DADS released four information letters: NFs: Written documentation of admission and discharge is required from NFs for an individual to access MDCP services through the Money Follows the Person option. An individual may be eligible to access MDCP services if he/she completes either an NF stay no fewer than 30 consecutive days or a limited NF stay if the individual is determined to be too medically fragile to complete a 30-day stay. (Letter) CBA HCSSA and CWP HCSSA: Unless … [Read more...] about ILs: MFP Options, Screening Employees/Contractors
TX Register Updates: May 17 Hearing, RFPs
The following information was obtained from the April 29 issue of the Texas Register: Public Hearings and Notices HHSC will hold a hearing to receive public comments on Medicaid payment rates for the following: 17-Alpha Hydroxyprogesterone Caproate; Diabetic Equipment and Supplies; Incontinence Supplies; Medicaid Calendar Fee Reviews; Mobility Aids; Otology and Audiometry Services; Substance Use Disorder Services; and Surgical Procedures. The hearing will be held on May 17, 2011, at … [Read more...] about TX Register Updates: May 17 Hearing, RFPs
Note About House and Senate Bills
On the Garlo Ward blog, we alert providers to recently introduced House and Senate bills. As you know, the legislative process tends to be slow; it may take months for the legislature to refer, debate, and vote on a bill. That’s why it’s important for providers to check on relevant bills periodically for status updates. This link will bring up posts that point to bills as introduced. Some of these bills have gone through committee. Be sure to check each post for bills that affect you. … [Read more...] about Note About House and Senate Bills
Providers Could See Performance-Based Medicaid Payment
Last week, the state Senate unanimously passed a bill that would change payment rates for Medicaid and the State Child Health Insurance Program from procedure-based to performance-based. The purported goal is to raise quality of care while reducing costs. An excerpt: That bill also gives the Health and Human Services Commission the authority to try out various performance-based payment models through pilot programs. One potential pilot program, which already has raised some antitrust concerns, … [Read more...] about Providers Could See Performance-Based Medicaid Payment
IL Letters: PACE, Form H3087 Error
DADS released three information letters: PACE providers: DADS reminded these providers to use the applicant's/participant's physical address when completing all documentation for Medicaid. The PACE site's address should not be used on these forms. (Letter) DADS clarified the date to be used as the "End Date" when completing the PACE SAS Registration Form used for data entry into the Service Authorization System (SAS) (Letter): "The client may voluntarily disenroll from Programs of … [Read more...] about IL Letters: PACE, Form H3087 Error
TX Register Updates: Texas Dental, Criminal History Change
From the April 22 issue of the Texas Register: Public Notice HHSC intends to submit to CMS a request for a new Medicaid waiver for the Texas Dental Program. Medicaid recipients age 21 and over, all Medicaid recipients living in Medicaid-paid facilities, and STAR Health Program recipients won't be eligible to participate in the statewide managed care dental program, but will continue to receive dental services through existing service delivery models. See the Texas Register for more … [Read more...] about TX Register Updates: Texas Dental, Criminal History Change
IL Letter and News Alerts
CBA, CLASS, CWP, CDA, DAHS, DBMD, MDCP, Medicaid Hospice, and PHCP: -- DADS clarified policies related to complaints that allege providers have violated rules that prohibit solicitation. (Letter) Report an allegation to HHSC online or at 800-436-6184. -- DADS invites all NFs in regions 2, 9, and 10 to a provider meetings on June 14, 2011, from 9-12 p.m. and 1:30-4:30 p.m. The meeting will be held at Southern Hills Church of Christ, 3666 Buffalo Gap Rd., Abilene, TX 79605. Registration … [Read more...] about IL Letter and News Alerts
Texas Hospitals in Budget Cut Crosshairs
Texas has a problem. As lawmakers try to stretch an ever-shrinking budget, providers face reimbursement cuts and other setbacks. In addition to the 10 percent Medicaid reimbursement cut, hospitals face additional setbacks. If the budget riders passed by the Senate Finance Committee last week become law, for instance, hospitals would be reimbursed for Medicaid patients according to the average rate in the state, as opposed to their current unique rate system. Additionally, federal matching … [Read more...] about Texas Hospitals in Budget Cut Crosshairs
TX Register Updates: Pharmacy and Nursing Changes
From the April 15 issue of the Texas Register: Proposed Rules HHSC proposes new §354.1042, concerning home health supplies provided by a pharmacy, and new §354.1877, concerning quantity limitations; and the repeal of Subchapter W concerning pharmacy limitations, which consists of §354.3047, concerning quantity limitations, and §354.3092, concerning review and evaluation. The changes would allow pharmacies enrolled in the VDP to provide a limited set of basic home health supplies commonly … [Read more...] about TX Register Updates: Pharmacy and Nursing Changes
Nursing Facilities Most Vulnerable in Budget Battle
As Medicaid reimbursement rates for all providers may be reduced by 10 percent in the current budget battle, nursing facilities would be hit harder than other providers. According to the Texas Tribune, the shortfall is caused by a lower level of tax funding, an increased number of beneficiaries set to enter the system, and fewer federal matching funds. Texas has over 1,000 nursing facilities, and at least half could close because of reduced Medicaid payment rates. An excerpt: The care provided … [Read more...] about Nursing Facilities Most Vulnerable in Budget Battle
