Carole Keeton Strayhorn, Texas Comptroller, chastised the Texas Health and Human Services Commission for its $800 million contract with Accenture, a group that administers Medicaid enrollment and other social services. Citing mismanagement, Stayhorn says the contract “must be ended.†According to the Houston Chronicle, Accenture’s call centers experience computer glitches and lost and backlogged applications. Strayhorn, who is running for governor, asked lawmakers to transfer project … [Read more...] about Texas Comptroller To Lawmakers: End Accenture Contract
Archives for October 2006
Hearing on Proposed Provider Reimbursement Rates
The Texas Health and Human Services Commission (HHSC) announced in the October 20 Texas Register that there will be a public hearing for comments on proposed interim Medicaid reimbursement rates that will apply to large, state-operated Intermediate Care Facilities for Persons with Mental Retardation. Included are state schools operated by the Texas Department of Aging and Disability Services. The hearing will be held on Monday, November 6, 2006, at 2:00 p.m. in the Lone Star Conference Room … [Read more...] about Hearing on Proposed Provider Reimbursement Rates
The False Claims Act–A Significant Hammer!
For an example of how whistleblowers and the False Claims Act interact, read this article, Home Health Care Industry Reels from Medicare Scandal. Whistleblowers can bring qui tam lawsuits against providers and benefit hugely. In this particular case, the whistleblower benefits as follows: The False Claims Act permits individuals to file qui tam lawsuits against companies that defraud the government. Liable companies pay as much as three times the government's losses plus penalties for … [Read more...] about The False Claims Act–A Significant Hammer!
Provider Letter: HCSSA Presurvey
The Texas Department of Aging and Disability Services issued a provider letter that replaces PL #05-25, effective June 1, 2006. The revised letter reflects changes in presurvey requirements, pursuant to 40 Texas Administrative Code Chapter 97 amendment. From the letter: The administrator, alternate administrator, supervising nurse (if applicable), and alternate supervising nurse (if applicable) of a HCSSA applying for licensure must attend a presurvey conference per 40 TAC Section … [Read more...] about Provider Letter: HCSSA Presurvey
Geriatric Doctors In Short Supply
The long term care insurance industry is not the only one that will feel the aging baby boomer surge. Geriatric physicians are in short supply, an imbalance that will become more obvious as baby boomers retire and require specialized treatment. (New York Times - free registration required) Geriatrics is not a popular specialty in medical schools, and the fact that geriatric medicine doesn’t pay as well as other specialties means there’s no economic incentive to choose to focus on … [Read more...] about Geriatric Doctors In Short Supply
More Money for Doctors Reporting Quality of Care Data
Physicians who provide care to Medicare patients with chronic conditions will have an incentive to do more paperwork. The Kaiser Network reports that the Centers for Medicare and Medicaid Services will begin a three-year pilot program that will pay physicians to report quality of care data. An excerpt: The three-year program will begin next year in 800 small- or medium-sized practices in Arkansas, California, Massachusetts and Utah. During the first year, physicians will be paid for … [Read more...] about More Money for Doctors Reporting Quality of Care Data
CMS Offers Online Tools to Help Medicare Part D Beneficiaries
Medicare Part D beneficiaries with questions about the prescription drug program can now access more information online. At the Centers for Medicare and Medicaid Services (CMS) web site, a tool called the "Drug Plan Finder" should contain information about all available drug plans, according to the Kaiser Network. Users can compare plans across states and learn how to lower costs during gaps in coverage. Kaiser also reports that CMS released an analysis of prescription drug plan savings: … [Read more...] about CMS Offers Online Tools to Help Medicare Part D Beneficiaries
CMS Computer System Leaves Medical Records At Risk
According to a new Government Accountability Office (GAO) report, the computer system at the Centers for Medicare and Medicaid Services (CMS)has weaknesses that could result in unauthorized disclosures of medical records. (Source) Former CMS administrator Mark McClellan, who left his position last weekend, told the Associated Press that the GAO didn’t find evidence of compromised records, and that "we appreciate GAO's assistance in identifying important opportunities for the contractor to … [Read more...] about CMS Computer System Leaves Medical Records At Risk
Provider Letters: Desk Review and NPI Collection Process
In a letter to Home and Community Support Services Agencies, the Texas Department of Aging and Disability Services (DADS) reminds these providers of the requirement to report allegations of abuse, neglect, or exploitation of clients to DADS and the Department of Family and Protective Services (DFPS). These incidents previously were investigated by on-site visits. In September 2004, the process was changed to allow desk reviews instead of on-site visits. The provider letter answers frequently … [Read more...] about Provider Letters: Desk Review and NPI Collection Process
Over 41,000 Qualified Nursing School Applicants Rejected in 2005
Nursing schools had to turn away over 41,000 qualified applicants in 2005 because there weren't enough faculty to teach. This is an unfortunate trend because of the overall nursing shortage nationwide. According to USA Today, 7.9 percent of faculty positions at nursing schools remain unfilled, and the Department of Health and Human Service reports that the 10 percent RN vacancy rate will increase to 36 percent by 2020. In July, I blogged about the high turnover rate in health care jobs and … [Read more...] about Over 41,000 Qualified Nursing School Applicants Rejected in 2005