 1, 2011
Recent Reforms to the Texas Medical Board Disciplinary Process
Effective September 1, 2011, House Bill 680 moderately reforms the disciplinary process of the Texas Medical Board (“TMB”). The key points of the reform are listed below. Anonymous complaints: The TMB will no longer accept anonymous complaints. “Anonymous” is defined as a complaint that “lacks sufficient information to identify the source or the name of the person who filed the complaint.” That is, the TMB has to be able to identify the complainant. However, the TMB does not have to inform … [Read more...] about Recent Reforms to the Texas Medical Board Disciplinary Process
