Garlo Ward, P.C.

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Use of nonspecific International Classification of Diseases (ICD) codes for “debility” and “adult failure to thrive” as principal diagnoses for Medicaid Hospice certification.

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The purpose of this letter is to inform Medicaid Hospice providers, effective October 1, 2014, the use of nonspecific diagnosis ICD codes for “debility” and “adult failure to thrive” will no longer be acceptable as the principal diagnosis on Form 3071, Individual Election/Cancellation/Update, for Medicaid hospice certification. In the August 7, 2013 publication of the Federal Register, the Centers for Medicare & Medicaid Services (CMS) issued a final rule: Medicare Program; FY2014 … [Read more...] about Use of nonspecific International Classification of Diseases (ICD) codes for “debility” and “adult failure to thrive” as principal diagnoses for Medicaid Hospice certification.

DADS Provider Alert regarding coding of ADLs

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Improper Coding for MDS Item G0110 Could Cause Changes to RUG Values Nursing facility and skilled nursing facility providers must use the proper activities of daily living (ADL) coding when completing column 1 of item G0110 on the MDS 3.0 assessment. The Texas Health and Human Services Commission (HHSC) Office of the Inspector General (OIG) staff have announced that improper coding could cause changes to RUG values during Medicaid reviews. While neither federal nor state rules specifically … [Read more...] about DADS Provider Alert regarding coding of ADLs

Discontinuation of Service Categories in the Texas Home Living Program

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The purpose of this information letter is to inform Texas Home Living (TxHmL) program providers and local authorities the two service categories for the TxHmL Program: the Community Living Service Category and the Technical and Professional Supports Service Category, were discontinued effective September 1, 2014. The TxHmL Program rules at Texas Administrative Code (TAC), Title 40, Chapter 9, Subchapter N, have been amended to reflect the deletion of all references to and requirements … [Read more...] about Discontinuation of Service Categories in the Texas Home Living Program

Transportation Requirements for Abuse, Neglect and Exploitation Investigations

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The purpose of this information letter is to inform Home and Community-based Services (HCS) and Texas Home Living (TxHmL) program providers of transportation requirements when an individual is involved in a Department of Family and Protective Services (DFPS) abuse, neglect, and exploitation (ANE) investigation. When an individual receiving services is involved in an ANE investigation of a service provider, DFPS may indicate a forensic interview of the individual be conducted by a … [Read more...] about Transportation Requirements for Abuse, Neglect and Exploitation Investigations

HHSC to Re-issue Data Project Procurement this Fall

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HHSC to Re-issue Data Project Procurement this Fall AUSTIN — The Texas Health and Human Services Commission (HHSC) plans to re-issue a request for proposals (RFP) for a major data project this fall. The original procurement was canceled so the state could make revisions to help lower the costs for the project. "This is an important project to help improve the quality and efficiency of Medicaid services, and we're committed to getting it right," said Texas Health and Human Services … [Read more...] about HHSC to Re-issue Data Project Procurement this Fall

Implementation of Amendments and New Rules to 40, Texas Administrative Code, Chapter 41, Consumer Directed Services Option

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DADS Information Letter 14-58 informs Financial Management Services Agencies (FMSA) and Consumer Directed Services (CDS) option employers of the changes to 40 Texas Administrative Code (TAC), Chapter 41, Consumer Directed Services Option. Effective September 1, 2014, CDS employers will be required to: · complete, at the initial orientation, a Service Provision Requirements Addendum to DADS Form 1735, Employer and Financial Management Services Agency Service Agreement (Section 41.207-Initial … [Read more...] about Implementation of Amendments and New Rules to 40, Texas Administrative Code, Chapter 41, Consumer Directed Services Option

Consumer Directed Services Budget Rate Changes for Primary Home Care

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DADS Information letter 14-57 provides direction to Financial Management Services Agencies (FMSAs) on updating Consumer Directed Services (CDS) employers’ budgets to accommodate the new payment rate, effective September 1, 2014, for Primary Home Care (PHC). The Health and Human Services Commission (HHSC)-approved rates can be found at https://www.hhsc.state.tx.us/Rad/long-term-svcs/index.shtml. Service Authorization Changes The rate change for PHC requires a service authorization change. By … [Read more...] about Consumer Directed Services Budget Rate Changes for Primary Home Care

New Payment Rates

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The Health and Human Services Commission (HHSC) approved new payment rates for the following programs: Medically Dependent Children Program (MDCP) and associated Consumer Directed Services. The new payment rates can be accessed through the HHSC Rate Analysis website at the following address: http://www.hhsc.state.tx.us/rad/long-term-svcs/index.shtml Once you access this website, scroll down to the “Payment Rate Information” heading and click on the link entitled “2015 Payment Rates – … [Read more...] about New Payment Rates