According to HHS, in order to begin improving the state’s inpatient psychiatric care system which provides care for adults, adolescents and children, a total of $47.7 million will be allocated to renovate and architecturally plan for the replacement of existing facilities as well as plan and design a new hospital. The funding is part of $300 million approved by the 85th Texas Legislature to improve the state hospital system in the 2018-2019 biennium) Projects to be funded and implemented … [Read more...] about Health and Human Services Commission Allocating $47.7 million to Improve State Hospital System
Nursing Providers: Avoiding Common Errors that Result in Nursing Facility Specialized Services Denial
Information Letter No. 18-02 -Nursing Facility providers often make two common mistakes that usually result in denial of authorization requests or Health and Human Services Commission (HHSC) Preadmission Screening and Resident Review (PASRR) NF specialized services or assessments. To avoid this error, DADS has published this letter to help avoid these errors. The two most common reasons HHSC denies authorization requests for PASRR specialized services and assessments are: 1. NF staff … [Read more...] about Nursing Providers: Avoiding Common Errors that Result in Nursing Facility Specialized Services Denial
2019 Advance Notice of Methodological Changes for Medicare Advantage Capitation Rates and Part D Payment Policies
The Centers for Medicare & Medicaid Services (CMS) released Part I of the 2019 Advance Notice of Methodological Changes for Medicare Advantage Capitation Rates and Part D Payment Policies (the Advance Notice), which contains key information about proposed updates to the Part C Risk Adjustment Model and the use of encounter data. According to the Press release: The 2019 Advance Notice is being published in two parts this year due to requirements in the 21st Century Cures Act, which mandated … [Read more...] about 2019 Advance Notice of Methodological Changes for Medicare Advantage Capitation Rates and Part D Payment Policies
Cost Report Training Information For Service Providers
Information Letter No. 18-01 - Cost report training is required every other year for the odd-year cost report in order for the preparer to be qualified to complete both that odd-year cost report and the following even-year cost report. Upon successful completion of either an Initial or Refresher Cost Report Training webinar, preparers who have previously completed cost report training for that same program will be awarded credit for completing the webinar and will be able to submit a 2017 cost … [Read more...] about Cost Report Training Information For Service Providers
CMS Launches Data Submission System for Clinicians in the Quality Payment Program
In a press release, CMS announced that doctors and other eligible clinicians participating in the Quality Payment Program can begin submitting their 2017 performance data using a new system on the Quality Payment Program website (qpp.cms.gov). The Quality Payment Program has two tracks you can choose:Advanced Alternative Payment Models (APMs) orThe Merit-based Incentive Payment System (MIPS)The data submission system is an improvement from the former systems under the CMS legacy programs, which … [Read more...] about CMS Launches Data Submission System for Clinicians in the Quality Payment Program
Medicare program’s penalty protocols for Nursing homes change under Trump Administration
In 2016, the nursing home industry requested the change in the Medicare program's penalty protocols and now, according to reports, a new policy from the Trump administration will roll back fines against nursing homes cited for mistreatment or neglect. The New York Times research found that nearly 6,500 nursing homes in the U.S. have received at least one citation for a serious violation since 2013 and about two-thirds of those have been fined by Medicare.According to this New York Times excerpt … [Read more...] about Medicare program’s penalty protocols for Nursing homes change under Trump Administration
Effective Date for Enrollment ID/RC Assessments for Individuals in the Home and Community-based Services and Texas Home Living Programs
Information Letter Number: 17-29 The initial effective date of an enrollment ID/RC Assessment for an individual who is enrolled in the Home and Community-based Services or Texas Home Living Program on or after January 1, 2018 will be the same as the effective date of the individual’s initial individual plan of care (IPC). This change is being made to simplify the renewal process for an individual’s ID/RC Assessment and IPC. So if an initial IPC is authorized by HHSC with an effective date … [Read more...] about Effective Date for Enrollment ID/RC Assessments for Individuals in the Home and Community-based Services and Texas Home Living Programs
Texas to receive $25 Billion in Medicaid Funding after Approval of the 1115 Demonstration Waiver
According to The Office of Texas Government news release, the Texas Health and Human Services Commission and the Centers for Medicare and Medicaid Services have reached an agreement to continue a critical part of the state’s Medicaid program over the next five years.The approval of the 1115 Demonstration Waiver will allow the state to continue expanding managed care to Medicaid clients while also preserving supplemental payments to hospitals and other critical Medicaid providers. According to … [Read more...] about Texas to receive $25 Billion in Medicaid Funding after Approval of the 1115 Demonstration Waiver
Provider Letter regarding Rule Amendments in Texas Administrative Code (TAC) – Change of Ownership
Provider Letter No. 17-38 - the Health and Human Service Commission (HHSC) added new rules and amended existing rules regarding the change of ownership (CHOW) process for ALFs. According to the letter, under the amended rules, a CHOW occurs when the federal tax identification number of the license holder changes. When the number changes, the incoming license applicant must apply for an initial license and submit the required documents as required by §92.12(b), which states that an applicant … [Read more...] about Provider Letter regarding Rule Amendments in Texas Administrative Code (TAC) – Change of Ownership
PPAT Notice For Draft Rule Amendments Regarding Abuse, Neglect & Exploitation
Texas Health and Human Services (HHS) implemented rules that address changes in the authority of the DFPS Adult Protective Services (APS) Provider division, as amended by SB 1880 and SB 760, 84th Legislative Session (2015). The changes give the APS Provider division the authority to investigate an allegation of abuse, neglect, or exploitation (ANE) of an adult or child who receives a service from a provider who contracts with HHSC to provide Medicaid waiver or Medicaid state plan services and … [Read more...] about PPAT Notice For Draft Rule Amendments Regarding Abuse, Neglect & Exploitation