The Texas Department of Aging and Disability Services (DADS) informed Community Services Waiver Providers about the increase in individual cost limits for six Medicaid waiver programs operated by DADS. The three-page August 20 letter includes of a breakdown of cost limits for such programs as the Consolidated Waiver Program and the Deaf-Blind with Multiple Disabilities Program. You may download the letter here. In an August 24 provider letter to Assisted Living Facilities, Adult Day Care … [Read more...] about DADS Letters: Individual Cost Limits, New Convictions
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Board of Nurse Examiners Updates
The Texas Board of Nurse Examiners has proposed to amend §211.6 and §211.7 of the 22 Texas Administrative Code to implement §301.1595 of the Texas Occupations Code, as applicable to the committees' make-up. From the Texas Register: Section 211.6 was amended in March 2007 to comply with the Sunset Advisory Committee staff's recommendations which were subsequently incorporated into House Bill 2426 (HB 2426). Subsection (f)(4) is recommended to incorporate consistency in the rule by … [Read more...] about Board of Nurse Examiners Updates
Deinstitutionalizing Nursing Home Care
In 1987, Congress signed into law the Nursing Home Reform Law, which established nursing home oversight rules to improve facilities. Mary Ousley, past chair of the American Health Care Association, testified before Congress in May about the long term care profession’s experience since the Nursing Home Reform Law went into effect and the need for facilities, providers, regulators, and consumers to work together to improve nursing home care. Last year, lawmakers introduced a bill called the … [Read more...] about Deinstitutionalizing Nursing Home Care
Congress Investigates Long Term Care Insurers
The New York Times (free registration) reports that Congress is putting the long term care insurance industry “under scrutiny.†The House Committee on Energy and Commerce is investigating long term care insurers Conseco and the Penn Treaty American Corporation. It seems that certain long term care insurers are making policyholders jump through hoops to have their claims paid. Congressman John Dingell of Michigan told the paper that “We have two companies that seem to be engaging in … [Read more...] about Congress Investigates Long Term Care Insurers
Bush Proposes Medicare Reimbursement Cuts to Fund Proposals
The Bush administration seeks to cut Medicare reimbursements to hospitals, home health agencies, and skilled nursing facilities in an effort to save as much as $100 billion to fund health care proposals. (Kaiser Network) Last week, the House Ways and Means Health Subcommittee, chaired by Democrat Pete Stark, held a hearing to consider a proposal from the Bush administration “to freeze Medicare reimbursements for home health agencies and skilled nursing facilities." A health care … [Read more...] about Bush Proposes Medicare Reimbursement Cuts to Fund Proposals
Medicare Prescription Drug Negotiation Bill Stalls in Senate
Earlier this month, the U.S. House of Representatives passed a bill that would require the government to negotiate Medicare Part D prescription drug prices with drug companies. (See Congress Debates Medicare Part D Drug Price Negotiating) Last week, the measure failed to receive enough for votes for a floor debate in the Senate. (Medical News Today) Those who oppose the bill fear that requiring the government to negotiate instead of allowing the market to dictate drug prices will stifle drug … [Read more...] about Medicare Prescription Drug Negotiation Bill Stalls in Senate
Congress Debates Medicare Part D Drug Price Negotiating
Congressional discussions about the government negotiating Medicare Part D drug prices is ongoing. Although President George W. Bush has threatened to veto legislation allowing the government to negotiate prescription drug prices, lawmakers are moving forward. The House of Representatives passed a measure that would require the secretary of the Department of Health and Human Services to barter with drug companies over Medicare Part D drug prices. (UPI) The Senate version of the bill is … [Read more...] about Congress Debates Medicare Part D Drug Price Negotiating
Pharmaceutical Companies Overcharge Feds
Lawmakers and advocacy groups claim that prescription drug makers have been overcharging the Medicaid program. (Newhouse News Service) Testifying before the House Committee on Oversight and Government Reform, Ron Tenpas, a U.S. associate deputy attorney general, said drug companies are required by law to give Medicaid programs the same discount as managed care plans and hospitals, but they have not. The government contends drug companies have concealed this practice. So far, about $3.9 … [Read more...] about Pharmaceutical Companies Overcharge Feds
More Medicare Part D Fall-Out for Pharmacists
Last year I blogged about a group of Texas pharmacists (independent operators) lobbying the White House for reimbursement for Medicare Part D prescription drugs. (See Texas Pharmacists Lobby White House) The pharmacists were not receiving sufficient reimbursement to make up for the millions of dollars worth of drugs they gave to Part D patients for free, in part because Part D was new and confusing, and patients who needed medications couldn’t afford to wait for approval. To make … [Read more...] about More Medicare Part D Fall-Out for Pharmacists
Cost of Medicare Part D Lower Than Expected
According to the Congressional Budget Office (CBO), the cost of Medicare Part D over 10 years will be $265 billion less than estimated last August. (Source) The Medicare prescription drug benefit will cost $38 billion this year and $675 billion from 2007 through 2016. CBO director Peter Orszag (pictured) said the lowered cost estimate is attributed to the "lower-than-expected bids" of prescription drug plans. "The bids are coming in, and the pricing is coming in better than anticipated, … [Read more...] about Cost of Medicare Part D Lower Than Expected
