HHSC Report- Effective January 1st 2018, information contained in PPAT on cost report rule changes to be adopted by March 2018, address the implementation of a cost report reform initiative for HCS/TxHmL and ICF/IID providers as required by Texas Health and Human Services Commission (HHSC)On Jan. 1st, HHSC requires only even-year cost reports beginning with the providers’ 2018 fiscal year cost reports for HCS/TxHmL (§355.722(a) and ICF/IID(§355.105(c)(1) )providers. HHSC also proposes … [Read more...] about Proposed Amendments to streamline ICF/IID & HCS/TxHmL Provider Cost Report Rules
ALF’s- Resolution of an Immediate Threat of Harm During an On-site Inspection
Provider Letter 17-36 ? If there's an Immediate Threat of Harm to the health and safety of residents at an Assisted Living Facilities during an On-site Inspection HHSC is authorized by HSC §247.042 to suspend the facility’s license or immediately close the facility. The inspector will conclude the review if, after reviewing documentation and reviewing sufficient evidence, the inspector determines that the residents are no longer at risk of serious injury, impairment or death. According to the … [Read more...] about ALF’s- Resolution of an Immediate Threat of Harm During an On-site Inspection
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.
Participant Surveys in the DBMD Program Receiving Licensed Assisted Living
Information Letter No. 17-24 DADS has published its latest information letter directed to Deaf Blind with Multiple Disabilities (DBMD) Program Providers. The letter outlines the Texas Health and Human Services Commission requirements for the DBMD program providers to perform certain activities related to participant surveys in the DBMD Program and to complete a provider survey. HHSC will schedule face-to-face visits with these people to survey them about the services they receive and their … [Read more...] about Participant Surveys in the DBMD Program Receiving Licensed Assisted Living
Amended ICF rules for Individuals with an Intellectual Disability or Related Conditions
HHSC has adopted amendments regarding a change of ownership in 40 TAC Chapter 90, Intermediate Care Facilities for Individuals with an Intellectual Disabitlity or Related Conditions, that went into effect on October 11, 2017. The adopted rules:Revise requirements related to a change of ownership of a license holder for an intermediate care facility for individuals with an intellectual disability or related conditions (ICF/IID);require a license holder that does not undergo a change of ownership … [Read more...] about Amended ICF rules for Individuals with an Intellectual Disability or Related Conditions
Changes to HCS Handbook Regarding Results of Residential Visit
Information Letter No. 17-23 – The Texas Health and Human Services Commission (HHSC) is making changes to the HCS Handbook, Section 14411. The handbook revisions pertain to results from a residential visit described in rule at Title 40, Texas Administrative Code, §9.171(j).The changes will explain how a score from a residential visit is calculated• Clarify when evidence of correction is required after a residential visit• Clarify when HHSC takes follow-up action after a residential visit• … [Read more...] about Changes to HCS Handbook Regarding Results of Residential Visit
HHSC Requires Providers to Immediately Redo all Nurse Aide Registry Status Searches
Provider Letter No. 17-24 All Providers who used the Nurse Aide Registry(NAR) from June 14, 2017, through August 3, 2017 are now required by HHSC to recheck the status searches due to an error by contractor Pearson Vue which placed ineligible nurse aides on “Active” status and mailed these ineligible individuals an invalid certificate. This error also caused 50 inaccurate event-based emails to be sent to 19 individual candidates. If a search result now shows that a nurse aide is not in … [Read more...] about HHSC Requires Providers to Immediately Redo all Nurse Aide Registry Status Searches
Billing for Preadmission Screening and Resident Review Assessments and Services
Information Letter No. 17-20 - Addressed to Nursing Facility Providers on how to bill for Therapies, Customized Manual Wheel Chairs (CMWC) and Durable Medical Equipment (DME) reimbursed through the Preadmission Screening and Resident Review (PASRR) program at HHSC. Nursing facility providers must review the resident’s Medicaid Eligibility and Service Authorization Verification (MESAV) to verify a service authorization has beencreated and to determine which service code was used. Nursing facility … [Read more...] about Billing for Preadmission Screening and Resident Review Assessments and Services
Fiscal Year 2017 Cutoff Dates for Fee-for-Service Year-end Closeout Processing
Information Letter No. 17-17This is a reminder that, with the fiscal year change, any claims for services performed in fiscal year 2015 (September 1, 2014 to August 31, 2015) that TMHP receives after Noon, Tuesday, August 8, 2017, will become miscellaneous claims and cannot be paid through the standard Claims Management System payment process. Fiscal Year 2015 Miscellaneous Fee-for-Service (FFS) Claims Cutoff:Noon, Tuesday, August 8, 2017Fiscal Year 2017 FFS Claims Processing Cutoff: Noon, … [Read more...] about Fiscal Year 2017 Cutoff Dates for Fee-for-Service Year-end Closeout Processing
Updated Preferred Provider Arrangement for All Managed Care Organizations
MCO Preferred Provider Memorandum In the latest memo update for all managed care organization starting in Fiscal year 2018, HSS is providing Guidance on Preferred Provider Arrangements and Network Access Requirements. The Medicaid and CHIP managed care contracts, including the Uniform Managed Care Contract (UMCC), will require that managed care organizations (MCOs) continue to transition provider payment methodologies from volume based payment approaches to quality-based alternative payment … [Read more...] about Updated Preferred Provider Arrangement for All Managed Care Organizations
