Texas Health and Human Services Commission (HHSC) has adopted new rules that affect various provisions of Chapter 358, Medicaid Eligibility. The following are new sections: (from the September 22 Texas Register): §358.431 Transfer of Assets §358.432, Home Equity Treatment §358.433, Treatment of Entrance Fees for Individuals Residing in Continuing Care Retirement Communities HHSC adopted the changes to incorporate mandatory provisions of the Social Security Act. In related … [Read more...] about Texas Register Updates: Transfer of Assets, Provider Payments
Whistleblower Actions Under the Federal False Claims Act
Go the federal Department of Justice website (www.usdoj.gov), and you can read how the largest health care system and second largest employer in New Jersey agreed to pay $265 million to resolve a qui tam lawsuit’s allegations in of defrauding Medicare. Click here for the web page. The agreement could also mean huge rewards for the three whistleblowers who started the whole thing. As part of the settlement, St. Barnabas Care System entered into a corporate compliance agreement with the … [Read more...] about Whistleblower Actions Under the Federal False Claims Act
Physicians Reject Offer To Block Reimbursement Rate Cuts
Last month I mentioned that the American Medical Association (AMA) and other doctors groups planned to lobby Congress during the August recess to block a scheduled reduction in Medicare reimbursement rates. In the ongoing saga, one lawmaker recently made an offer that was easy to refuse: send us quality-of-care reports, and we’ll block the reduction. (Kaiser Network) No thanks, said the AMA. Physicians are not only trying to block the cut; they’re seeking a 2 percent increase in … [Read more...] about Physicians Reject Offer To Block Reimbursement Rate Cuts
Texas Register Publishes New Rule, Hearing Notices
The Texas Health and Human Services Commission (HHSC) adopted §354.1450, which governs auditing of Medicaid providers. HHSC must notify providers of an upcoming audit no later than seven days before the field portion of the audit starts. If a pharmacy is being audited, HHSC must notify the pharmacy's corporate office. For more information on the new rule, see this section of the July 21 Texas Register. HHSC has extended comment periods and issued hearing notices for two proposed amendments of … [Read more...] about Texas Register Publishes New Rule, Hearing Notices
The End of Medicine : How Silicon Valley (and Naked Mice) Will Reboot Your Doctor
That's the name of a new book by Andy Kessler. I haven't read the book yet, but it is about amazing new breakthroughs (via Silicon Valley) in diagnostic tools that will be able to detect potential problems long before they become a problem. The book description at Amazon.com says the following about the book: Your doctor can't be certain what's going on inside your body, but technology will. Embedding the knowledge of doctors in silicon will bring a breakout technology to health care, and … [Read more...] about The End of Medicine : How Silicon Valley (and Naked Mice) Will Reboot Your Doctor
Politicians Push to Eliminate Medicare Drug Penalty
The deadline to sign up for Medicare's prescription drug program has come and gone, but a bipartisan group of politicians is pushing to eliminate the late fee for beneficiaries who missed the deadline. The next open enrollment period begins in November. (Kaiser Network) Department of Health and Human Services Secretary Mike Leavitt wants Congress to wait until final enrollment numbers are determined before passing the legislation. I agree. The proposed legislation would cost taxpayers $18 … [Read more...] about Politicians Push to Eliminate Medicare Drug Penalty
The Time to Plan for Long Term Care is Now
Long term care expert Catherine Hawes, Ph.D., a professor at the Texas A&M Health Science Center School of Rural Public Health, says: "We spend more time doing research about a car we want to buy than we do when selecting a nursing home or assisted living facility." (Medical News Today) Hawes is right, of course. We have a tendency to focus more on our immediate needs and less on some distant possibility in the future. Because we're living longer, however, at some point we may need to be … [Read more...] about The Time to Plan for Long Term Care is Now
Assisted Living Facilities’ Ability To Restrict Residents Contracting for Health or Personal Care Services.
The Attorney General (AG) of Texas issued an important opinion on February 23rd addressed to the Texas Department of Aging and Disability Services (DADS) regarding "retirement centers" that require residents to use the centers' own home health agencies. First, the AG agreed with DADS' interpretation that an establishment, including one characterized as a retirement community, that furnishes food and shelter to four or more persons who are unrelated to the proprietor and that requires those … [Read more...] about Assisted Living Facilities’ Ability To Restrict Residents Contracting for Health or Personal Care Services.
Quality First Pledge
In the long term care industry, there is what's known as the "Quality First Pledge," containing seven core principles: Continuous Quality Assurance and Quality Improvement Public Disclosure and Accountability Patient/Resident and Family Rights Workforce Excellence Public Input and Community Involvement Ethical Practices Financial Stewardship (Source: American Health Care Association) Harborside Healthcare, a long term care provider, released a quality report titled, … [Read more...] about Quality First Pledge
Important New Provider Letter Affecting Both Hospice Providers and Nursing Facilities
Important New Provider Letter Affecting Both Hospice Providers and Nursing Facilities DADS has replaced April 29, 2005, hospice and nursing facility Provider Letter 05-20 with Long Term Care (LTC) Provider Letter No. 06-07 in order to emphasize that Medicaid hospice providers will not be paid for services unless the hospice provider already has its contract and Medicaid number. The bottom line is that... If licensed and certified hospice providers provide hospice services to an … [Read more...] about Important New Provider Letter Affecting Both Hospice Providers and Nursing Facilities
