-- HHSC adopted amendments to §9.553, Definitions; §9.555, Definitions of TxHmL program service components; §9.567, Process for Enrollment; §9.578, Program Provider Certification Principles: Service Delivery; and §9.583, TxHmL program principles for local authorities, in Subchapter N, TxHmL Program, Chapter 9, Intellectual Disability Services--Medicaid State Operating Agency Responsibilities. -- From the news alert page: Some DADS waiver clients were enrolled in STAR+PLUS or got STAR+PLUS … [Read more...] about Alerts and News: Court Decision, STAR+PLUS Mistake
LTC News: CMS Rules, Provider Court Case
-- "After years of trying to clamp down on hospital spending, the federal government wants to get control over what Medicare spends on nursing homes, home health services and other medical care typically provided to patients after they have left the hospital." - Kaiser -- "In a rule issued today, [CMS] finalized payment rates and policies for 2014, including a major proposal to support care management outside the routine office interaction as well as other policies to promote high quality … [Read more...] about LTC News: CMS Rules, Provider Court Case
LTC News: Physicians Concerned
-- "States are not doing a good job of monitoring how Medicaid managed care enterprises handle providers serving high-risk populations, according to a new government report." – McKnight's -- "Prospective Medicare changes regarding physician payments might unfairly penalize doctors working in long-term care settings, according to a prominent medical directors association...For example, the government has set incentives for physicians to meet 'meaningful us' thresholds for electronic health … [Read more...] about LTC News: Physicians Concerned
LTC News: Drs. Medicare Payment
-- "The Democratic and Republican leaders of two key congressional committees have agreed on a framework to scrap the problematic Medicare payment formula for physicians and replace it with one that would link physician reimbursement to the quality of care provided, a step that could put an end to the annual "doc fix" debate." - Kaiser -- "A bill in the House of Representatives aims to create a 'trusted provider' status in the Medicare program, which would potentially streamline the … [Read more...] about LTC News: Drs. Medicare Payment
TX Register Updates: Corrections, Dual Eligibles
The following information was obtained from the November 1 issue of the Texas Register. Public Notices A correction to a public notice that appeared in the September 13, 2013, issue regarding the intent to submit a request for an amendment to the MDCP Medicaid waiver: The waiver transfer process, allowing individuals to transfer between waivers when medically necessary for services to continue to ensure health and safety, was previously described in the public notice published in the … [Read more...] about TX Register Updates: Corrections, Dual Eligibles
LTC News: Doctors, Pharmacists, and Nurses
-- "The Texas Medical Association, Texas Hospital Association and Texas Academy of Family Physicians said many physicians and hospitals have also been unable to determine which health plans offered in the marketplace include them in their provider networks. 'Physicians, they just want to know who's walking through their door and what kind of coverage they’re going to have,' said Lee Spangler, vice president of medical economics at the Texas Medical Association. 'They’d like that uncertainty to … [Read more...] about LTC News: Doctors, Pharmacists, and Nurses
TX Register Updates: Level II Service, ACA Reqs.
The following information was obtained from the October 25 issue of the Texas Register. Proposed Rules The Texas Medical Board proposed to amend §192.1, Definitions, which would add language providing that the administration of certain local anesthesia, peripheral nerve blocks, or both in a total dosage amount that exceeds 50 percent of the recommended maximum safe dosage per outpatient visit is a Level II service. See the Texas Register for details. Withdrawn Rules The Texas Medical … [Read more...] about TX Register Updates: Level II Service, ACA Reqs.
TX Register Updates: Correction, Base Wage
The following information was obtained from the October 11 issue of the Texas Register. Public Notice Correction HHSC published a notice in the September 20 issue about the agency's intent to submit a request to amend the THTQIP. An excerpt: In the prior public notice published in the September 20, 2013 issue of the Texas Register, HHSC discussed the agency's intent to request the addition of cognitive rehabilitation therapy as an available service in the STAR+PLUS home and community … [Read more...] about TX Register Updates: Correction, Base Wage
