DAHS providers that have a DAHS contract with the Texas Department of Aging and Disability Services (DADS) are advised of revised eligibility criteria and assessment procedures.Pending completion of proposed rule amendments to Texas Administrative Code (TAC), Title 40 Part 1, Chapter 48, §48.2915, providers of DADS DAHS are notified effective October 15, 2015, the following eligibility criteria will apply:? DAHS services must be prescribed by a physician who has certified that the individual … [Read more...] about Day Activity and Health Services Eligibility Criteria and Eligibility Assessment Procedures
Transition Assistance Services, Pre-enrollment Minor Home Modifications and Pre-enrollment Minor Home Modifications Assessments in the Home and Community-based Services
Texas Department of Aging and Disability Services (DADS) rules amendments go into effect for HCS providers and LIDDAs that address the provision of transition assistance services (TAS), pre-enrollment minor home modifications, and preenrollment minor home modifications assessments and are set forth below. Also illustrated below are other operational requirements for service coordinators and program providers regarding TAS, pre-enrollment minor home modifications, and pre-enrollment minor home … [Read more...] about Transition Assistance Services, Pre-enrollment Minor Home Modifications and Pre-enrollment Minor Home Modifications Assessments in the Home and Community-based Services
Draft guidelines for prescribing opioids for chronic pain
The CDC is requesting comments from stakeholders regarding the new draft guidelines. Here are some opinions---The National Hospice & Palliative Care Organization has given its response, stating that it is “pleased that the guidelines exclude patients who are at the end of life, with language that states ‘outside end-of-life care.’”NHPCO stated several concerns it has with the draft guidelines, including the short timeline of the commenting period, an apparent lack of documentation behind the … [Read more...] about Draft guidelines for prescribing opioids for chronic pain
HHSC – Sunset and the Transition of the State Agencies under HHSC; Vision of HHS Transformation
Health and Human Services Commission (HHSC) Acting on direction from the Texas Legislature, the health and human services agencies have startedactivities that lay the groundwork for transformation of the health and human services system. Thefollowing information was taken from the HHSC Connection. Contrary to what some might believe, the 84th Texas Legislature did not approve beginning-to-endinstructions for how the health and human services agencies should reorganize. Yes, … [Read more...] about HHSC – Sunset and the Transition of the State Agencies under HHSC; Vision of HHS Transformation
ICD 10; what to do with difficult submissions
As you know, ICD 10 begins October 1, 2015. CMS MLN released information to providers on claimsubmission alternatives when you have difficulties submitting ICD-10 claims due to being unable tocomplete necessary systems changes or having issues with billing software, vendor(s), orclearinghouse(s). The article states that the following claims submission alternatives are available: Freebilling software, provider internet portals, direct data entry (DDE), and paper claims. Each … [Read more...] about ICD 10; what to do with difficult submissions
Medicaid Payment Rates
Medicaid Payment RatesAs you know, the CMS Medicaid hospice payment rates memo was released on September 1, 2015. Therequirements reflect the Medicare final rule which was published on August 6, 2015. The rule changesimplement several items:? Payment methodology for routine home care (RHC) – beginning January 1, 2016 the RHC rateswill be implemented; a higher base payment for the first 60 days of care and a reduced rate forthe days thereafter.? Service Intensity Add-on – this is payment for … [Read more...] about Medicaid Payment Rates
Adventist Health – To Pay $118MM
Adventist Health System has agreed to pay $118.7 million to settle a whistleblower lawsuit that alleges the Florida-based company paid kickbacks to doctors in exchange for referrals.The 2012 lawsuit alleges Adventist, which operates skilled nursing facilities, rehabilitation facilities, hospitals and other healthcare facilities in 10 states, gave physicians bonuses and increased salaries, and allowed them to overbill, in exchange for referring their patients to Adventist facilities. The suit was … [Read more...] about Adventist Health – To Pay $118MM
SNF aide, 77, pleads guilty to rape, faces $15 million fine if abuses again
A former employee of a Minneapolis nursing home pleaded guilty this week to chargesthat he raped a resident who suffered from dementia. He also agreed to an unusual settlement that would require him to pay $15 million to the victim's estate if he is convicted again.George Sumo Kpingbah, 77, was working as an aide at Walker Methodist Health Center when he was found abusing an 83-year-old resident by a nurse on her rounds in December 2014. A Department of Health investigation found the facility … [Read more...] about SNF aide, 77, pleads guilty to rape, faces $15 million fine if abuses again
HCS Dental Limit Increased to $2000/year 9/1 Documents You Need to Proceed
Information Letter No. 2015-51 - Service Limit Increase for Dental Treatment in the Home and Community-based Services ProgramAddressed to:Home and Community-Based Services (HCS) ProvidersLocal Intellectual and Developmental Disability AuthoritiesHome and Community-based Services (HCS) Program Billing Guidelines09/01/2015 05:30 AM CDT Dental Limit Increase Questions about Dental Requisition Fees?Check page 2 of "HCS Rates Effective September 1, 2015."Visit us at Garlo Ward, PC … [Read more...] about HCS Dental Limit Increased to $2000/year 9/1 Documents You Need to Proceed
Revised HCS, CLASS, DBMD, TxHmL Forms – Includes HCS Transportation, TAS, and Pre-Enrollment Minor Home Modifications
DADS has published the following revised forms related to transportation, transition assistance services (HCS only), and pre-enrollment minor home modifications (HCS only). Please begin using the current versions of these forms during the service planning process. As the agency continues to release new or revised forms, providers will be notified.Revised forms:Form 3595 - IPP Service ReviewForm 3598 - Individual Transportation PlanForm 3608 - Individual Plan of Care (IPC) - HCS/CFCForm … [Read more...] about Revised HCS, CLASS, DBMD, TxHmL Forms – Includes HCS Transportation, TAS, and Pre-Enrollment Minor Home Modifications
