The 11-member Physician-Focused Payment Model Technical Advisory Committee(PTAC) established by MACRA to consider whether models submitted by stakeholders qualify as Medicare alternative payment models voted to move forward on proposals for two alternative payment models for review by the HHS secretary. One model, the Patient and Caregiver Support for Serious Illness model, was submitted by the American Academy of Hospice and Palliative Medicine. The second model is the Advanced Care Model … [Read more...] about Two new proposals address alternative payment models for patients in Palliative Care.
CMS is adding flexibility to their expansion of benefits by redefining health-related supplemental benefits to include services that increase health and improve quality of life, including coverage of non-skilled in-home supports and more. Hospice care and palliative care are considered as well as supplemental benefits down the road. Benefits will only be available to some of the participants of Medicare Advantage plans. These benefits will not be extended to original Medicare. Supplemental … [Read more...] about CMS proposed adding non-skilled in-home care as a supplemental benefit to Medicare Advantage plans in 2019.
Information Letter No. 18-04 This letter provides an annual update to the International Classification of Diseases, Tenth Revision (ICD-10) code set as of October 1, 2017, which includes new and revised ICD-10 diagnostic codes. Health and Human Services Commission (HHSC) has revised the HHSC-Approved Diagnostic Codes for Persons with Related Conditions. List of Invalid ICD-10 Related Conditions Codes: The following ICD-10 diagnoses codes are no longer valid and were deleted from the … [Read more...] about Changes to HHSC-Approved Diagnostic Codes for Persons with Related Conditions List
Information Letter No. 18-03 - This notice provides details on the 2018 Upper Payment Limit (UPL) Program that alerts providers of Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions (ICF/IID) that the window to participate in all Quarters for the 2018 Upper Payment Limit (UPL) program, covering October 1, 2017 -March 31, 2018, closes on February 22, 2018. According to the letter, there is no “roll-over” enrollment. If you wish to enroll in all … [Read more...] about Deadline for ICF/IID Providers to Participate in the 2018 Upper Payment Limit (UPL) Program
Information Letter No. 18-01 - Cost report training is required every other year for the odd-year cost report in order for the preparer to be qualified to complete both that odd-year cost report and the following even-year cost report. Upon successful completion of either an Initial or Refresher Cost Report Training webinar, preparers who have previously completed cost report training for that same program will be awarded credit for completing the webinar and will be able to submit a 2017 cost … [Read more...] about Cost Report Training Information For Service Providers
CMS halts enforcement of some standards required by nursing homes that would enhance safety procedures for patients. In this notice: Temporary Enforcement Delays for Certain Phase 2 F-Tags and Changes to Nursing Home Compare posted late last month, the CMS announced an 18-month moratorium on enforcement remedies in some nursing home regulation that was finalized last year.Memorandum Summary from CMS Inlcuded:Temporary moratorium on imposing certain enforcement remedies for specific Phase 2 … [Read more...] about Enforcement of Obama-era nursing home standards and enforcement remedies halted by CMS
Provider Letter No. 17-28 and Information Letter No. 17-27 addresses Health and Human Services Commission (HHSC) allowing an exception to the service limits for replacing or repairing adaptive aids and minor home modifications for certain individuals enrolled including those in the:Community Living Assistance and Support Services (CLASS)Deaf Blind with Multiple Disabilities (DBMD) ProgramHome and Community-based Services (HCS) Texas Home Living (TxHmL) ProgramSpecifically, individuals whose … [Read more...] about Service Limit Exceptions in Programs for Adaptive Aids and Minor Home Modifications Due to Hurricane Harvey
Provider Letter No. 17-37 – The Department of Aging & Disability Services (DADS) is no longer a stand-alone agency and has been transferred to the Health and Human Service Commission (HHSC), although the regulatory processes for notifying providers of changes to licensure requirements will remain unchanged. Regulatory programs and management of the operations for state supported living centers will transfer to HHS .The provider letter details that HHSC will continue to notify providers of … [Read more...] about DADS Functions Abolished after 2-Year HHS Transformation
Information Letter No. 17-25 – The information letter informs residents that were affected by Hurricane Harvey that The Texas Health and Human Services Commission can implement extensions of eligibility and individual plan of care authorizations on a case-by-case basis. An extension can be requested by a CLASS case management agency, CLASS direct service agency or DBMD program provider.The extension is for individuals that had permanent residence in a county declared a federal disaster area … [Read more...] about Extensions of Eligibility and Individual Plan of Care Authorizations for Individuals in CLASS and DBMD Impacted by Hurricane Harvey
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.