The following information was obtained from the June 15 issue of the Texas Register. Public Notice Correction HHSC corrected a public notice published in the April 6, 2012, issue about submitting a request to renew the MDCP waiver: The notice incorrectly stated that the waiver provided in-home child care, including in the individual's or a family member's home, or a foster family's home. It should have stated: Services include respite, adaptive aids, minor home modifications, financial … [Read more...] about TX Register Updates: Correction & Reimbursement Change
ILs/PL: Annual Mandatory ALF Training
DADS released two information letters and one provider letter: Medicaid Hospice: DADS asked these providers to submit the form attached to the letter, which shows the methodology CMS uses to determine the provider's Medicare overall cap for FFY 2010 and 2011. The deadline for submitting this information was May 15, 2012. (Letter) ALFs: DADS provided information about annual mandatory training for ALFs. See the provider web page for more information. (Letter) AFC, ALF, CBA, CLASS, … [Read more...] about ILs/PL: Annual Mandatory ALF Training
DADS News Alerts: Cultural Change Initiative, NF meeting
-- As part of the cultural change initiative, DADS will host four symposia in 2012. Registration information will be available a month before each event: Lubbock – Wednesday, August 22, Holiday Inn Lubbock - Hotel and Towers Dallas – Friday, August 24, Westin Park Central San Antonio – Tuesday, November 13, Sheraton Gunter Hotel Houston – Thursday, November 15, Houston Marriott Westchase -- DADS issued an alert to providers and other qualified entities to become a residential … [Read more...] about DADS News Alerts: Cultural Change Initiative, NF meeting
Private Home Health Care Profitable
The Baby Boom generation will be a business boom, indeed. According to USA Today, home health is a very profitable franchise for several reasons. The children of aging parents who need care work, so fewer are available to provide full-time home care for parents and other relatives. If the franchise is so profitable now, imagine how lucrative it will be in the next 10-20 years. Michelle Rowan, president of a market research firm that released a report about the booming business, attributes … [Read more...] about Private Home Health Care Profitable
TX Register Updates: Consultant, Medicare Equalization
The following information was obtained from the April 27 issue of the Texas Register. HHSC has entered into a sole source agreement for consulting services for May 15, 2012. The consultant will, among other things, assist HHSC in meeting standards and requirements of the waiver under section 1115 of the Social Security Act. HHSC intends to submit transmittal number 12-022 to the Texas State Plan for Medical Assistance, which would exempt services provided by psychologists, psychiatrists, … [Read more...] about TX Register Updates: Consultant, Medicare Equalization
Non-payment for “Never Events”: Coming to a Long-Term Care Provider Near You
Since October 2008, the Centers for Medicare and Medicaid Services ("CMS") have not paid hospitals for certain hospital-acquired conditions. That is, CMS will not pay for certain conditions that were not present in the patient upon admission. The conditions are, as designated by CMS, conditions that are: (a) high cost or high volume or both, (b) result in the assignment of a case to a DRG that has a higher payment when present as a secondary diagnosis, and (c) could reasonably have been … [Read more...] about Non-payment for “Never Events”: Coming to a Long-Term Care Provider Near You
DADS News Alerts: Medicare Part A Clarification, Meetings
-- CMS posted a second errata for the MDS 3.0 RAI Manual. The two PDF files: MDS 3.0 RAI Manual (v1.08) Errata v3 MDS 3.0 RAI Manual (v1.08) Errata v4 -- CMS staff clarification of a Medicare Part A stay -- When such a resident is discharged: [T]he Assessment Reference Date (ARD) of a scheduled Medicare Prospective Payment System (PPS) assessment may be adjusted to the day the resident is discharged only when the ARD for the scheduled PPS assessment was set prior to the day of … [Read more...] about DADS News Alerts: Medicare Part A Clarification, Meetings
ILs: Medicaid Hospice
DADS released four information letters: CLASS: DADS has changed the monitoring review period in conjunction with implementing new contract and fiscal compliance monitoring tools for CLASS CMAs and DSAs. (Letter) Medicaid Hospice: DADS will begin identifying the overall aggregate payments made to hospice providers during each hospice cap period using claims paid in State fiscal year 2010. (Letter) Medicaid Hospice and NF: DADS clarified which provider is responsible for billing … [Read more...] about ILs: Medicaid Hospice
TX Register Updates: Dual Eligibles, TANF, and SNAP
The following information was obtained from the April 20 issue of the Texas Register. Proposed Rules HHSC proposes to amend §354.1143, Coordination of Medicaid with Medicare Parts A, B, and C, which would authorize HHSC to make higher cost-sharing payments for dual eligibles for certain services if HHSC determines it's necessary to ensure adequate access or that it would be more cost-effective. For details, see the Texas Register. HHSC also proposed to amend §355.8065, Disproportionate … [Read more...] about TX Register Updates: Dual Eligibles, TANF, and SNAP
TX Register Updates: Contract Awards, Medicare Billing Prohibition
The following information was obtained from the April 13 Texas Register: Public Notices HHSC announced several contract awards. See the Texas Register for a listing of the companies. HHSC intends to submit transmittal number 12-010, which would convert the reimbursement methodology for non-emergency medical transportation services from fee-for-service to full risk capitation in the following designated counties: Collin, Dallas, Denton, Ellis, Hood, Hunt, Johnson, Kaufman, Navarro, … [Read more...] about TX Register Updates: Contract Awards, Medicare Billing Prohibition
