On February 28, the Texas Health and Human Services Commission issued a letter to Community Based Alternatives, Community Living Assistance and Support Services, Case Management Agency, Direct Service Agency, and Primary Home Care Providers, informing them about new rules related to Consolidated Cost Reporting Requirements for the 2007 Cost Report.
For details on the new rule, including how and when to submit a schedule, download the letter here.
The Texas Department of Aging and Disability Services informed Nursing Facility, Intermediate Care Facilities/Mental Retardation, and Community Program Providers that the U.S. Treasury will start sending out Economic Stimulus Payments (rebates) to eligible individuals in Texas. From the letter:
In most cases, taxpayers who have federal filing requirements will not have to do anything other than file their 2007 federal tax return and the Internal Revenue Services (IRS) will take care of the rest.
However, there are some Texas citizens, particularly those served by the Department of Aging and Disability Services (DADS) who do not have a federal tax filing requirement but may be eligible for a rebate. These people will need to file a 2007 federal tax return to be eligible for the rebate. The IRS would like to work with your office to reach these people.
Download the letter and attached document for more information about the rebate.
The Texas Department of Aging and Disability Services (DADS) informed nursing facility administrators about the Nursing Facility Quality Review Process for 2008. This year, the Nurse Aid Competency Evaluation Services Plus Foundation, Inc. will conduct evaluations, accessing residents’ clinical records and behavior monitoring logs. Download the letter for more information.
According to a memo to Regulatory Service Regional Directors and State Office Managers, surveyors must accept and display in a conspicuous location a preprinted resident rights poster issued to Skilled Nursing Facilities and Nursing Facilities through the Long-Term Care Ombudsmans Program and DADS’ Regulatory Services.
Facilities also must give residents and their families a copy of the rights statement upon admission. For more information, download the memo.
The National Governors Association has gone on record to oppose the Bush administration’s proposal to shift more Medicaid costs to the states. (Kaiser Network)
The shift reportedly will save $15 billion over five years. One change under the new rules is that states no longer will be allowed to use Medicaid funds to help pay for physician training. The administration contends there’s “no explicit authorization under the Medicaid statute to subsidize the training of physicians.” This change reportedly will save $1.8 billion over five years.
Additionally, hospitals and nursing homes will see new limits on Medicaid payments. At least two Republican governors are publicly critical of the plan.
Related post:
The Texas Department of Aging and Disability Services has released four new information letters:
NF:
- Customized Power Wheelchairs Added as Medicaid Nursing Facility Program Service (letter)
ICF/MR:
- Posting of Models Used by the Texas Health and Human Services Commission to Evaluate Cost Reports (letter)
HCS, TxHmL, and CDSA:
- Implementation of Consumer-Directed Services Reimbursement Rates (letter)
ICM:
- Electronic Data Interchange – Action Required (letter)
The following information was obtained from the February 15 edition of the Texas Register:
Open Meeting
The Texas Health and Human Services Commission (HHSC) will hold public hearings on proposed Medicaid payment rates for various procedure codes on February 29, 2008, at 1:30 p.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 hearing and where to send written comments, see the relevant section of the Texas Register.
Proposed Rules
HHSC has proposed to repeal §355.454, Frequency of Reporting Costs, and proposed to amend §355.457, Fiscal Accountability. The changes would eliminate unnecessary language and update procedures. For more information, see the relevant section of the Texas Register.
The Texas Board of Nursing proposes to repeal §217.19 (Incident-Based Nursing Peer Review), and §217.20 (Safe Harbor Peer Review for Nurses). The Board voted to withdraw proposed new rules based on comments about the rules. For more information, see the relevant section of the Texas Register.
The board also proposes to amend 22 Texas Administrative Code §223.1, concerning Fees. The fee for FBI background and criminal history checks was reduced from $24 to $19.25, for an interim period. For more information, see the relevant section of the Texas Register.
Adopted Rules
The Texas Board of Nursing has adopted amendments to: 1) 22 Texas Administrative Code §214.2, concerning Definitions relating to Vocational Nursing Education; and 2) 22 Texas Administrative Code §215.2, concerning Definitions; §215.3, concerning Program Development, Expansion, and Closure; and §215.4, concerning Approval, relating to Professional Nursing Education. The board also adopted the repeal of §217.13, concerning Peer Assistance Programs.
See the relevant section of the Texas Register for information about changes to all three sections.
The Bush administration has proposed to raise Medicare drug benefit premiums for “higher-income” beneficiaries. (Kaiser Network)
The proposal includes a cap on non-economic damages in medical malpractice suits and a requirement for health care providers to implement electronic records. The proposal isn’t a move to placate House Democrats (the part about raising premiums for high earners), however; under the 2003 Medicare law, President Bush is required to submit a Medicare savings proposal.
Individual beneficiaries who make at least $82,000 and couples who make at least $164,000 may see their premiums rise. Mike Leavitt, secretary of the Department of Health and Human Services, says the administration’s budget request would reduce Medicare spending by $178 billion over five years.
In related news, Medicare will no longer reimburse hospitals for the following “preventable” errors: urinary tract infections from catheters, bloodstream infections from using catheters, falls, bed sores or pressure ulcers, objects left in a patient during surgery, blood incompatibility, an infection after heart surgery called mediastinitis, and air embolism. (AP)
The Texas Department of Aging and Disability Services has released 10 new information letters, dated from January 28 to February 12:
- Clarification of Policy and Procedures for Reinstating Personal Assistance Services (PAS) Following a Temporary Institutional Stay (letter)
- Correction to Form 3621 (letter)
- ICM: Long Term Service and Supports (LTSS) Program Operations (letter)
- ICM Program Contracts — Action Required (letter)
- Money Follows the Person Demonstration Program (MFP) — Eligibility and Participation (letter)
- HCS Transfer Process and Transfer Forms (Replaces IL #07-71) (letter)
- Texas Home Living (TxHmL) Transfer Process and Transfer Forms (letter)
- Handling of a Limited Number of Consumer Authorizations Not Converting to ICM (letter)
- Elimination of Paper Forms 3618, 3619 and 3652-A Effective August 1, 2008/Requirement for Electronic Submission Effective August 1, 2008 (letter)
- ICM Specialized Nursing Services (letter)
The Bush administration plans more Medicaid rule changes. Earlier this week, CQ Weekly reported that the administration plans to shift more Medicaid costs to the states, prompted by Government Accountability Office studies that show states have used “questionable” practices to gain more federal dollars. (Kaiser Network)
From the report (emphases added):
The first regulation, to be issued March 3, would end payments for ancillary services provided under case-management plans. The administration considers these services, which can include assistance finding housing or paying utility bills, outside the scope of Medicaid. The second regulation, to be issued May 25, would limit how much states could pay health care providers; end Medicaid reimbursements for medical intern and resident salaries; end reimbursements to schools for busing Medicaid-eligible students; and limit the range of services that could be considered “rehabilitation” for Medicaid patients.
The administration seems to be taking an aggressive approach to curbing Medicaid waste. If a Democrat wins the White House in November, however, these Medicaid funding cuts could be rescinded or scaled back.
Related posts:
The following information was obtained from the February 1st and 8th editions of the Texas Register:
Open Meetings
The Texas Department of Health and Human Services (HHSC) will hold a public rate hearing on February 20, 2008, at 9:00 a.m. in the Palo Duro Canyon Conference Room of the Braker Center, Building H, at 11209 Metric Boulevard, Austin, Texas 78758-4021. The topic will be proposed Medicaid payment rates for Institutions for Mental Diseases.
HHSC also announced its intent to submit amendments to the Deaf Blindness and Multiple Disabilities program waiver and a waiver renewal for the STAR Program. Follow this link to read more about the hearing and submissions.
An announcement:
The Department of Aging and Disability Services (DADS) has begun the process of developing the FYs 2008-2009 Report Update for State Mental Retardation Facilities, which will be submitted with the DADS FYs 2010-2011 Legislative Appropriations Request. This report is statutorily required by the Health and Safety Code (HSC), Title 7 of the Mental Health and Mental Retardation, Chapter 533, §533.032, Long-Range Planning.
DADS is seeking input regarding long-term planning information to be discussed in this report.
Written comments must be received by February 22, 2008, 5:00 p.m. See the relevant section of the Texas Register for more information.
Proposed Rules
HHSC has proposed a new §355.310, concerning the reimbursement methodology for customized power wheelchairs (CPWCs) and associated physical or occupational therapy evaluations for qualified Texas nursing facility residents, which describes the reimbursement methodology for CPWCs and associated physical or occupational therapy evaluations for qualified Texas nursing facility residents. See the relevant section of the Texas Register for more information about the proposed rule.
Withdrawn Rules
The Texas Board of Nursing has withdrawn the proposed repeal of §217.19 and §219.20, and the proposed new §217.19 and §219.20. See the relevant section of the Texas Register for more information.
Adopted Rules
On behalf of DADS, HHSC has adopted amendments concerning licensing standards for the following providers:
The following information was obtained from the January 25 edition of the Texas Register:
Open Meetings
The Texas Health and Human Services Commission (HHSC) will conduct a public hearing on February 11, 2008, at 9:00 a.m., to receive public comment on proposed payment rates for the Residential Care program, assisted living/residential care services under the Community Based Alternatives program, assisted living/residential care services under the Consolidated Waiver program and Community Based Alternatives Personal Care III services.
For more information about the hearing and where to send public comments, see the relevant section of the Texas Register.
Adopted Rules
HHSC adopted amendments to §§352.1 - 352.9, concerning the quality assurance fee for the Intermediate Care Facilities for Persons with Mental Retardation program. HHSC also adopted to 355.503, concerning Reimbursement Methodology for the Community-Based Alternatives Waiver Program and the Integrated Care Management-Home and Community Support Services and Assisted Living/Residential Care Programs; §355.505, concerning Reimbursement Methodology for the Community Living Assistance and Support Services Waiver Program; and §355.5902, concerning Reimbursement Methodology for Primary Home Care.
See the relevant section of the Texas Register for more information about the amendments.
On behalf of DADS, HHSC adopted amendments to §19.1306, in Chapter 19, Nursing Facility Requirements for Licensure and Medicaid Certification. See the relevant section of the Texas Register for more information about the amendments.