The following information was obtained from the February 27 issue of the Texas Register: Public Notices The Texas Health and Human Services Commission (HHSC) announced its intent to submit to the Centers for Medicare and Medicaid Services a request to amend the State of Texas Access Reform + PLUS (STAR+PLUS) program, to integrate delivery of acute and long-term care services through a managed care system. HHSC also intends to submit an amendment to the Texas State Plan for Medical … [Read more...] about Texas Register Updates: STAR+PLUS Changes
MedPAC’s 2009 Report to Congress
The Medicare Payment Advisory Commission (MedPAC), which advises Congress on Medicare issues, released its 2009 report to Congress. The report includes payment policy recommendations for nine payment systems: hospital inpatient, hospital outpatient, physicians, ambulatory surgical center, outpatient dialysis, skilled nursing, home health, inpatient rehabilitation facilities, and long-term care hospitals. From the press release: FEE-FOR-SERVICE PAYMENT UPDATE … [Read more...] about MedPAC’s 2009 Report to Congress
Law, Health & Liberty Podcast–Andy Schlafly of the Association of American Physicians & Surgeons
This is Garlo Ward's second podcast. It now has a name, Law, Health & Liberty. Click on the title to see the podcast. I chose this name because I see my firm's job as protecting the liberty interests of health providers against the actions of government which undermine your ability to serve patients, consumers and residents. In this podcast, I interview Andy Schlafly , the General Counsel of the Association of American Physicians and Surgeons (AAPS) about sham peer review and the … [Read more...] about Law, Health & Liberty Podcast–Andy Schlafly of the Association of American Physicians & Surgeons
Texas Register Updates: Medicaid Payment Rate Hearings, Etc.
The following information was obtained from the January 23 and January 30 issues of the Texas Register: Public Hearings and Notices The Texas Health and Human Services Commission (HHSC) will hold public hearings on Medicaid payment rates for several programs on February 17, 2009, at 1:30 p.m., in the Lone Star Conference Room of HHSC, Braker Center, Building H, located at 11209 Metric Boulevard, Austin, Texas. Follow this link and scroll down to read each entry. HHSC announced its … [Read more...] about Texas Register Updates: Medicaid Payment Rate Hearings, Etc.
Information Letters: PACE and Hospice Provider Updates, Etc.
The Texas Department of Aging and Disability Services (DADS) released three new information letters: Community Services Medical Necessity (MN) and Level of Care (LOC) Assessment for PACE Participants Residing in Nursing Facilities (NFs) DADS served notice to PACE providers about MN/LOC assessments and billing for participants whose permanent residence is a Medicaid NF. PACE submits assessments to the Texas Medicaid Healthcare Partnership every year, and the organization is responsible … [Read more...] about Information Letters: PACE and Hospice Provider Updates, Etc.
More Doctors E-Prescribing
To eliminate medication errors caused by misreading handwritten prescriptions and other purposes, the Centers for Medicare and Medicaid Services (CMS) introduced an electronic prescribing system. To encourage doctors to use the system, CMS allowed them to earn a payment of two percent of the total allowed Medicare charges during 2009 and another two percent incentive payment for successfully reporting measures under the Physician Quality Reporting Initiative. It looks like the incentives are … [Read more...] about More Doctors E-Prescribing
Medicaid Enrollment Climbs During Recession
As expected, Medicaid enrollment grew by 5-10 percent in several states in the past year because of the recession. (Kaiser Network) Sixteen of the 40 states that responded to a New York Times survey reported at least a 5 percent increase in Medicaid enrollment in the past year. States also reported an increase in State Children's Insurance Program (SCHIP) enrollment. Consequently, states experienced a large number of people trying to enroll, swamping social services agencies. States may … [Read more...] about Medicaid Enrollment Climbs During Recession
SCHIP Bill Would Bar New Physician-Owned Hospitals
Last week, the U.S. House of Representatives approved a bill that would reauthorize and expand the State Children’s Health Insurance Program (SCHIP). The measure, which passed by a vote of 289 to 139, would expand coverage for children from families with incomes of up to three times the federal poverty. Such an expansion would cover three million more children. The Kaiser Network reported yesterday that the House version of the SCHIP bill would prohibit the construction of new … [Read more...] about SCHIP Bill Would Bar New Physician-Owned Hospitals
Texas Register Updates: Repeal of Fair Hearing Rules, Texas Medical Board Rule Changes
The following information was obtained from the January 9 and January 16 issues of the Texas Register: Public Hearing The Texas Health and Human Services Commission (HHSC) will hold a public hearing on January 30, 2009, at 10:00 a.m. to receive public comment on the proposed interim per diem Medicaid reimbursement rate for small, state-operated Intermediate Care Facilities for Persons with Mental Retardation operated by DADS. The hearing will be held in the Piney Woods Conference Room of … [Read more...] about Texas Register Updates: Repeal of Fair Hearing Rules, Texas Medical Board Rule Changes
California Supreme Court Bars Balance Billing
Emergency department doctors and hospitals in California can no longer directly bill insured patients for charges HMOs refuse to pay. Last week, the state's highest court barred balance billing and contended that ER doctors and HMOs must iron out their disagreements. The responsibility should not fall on patients. (Source) In a press release, Governor Arnold Schwarzenegger wrote: "This ruling will protect Californians who have done the right thing by obtaining insurance, but then later … [Read more...] about California Supreme Court Bars Balance Billing