Republicans and Democrats on Capitol Hill are trying to reach a compromise on expanding the State Children’s Health Insurance Program (SCHIP). (Kaiser Network)

Two weeks ago, President George W. Bush vetoed a bill that would have added $35 billion to SCHIP over a five-year period. Last week, the House of Representatives passed a modified SCHIP bill, but the vote was not veto-proof.

If the two sides of the aisle can reach a compromise, the bill may have a chance of becoming law. However, Congressional Quarterly Today reports that some members of the Congressional Black Caucus will not support the SCHIP bill if “significant changes are made as concessions to Republicans.”

In a recent provider letter, the Department of Aging and Disability Services (DADS) reminded Nursing Facilities that any facility that decided to voluntarily close must give residents at least 30 days written notice of this intent, pursuant to Texas Human Resources Code §102.003, 40 Texas Administrative Code (TAC) §19.401(b)(21) and §19.502(e)(1), and 42 Code of Federal Regulations (CFR) §483.12(a)(5).

For more information, download the letter here.

In an information letter to Community Based Alternative (CBA) Providers, DADS summarized changes related to ISP development for the CBA program and informed these providers about required ISP signatures. From the letter:

The Texas of Department of Aging and Disability Services (DADS) recently reviewed and revised ISP forms and processes to ensure requirements are met and to improve the efficiency and effectiveness of the process for CBA consumers, providers, and DADS case managers.

See the case manager handbook for more information. You may download the information letter here.

In an information letter to Home and Community-based Services (HCS) Program Providers, DADS requested input on obtaining information on best practices in policy, training, safety, risk management of an individual’s behavior related to restraint and seclusion, etc., for a report it is required to make available to individual facilities and programs, pursuant to Senate Bill 325, 79th Legislature, Regular Session, 2005.

The letter includes a list of eight questions for providers. If you plan to participate, please send your answers to DADS by November 15, 2007. Download the letter for more information.

According to U.S. Department of Health and Human Services secretary Mike Leavitt, President George W. Bush, who vetoed a bill to expand the State Children’s Health Insurance Program (SCHIP), would accept a bill that increases SCHIP funding by only $20 billion over five years, as opposed to $35 billion over five years. (Kaiser Network)

Yesterday, the U.S. House of Representatives voted on a modified SCHIP bill, but the measure still would increase spending by $35 billion over five years.

Opponents of the bill are concerned that the SCHIP program, which is designed to benefit children from low-income families, would expand to coverage to include adults, illegal aliens, and middle-income families who may be able to afford private insurance.

Listen to NPR’s coverage of the recent vote.

Also see Will the House Override President Bush’s SCHIP Veto?

Last August, the U.S. District Court for the District of Columbia ruled that the U.S. Department of Health and Human Services (HHS) must release Medicare physicians claims information for Illinois, Maryland, Virginia, Washington state, and the District of Columbia. (Kaiser Network)

An organization called Consumers’ CHECKBOOK/Center for the Study of Services sued for access to this information apparently “to help the public evaluate the performance of the program and the physicians,” and HHS cited physician privacy violations.

HHS filed notice to appeal on October 19. HHS spokesperson Kevin Schweers said the department was “fully committed to making available as much Medicare data as allowable by law. Unfortunately, in the case at hand, two federal courts interpret the law differently, and we’re caught in the middle until that dispute is settled. When that day does come, it’ll be a day too late as far as we’re concerned.”

The Texas Department of Aging and Disability Services (DADS) informed Home and Community-Based Services (HCS) and Texas Home Living (TxHmL ) Program Providers that it will offer a Data Entry Training Class for HCS and TxHml Waiver Program Providers. To see the full list of scheduled classes, download the letter here.

DADS informed Community Living Assistance and Support Services (CLASS) Case Management Agencies and Direct Services Agencies that beginning November 1, 2007, CLASS case managers may complete individual service plan (ISP) changes to add the new specialized therapies requisition fee to ISPs with a retroactive effective date of September 1, 2007, if applicable. Case managers must use revised Form 3621, which will be available on the DADS website on November 1, 2007.

Download the letter for more information.

Adopted Rules

The Texas Health and Human Services Commission (HHSC) adopted amendments to §48.2901 and §48.6003 in Chapter 48, Community Care for Aged and Disabled, to clarify eligibility criteria for certain community-based services provided by the Texas Department of Aging and Disability Services (DADS). An excerpt:

Under the new Integrated Care Management (ICM) Program, implemented in accordance with Texas Government Code, Chapter 533, Subchapter D, persons eligible for managed care services who live in areas of Texas in which the ICM Program is available (managed care service areas) are not eligible to receive certain services under DADS’ Community Care for Aged and Disabled (CCAD) programs. Eligible persons who live in managed care service areas will receive those CCAD services through the ICM Program.

For more information, see the relevant section of the October 12 Texas Register.

HHSC also adopted new sections to the code under Chapter 53, Integrated Care Management §1915(c) Waiver Services. HHSC was directed by the state legislature to develop a non-capitated, enhanced primary-care, case management model of Medicaid managed care. For more information and to read HHSC’s responses to public comments, see the relevant section of the October 12 Texas Register.

Opening Meeting

HHSC will hold a public hearing to receive comment on proposed rates for Hospice routine home, continuous home, inpatient respite, and general inpatient care. The meeting will be held on October 30, 2007, at 9:00 a.m., in the Lone Star Conference Room of the Health and Human Services Commission, Braker Center, Building H, located at 11209 Metric Blvd, Austin, Texas. For more information about the meeting and to read two public notices, see the relevant section of the October 12 Texas Register.

Last week, President George W. Bush vetoed a bill that would have expanded the State Children’s Health Insurance Program (SCHIP). His veto caused quite a backlash in the mainstream media and among Democrats. The House of Representatives will vote tomorrow whether to override the veto.

The expansion would add $35 billion over five years to the SCHIP program. Republicans who voted against the bill are concerned it will expand coverage to adults, illegal aliens, and middle-income families who may be able to afford private insurance. According to a USA Today/Gallup Poll of 1,009 people, half agree with those Republicans and the president: the program should focus on low-income families. (Kaiser Network)

An excerpt:

The poll found that 52% of people agree that SCHIP beneficiaries should be children in families with annual incomes up to 200% of the federal poverty level, while 40% say SCHIP should be extended to children in families with annual incomes up to 300% of the poverty level. In addition, 55% of respondents said they are very or somewhat concerned that SCHIP would create an incentive for families to drop private coverage.

According to USA Today, the poll shows that “while Bush may be losing the political battle with Democrats, he may be doing better on policy.” HHS Secretary Mike Leavitt said that policy is most important, adding, “There’s a lot of politics going on right now,” but “the politics will last a matter of weeks” and “policy here will go on for decades. We have to get this right.”

Also see Pelosi says Dems ’still in the fight’ on SCHIP.

Update (10/19): The House failed to override President Bush’s veto of a bill to expand SCHIP, falling 13 votes short of the necessary two-thirds. See the Dallas Morning News for more information.

The Texas Department of Aging and Disability Services (DADS) issued a letter to Nursing Facilities, Intermediate Care Facilities for Persons with Mental Retardation or Related Conditions, Assisted Living Facilities, and Adult Day Care Facilities, about incomplete licensure applications.

Specifically, DADS reminded these providers that a letter of explanation must accompany incomplete license applications, effective October 11. DADS will return incomplete applications that don’t include a letter. For more information, contact the manager of the Facility Certification Unit at (512) 438-2530 or the manager of the Facility Licensing Unit at (512) 438-2348. You may download the provider letter here.

Proposed Rules

The Texas Health and Human Services Commission (HHSC) has proposed to repeal §351.3(a) - (j) of the Purpose, Task, and Duration of Advisory Committees section, and replace it with new §351.3(1) - (13), to provide required information about the current HHSC advisory committees. See this link for more information.

HHSC also seeks to amend §355.7101, Cost Reporting for 24-Hour Residential Child Care Reimbursements, in its Reimbursement Rates Chapter, to clarify that Subchapter H (Reimbursement Methodology for 24-Hour Child Care Facilities) applies to the calculation of prospective daily unit rates paid by the Department of Family and Protective Services (DFPS) for 24-Hour Residential Child Care services, and other requirements. For more information, see the relevant section of the October 5 Texas Register.

Adopted Amendments

The Texas Board of Nursing has adopted amendments to sections of the code pertaining to Practice and Procedure. The amendments authorize the board to adopt, enforce, and repeal rules consistent with its legislative authority under the Nursing Practice Act. For more information, see the relevant section of the October 5 Texas Register.

Hearing and Notice

HHSC will hold a public hearing on October 30, 2007, at 1:30 p.m. to receive public comment on the proposed Medicaid payment rates for the 2007 annual procedure codes relating to X-ray services and physicians and certain other practitioners. The hearing will take place at the Big Bend Conference Room of the Health and Human Services Commission, Braker Center, Building H, located at 11209 Metric Blvd, Austin, Texas.

Additionally, HHSC announced that it intends to submit the state’s application for a renewal of the Texas Waiver for People with Deaf Blindness and Multiple Disabilities, a 1915(c) waiver program to the Texas State Plan for Medical Assistance under Title XIX of the Social Security Act. For more information on the hearing and notice, see the relevant section of the October 5 Texas Register.

Michigan governor Jennifer Granholm is set to sign a bill that will require the state to recoup the cost of Medicaid services from the estates of deceased recipients who lived in nursing homes or received in-home care, as required by federal law. (Source)

Under the old law, the estates of such recipients were exempt from recoupment. Lawmakers threatened to cut off funding if the state didn’t comply with the law.

According to The Detroit News, Community Health Department Director Janet Olszewski wrote: “Time is now of the essence and action by the Legislature is critical in maintaining supports and services provided by the state Medicaid program.”

However, there are exemptions to the recoupment requirement. If spouses, minor children, and disabled relatives still live in the house, it is exempt from the recoupment law.