Today the Centers for Medicare & Medicaid Services (CMS), in order to promote Medicaid and Medicare program efficiency, transparency, and burden reduction, proposed new rules that revise the applicable conditions of participation (CoPs) for providers and conditions for coverage (CfCs). The link of this rule will be republished in the Federal Register on Sept. 20. According to the fact sheet summary excerpt: This proposed rule would reform Medicare regulations that are identified as … [Read more...] about Medicare and Medicaid Programs – CMS, HSS Proposed Regulatory Provisions Fact Sheet
Proposed Veterans Medical Marijuana Safe Harbor Act could Legalize Cannabis for Military
As the growing population of military veterans seek access and rights to use medical cannabis to treat PTSD, chronic pain and other mental and physical war wounds, new legislation has now been filed by two Democratic senators (Senator Brian Schatz (D-HI) and Senator Bill Nelson (D-FL) that aims to basically legalize medical marijuana for them and let government physicians enable them to have access to it. According to reports, the Veterans Medical Marijuana Safe Harbor Act, would allow veterans … [Read more...] about Proposed Veterans Medical Marijuana Safe Harbor Act could Legalize Cannabis for Military
$434 Million in Financial Payments Improperly Issued by CMS to Insurers
In a new report by The HHS Office of Inspector General, the Centers for Medicare & Medicaid Services (CMS) was found to have wrongly funded $434.4 million in financial assistance payments to qualified health plan (QHPs) issuers for 461,127 policies. The audit revealed that the improperly authorized funding occurred in 2014, the first year the ACA law’s health insurance marketplaces went online. According to the report, CMS relied on insurers to verify that their enrollees were confirmed and … [Read more...] about $434 Million in Financial Payments Improperly Issued by CMS to Insurers
Proposed Rule for Permanent Risk Adjustment Program for 2018
A new Centers for Medicare & Medicaid Services (CMS) Press release details the proposed additional rule to address risk adjustment program for the 2018 benefit year. The rule would give payers the ability to receive 2018 risk adjustment payments by resolving legal contentions of the program’s operation and give CMS the ability to issue risk adjustment payments without interruptions for the current plan year. According to reports the risk adjustment payments also reimburse health insurers … [Read more...] about Proposed Rule for Permanent Risk Adjustment Program for 2018
Palliative Care and Hospice Education and Training Act goes to Senate For Approval, May Become Law
Palliative and hospice care can improve both the quality of care and quality of life for patients who are terminally ill and their families. Now the Senate has the decision to follow the U.S. House of Representatives, which has unanimously approved a bill that would help doctors and other healthcare professional elevate their skills in providing hospice and palliative care. The H.R.1676 - Palliative Care and Hospice Education and Training Act would also increase palliative care research and … [Read more...] about Palliative Care and Hospice Education and Training Act goes to Senate For Approval, May Become Law
Daily Care Service Authorization Necessary for the (PASRR) Specialized Services Authorization
Information Letter No. 18-07 - Addressed to Nursing Providers. Nursing Facility (NF) providers MUST ensure that a designated resident has a valid Daily Care service authorization reflected on the Medicaid Eligibility Service Authorization Verification (MESAV) at the significant steps in the submission and approval process for NF Specialized Services. The letter addresses how to minimize billing issues. NF staff must ensure all appropriate and necessary forms and assessment submissions have … [Read more...] about Daily Care Service Authorization Necessary for the (PASRR) Specialized Services Authorization
Technical Memoranda (TM) concerning prescribed Life Safety Code (LSC) standards for ALFs
Provider Letter 18-11 - Technical Memoranda (TM) concerning prescribed Life Safety Code (LSC) standards for ALFs to be responsible for reviewing the LSC TM and complying with the guidance provided therein. The LSC is a set of fire protection requirements designed to provide a reasonable degree of safety at Assisted Living Facilities. It covers construction, protection, and operational features designed to provide safety from fire, smoke, and panic. According to the letter and 2.0 Policy … [Read more...] about Technical Memoranda (TM) concerning prescribed Life Safety Code (LSC) standards for ALFs
Preparing for the Upcoming Fiscal Year 2018 Fee-for-Service Claims Billing Closeout
Information Letter No. 18-06 : This letter addresses preparation for the August 31, 2018, end of fiscal year closeout. Providers must promptly submit claims to be paid by the Health and Human Services Commission (HHSC) for any unbilled services. Any problems associated with the claims are resolved within the 12-month filing limitation. The letter directly addresses the following: Adult Foster Care Providers Assisted Living Facilities Community Attendant Services Providers Community … [Read more...] about Preparing for the Upcoming Fiscal Year 2018 Fee-for-Service Claims Billing Closeout
New Requirements for Rehabilitative Services and Nursing Facility Specialized Services
PL 18-01 (NF) -Last September 10, 2017, the Health and Human Services Commission (HHSC) added new rules and amended and deleted rules in Texas Administrative Code (TAC), Title 40, Part 1, Chapter 19, Nursing Facility Requirements for Licensure and Medicaid Certification. The Provider letter describes new requirements related to rehabilitative services and nursing facility (NF) specialized services and the provider responsibilities that arise from the new rules. Among many new rules and for … [Read more...] about New Requirements for Rehabilitative Services and Nursing Facility Specialized Services
Texas Register Update Concerning Delivery System Reform Incentive Payment (DSRIP) program.
The Texas Health and Human Services Commission (HHSC) adopts new Division 7, concerning DSRIP Program Demonstration Years 7-8, and within the new division (Review Texas Register for programs).The following information was obtained from the Novemeber 24 issue of the Texas Register.The Centers for Medicare & Medicaid Services (CMS) approved Texas' request for a new Medicaiddemonstration waiver entitled "Texas Healthcare Transformation and Quality Improvement Program" in accordance with §1115 … [Read more...] about Texas Register Update Concerning Delivery System Reform Incentive Payment (DSRIP) program.
