The following information was obtained from the September 16 issue of the Texas Register: Public Notice HHSC intends to submit transmittal number 11-045 to the Texas State Plan for Medical Assistance, which would limit payments for Medicare Part B services provided to dual eligibles to no more than the Medicaid payment amount for the same service, with the exception of dialysis services. See the Texas Register for more information. Proposed Rules The Texas Medical Board proposed … [Read more...] about TX Register Updates: Medical Board Changes
Medicaid Managed Care Expansion
Expanding managed care is one way Texas hopes to save money. One of ten states with specific expansion plans, Texas seeks to find a balance between cost reduction and quality care as the health care reform law, which will increase the Medicaid rolls, goes into effect. An excerpt from Kaiser Health News: Nearly every state uses managed care to some extent, and as of October 2010, about 66 percent of Medicaid enrollees were in managed-care plans of some type, according to the survey. That … [Read more...] about Medicaid Managed Care Expansion
ILs and PL: Weather-Related Closures, New Service Limits
DADS released one provider and six information letters: Adult Day Care, AL, HCSSAs, ICFs/MR, and NFs: CMS and DADS don't consider inclement weather-related or emergency state office closures to be state or federal holidays. Please submit any TAC- or federal code-required reports or other documents within the specified time frame, regardless closures. (Letter) CLASS Case Management and DSAs, HCS, CWP, and CDSAs: DADS will end the CWP on December 31, 2011, because it is no longer cost … [Read more...] about ILs and PL: Weather-Related Closures, New Service Limits
TX Register Updates: Medical Board Fees, Cease and Desist Orders
The following was obtained from the September 9 issue of the Texas Register: Public Notices HHSC adopted new per diem payment rates for the non-state operated ICF/MR, which can be found here. HHSC also intends to submit amendments to the Texas State Plan for Medical Assistance to modify the reimbursement methodologies as a result of Medicaid fee adjustments for: Durable Medical Equipment Prosthetics, Orthotics, and Supplies; Early Periodic Screening, Diagnosis and Treatment; Physicians and … [Read more...] about TX Register Updates: Medical Board Fees, Cease and Desist Orders
Primary Care Physicians Seek CMS Committee Changes
The Wall Street Journal reports that the American Academy of Family Physicians (AAFP), which represents primacy care doctors, has asked CMS to change the way its Relative Value Scale Update Committee (RUC) calculates Medicare reimbursements—which it says places a higher value specialists' work—and to add more members who represent primary care groups. A group of primary care physicians is suing CMS. An excerpt: "I think the whole thing needs to be replaced," said Paul Fischer, a doctor who … [Read more...] about Primary Care Physicians Seek CMS Committee Changes
ILs: Hospice Rates, Criminal Checks
DADS released three information letters. Medicaid Hospice: HHCS approved new payment rates for Medicaid hospice room and board for recipients living in a NF or ICF/MR, effective September 1, 2011. You can access the new rates at the HHCS Rate Analysis web page. (Letter) CBA AL/RC, CBA HCSSA, CLASS CMA and DSA, DAHS, DBMD, HCS, ICF/MR, NF, PHC, AL/RC, and TxHmL: HHSC adopted amendments to its Cost Determination Process rules governing the Informal Reviews and Formal Appeals at 1 TAC … [Read more...] about ILs: Hospice Rates, Criminal Checks
TX Register Updates: ICF/MR Hearing, ECI Changes
The following information was obtained from the September 2 issue of the Texas Register: Public Hearing and Notices HHSC will hold a public hearing on September 16, 2011, at 9 a.m. to receive public comment on the proposed interim per diem Medicaid reimbursement rates for small and large, state-operated ICFs/MR in the Lone Star Conference Room of the Braker Center, Building H, located at 11209 Metric Boulevard, Austin. HHSC intends to submit to CMS a request to amend the CLASS waiver … [Read more...] about TX Register Updates: ICF/MR Hearing, ECI Changes
DADS Alerts: Cancelled CLASS, NF Bed Allocation
-- DADS has cancelled the CLASS Basic Job Skills Training scheduled for September 6 - 7, 2011, in Austin. The next CLASS BJST is scheduled to take place April 10-11, 2012. Please call Laura Trevino, DADS Program Consultant, with questions at (512) 438-4385. -- DADS has posted new information to clarify current policies and procedures and to announce new procedures related to NF Medicaid bed allocation requirements outlined in 40 TAC §§19.2322 and 19.2324. -- A recording of the HCS … [Read more...] about DADS Alerts: Cancelled CLASS, NF Bed Allocation
ILs & PL: New Rates, Employee Screening
DADS released one provider and six information letters. Hospice Agencies with a Freestanding Inpatient Unit: DADS reminds these providers to ensure patient safety during an external or internal disaster. They must comply with TAC, Title 40, Part 1, Chapter 97, section §97.256 and have a written emergency preparedness and response plan based on a risk assessment of potential disasters most likely to occur in their service area. (Letter) CWP: HHSC approved new payment rates, effective … [Read more...] about ILs & PL: New Rates, Employee Screening
TX Register Updates: Amended Notice, Abolished SKIP
The following was obtained from the August 26 issue of the Texas Register: Public Notice HHSC issued an amended public notice of intent to seek a waiver from CMS to expand the STAR+PLUS program. An excerpt: The waiver request, in its final form, is now available to the public, as described below. HHSC is publishing this amended notice to alert interested parties that the comment period will remain open to take comments on the waiver request until 5:00 p.m., August 31, 2011. The waivers … [Read more...] about TX Register Updates: Amended Notice, Abolished SKIP
