On November 14, 2011, the U.S. Attorney's Office for the Southern District of Texas announced that a physician was sentenced for fraud regarding private insurance, Medicare and Medicaid. Armando Chavez, a former physician and owner of the Chavez Medical Group in East Houston, was sentenced to 60 months for conspiracy and 70 months for each of three mail fraud charges, all to run concurrently. Chavez was also ordered to pay $3,821,082 in restitution. The charges stem from improper billing at the … [Read more...] about Former Houston Physician Sentenced to Federal Prison for Mail Fraud Related to Private Insurance Billing
TX Register: Medical Board Updates
The following information was obtained from the December 16 issue of the Texas Register. Public Notice HHSC intends to submit an amendment to the Texas State Plan for Medical Assistance to update the current plan with recent fee schedule updates, including fees for new services and modified fees for existing services. See the Texas Register for more information. Withdrawn Rules The Texas Medical Board has withdraw the proposed amendment to §177.5, which appeared in the September 30, … [Read more...] about TX Register: Medical Board Updates
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
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
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
Medicare: Physicians, Home Health Cuts
Unless Congress decides otherwise by January 1, physicians will face a 27.4 percent cut in Medicare reimbursement fees. From the AP: No one expects lawmakers to allow the axe to fall, but 48 million beneficiaries and their doctors are looking on nervously. Temporary reprieves have created a recurring problem that gets harder and harder to fix. A 1990s budget law called for automatic cuts to doctors if Medicare costs kept rising. Congress has issued so many waivers that a permanent fix would … [Read more...] about Medicare: Physicians, Home Health Cuts
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
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
Texas Doctors Changing with the Times
The rising costs of health care and lower reimbursement rates are forcing some physicians to change the way they work. From the Texas Tribune: These new models present a culture shift for the state's physicians, who haven't been as quick to shed a kind of "lone ranger" status as some doctors elsewhere in the nation. But it has provided an intriguing benefit for patients, drawn to the convenience and comfort of a system financially motivated to keep them as well as possible. “Doctors in Texas … [Read more...] about Texas Doctors Changing with the Times
TX Register Updates: Oct. Hearings, Nursing & Physician Changes
The following information was obtained from the October 7 issue of the Texas Register: Public Hearings and Notice HHSC will hold a public hearing on October 27, 2011, at 9 a.m. to receive public comment on proposed rates for Hospice routine home, continuous home, inpatient respite, and general inpatient care, to be held in the Lone Star Conference Room. HHSC intends to submit transmittal number 11-055 to the Texas State Plan for Medical Assistance, which would establish the Recovery … [Read more...] about TX Register Updates: Oct. Hearings, Nursing & Physician Changes
