The Texas Department of Aging and Disability Services (DADS) released three new information letters:
- Helpful Nursing Facility Provider Information for the TILEs to RUGs Transition
DADS informed Nursing Facility and Hospice Providers about the September 1, 2008, transition from the Texas Index for Level of Effort (TILE) to the federal Resource Utilization Group (RUG). DADS says it is essential for providers to monitor future updates on the Texas Medicaid & Healthcare Partnership website at www.tmhp.com or the DADS Provider Communications website:
http://www.dads.state.tx.us/providers/communications/index.cfm
Download the four-page letter and attachment for more information.
- Helpful Community Services Provider Information for the TILEs to RUGs Transition
In a letter to Community Based Alternatives, Home and Community Support Services Agencies, Consolidated Waiver Programs, Program of All-Inclusive Care for the Elderly, State of Texas Access Reform Plus, and Integrated Care Management Providers, DADS informed these providers about the September 1, 2008, transition from the Texas Index for Level of Effort (TILE) to the federal Resource Utilization Group (RUG). Download the letter for more information.
- Provider Clarification to Rule §9.223, Review of Living Options
DADS clarified the responsibilities for Intermediate Care Facility for Persons with Mental Retardation Providers and Mental Retardation Authorities under Rule §9.223, Review of Living Options in a two-page letter. You may find the rule here.
According to DADS, providers must discuss living options with each individual and legally authorized representative, and document the discussion. For more information, download the letter.
The following information was obtained from the April 18 issue of the Texas Register:
Proposed Rules
The Texas Health and Human Services Commission (HHSC) has proposed to amend §355.8061, concerning payment for hospital services and §355.8069, concerning supplemental payments to certain rural public hospitals, in Title 1 of the Texas Administrative Code (TAC), Part 15, Chapter 355, Subchapter J, Division 4, Medicaid Hospital Services. The amendment would make changes to the Non-State-Owned Rural Public Hospital supplemental payment program.
See the relevant section of the Texas Register for more information.
The Texas Department of Aging and Disability Services (DADS) has proposed to amend 19 sections of the code, including those pertaining to Medicaid-certified facilities, the Medicaid hospice program, and the Medicaid Waiver program. Follow this link, and scroll down to read details in each section.
Adopted Rules
HHSC has adopted an amendment to §358.432, concerning Home Equity Treatment and adopts a new §358.444, concerning Medicaid Treatment of Qualified Long-Term Care Partnership Program Insurance Policies, which implements a Long-Term Care Partnership Program to enable individuals who purchase certain approved private long-term care insurance policies to have a dollar-for-dollar exclusion of their resources in an amount equal to the insurance benefits paid on behalf of the individual in determining eligibility for medical assistance.
See the relevant section of the Texas Register for more information.
DADS has adopted a new §19.2614, in Chapter 19, Nursing Facility Requirements for Licensure and Medicaid Certification without changes to the proposed text published in the January 18, 2008, issue of the Texas Register (33 TexReg 521), which will allow a nursing facility to procure a customized power wheelchair for a Medicaid-eligible nursing facility resident.
See the relevant section of the Texas Register for more information.
The Texas Department of Aging and Disability Services (DADS) has released two new information letters:
- TILEs to RUGs Training Information
DADS informed Nursing Facility Providers, Hospice Providers, Community Based Alternatives Home and Community Support Services Agencies, Consolidated Waiver Programs, Program of All-Inclusive Care for the Elderly, State of Texas Access Reform Plus, and Integrated Care Management Providers about the transition from Texas Index for Level of Effort (TILE) to the federal Resource Utilization Group (RUG-III). Transition will occur on September 1, 2008.
DADS is offering online training to providers. Download the two-page letter for more information.
- Money Follows the Person CBA Demonstration Service; Overnight Companion Services (OCS)
DADS informed Home and Community Support Services Agency Community Based Alternatives Providers in Cameron, Hidalgo and Willacy Counties, about new services in The Money Follows the Person (MFP) initiative. An excerpt of the three-page letter:
Effective May 1, 2008, eligible CBA MFP Demonstration participants residing in Cameron, Hidalgo and Willacy counties may access a new demonstration service, overnight companion services (OCS), to assist in their relocation from institutional to community living. OCS will be offered annually to up to 20 participants. OCS provide 8-12 consecutive hours during a 24 hour period of available, direct support and assistance in the individual’s home during normal sleeping hours, not restricted to normal nighttime hours.
For more details, download the letter.
The Texas Department of Aging and Disability Services (DADS) released three new information letters:
- Revised Coordination and Notification Process for Vocational Rehabilitation and Supported Employment Services
DADS informed Home and Community-based Services Program Providers, Texas Home Living Program Providers, Community Living and Support Services Program Providers, Deaf Blind and Multiple Disabilities Program Providers, Executive Directors of Mental Retardation Authorities, Superintendents of State Mental Retardation Facilities, and Intermediate Care Facilities for the Mentally Retarded and Related Conditions Program Providers about the revised process to inform individuals and providers of an individual’s eligibility status for employment services. Download the three-page letter for more information.
- Medicaid Hospice Continuous Home Care Per Diem
DADS informed Medicaid hospice providers that effective April 25, 2008, submitted claims for continuous home care will be electronically edited on the quantity billed. For more information, download the letter.
- Implementation of Money Follows the Person Demonstration (Demonstration); Referral of Nursing Facility Residents to Relocation Contractors; and Responsibilities of Relocation Contractors under the Demonstration
In an information letter to relocation contractors, DADS summarized recent policy changes related to the Demonstration, referral of nursing facility residents to relocation contractors, and the relocation contractor responsibilities under the Demonstration. For more details on policy changes, download the letter.
The Texas Department of Aging and Disability Services (DADS) announced that the Texas Health and Human Services Commission has approved rate changes for the Medicaid hospice program for Federal Fiscal Year 2008. The rate changes are the result of information provided by the Centers for Medicare and Medicaid Services.
The hospice cap amount for the cap year ending October 31, 2008, is $21,410.04. For information on where to mail paper vouchers, download the letter here.
In an information letter to Community Living Assistance and Support Services (CLASS), Case Management Agencies, and Direct Services Agencies, DADS alerted these providers that it will implement specialized respiratory nursing services and associated rates in the CLASS program. For more information, download the letter here.
DADS notified Home and Community-based Services (HCS) Providers about the process and forms to be used to accomplish temporary and permanent discharges of individuals who are receiving services in the HCS Program, effective December 1, 2007. Download the letter here for more information.
The Texas Department of Aging and Disability Services (DADS) notified all Long Term Services and Supports Providers about tentative plans for late-January Health and Human Services Commission system changes that will affect all claim payments. Because of a system upgrade, claims will not be paid between January 24 and February 6, 2008. For more information, download the letter here.
DADS notified Home and Community-based Services (HCS), Texas Home Living (TxHmL) Service Providers, and Mental Retardation Authorities about training on the Consumer Directed Services (CDS) option. CDS is scheduled to be implemented in early 2008. For a list of training dates and locations, download the letter here.
DADS informed HCS and TxHmL providers that there will be no claims payment processing on December 21, 2007, because of state holiday closures on December 24, 25, and 26, 2007. The processing schedule will resume on December 28, 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.
The Texas Department of Aging and Disability Services (DADS) notified Community Based Alternatives (CBA), Home and Community Support Services Agencies, CBA Assisted Living/Residential Care Providers, Consolidated Waiver Program Providers, Deaf-Blind with Multiple Disabilities Waiver Providers, Medically Dependent Children’s Program Providers, Primary Home Care Providers, and Day Activity and Health Services Providers that the Texas Health and Human Services Commission has raised the minimum wage for attendant care services, recognizing the impact of the federal minimum wage increase on certain provider types, effective August 1, 2007.
A second rate increase was effective on September 1, 2007. For more information, download the letter here.
DADS notified Non-state Operated Intermediate Care Facilities for Persons with Mental Retardation (ICF/MR) about Medicaid reimbursement rates for the ICF/MR Program, effective September 1, 2007 through August 31, 2009. Download the letter for more information.
On August 15, the Department of Aging and Disability Services (DADS) issued an information letter to Nursing Facility Administrators and Hospice Directors about the approval of new per diem payment rates for the Nursing Facility Program (NF), the Hospice Program in NFs, and the Swing Bed Program, effective September 1, 2007 through August 31, 2008. Download the letter here for more information.
In an August 16 letter, DADS informed Title XIX and Title XX Home Delivered Meals (HDM) Providers about documents they must use during uniform rate negotiations for Federal Fiscal Year (FFY) 2008 (October 1, 2007 - September 30, 2008). Information can be found on the HDM Program provider page. For more information, download the letter here.
On August 15, DADS issued a letter and a four-page attachment to Home and Community Support Services Agencies (HCSSA) to inform them about the HCSSA survey process. Download the letter and attachment here.
In a provider letter to Nursing Facility, Assisted Living Facilities, and Intermediate Care Facility for Persons with Mental Retardation Providers, dated August 17, DADS asked that they begin updating their vacancy information daily on the Facility Inventory, Vacancy, and Evacuation Status web site, at http://fives.dads.state.tx.us/, until further notice. DADS issued this notice because Hurricane Dean might enter the Gulf of Mexico this week. Download the letter here for more information.
In a letter dated June 26, the Texas Department of Aging and Disability Services (DADS), informed Intermediate Care Facilities for Persons with Mental Retardation, Home and Community-based Services, Texas Home Living and Community Living and Assistance Support Services about payment rate increases.
Increases range from 2.72 percent to 4.77 percent. For more information, download the letter here.
In a June 27 letter to Home and Community-Based Services (HCS) contractors, DADS informed these providers about the Mental Retardation Authority’s role with consumers of HCS contractors whose contract has been involuntarily terminated.
DADS has outlined the procedures for transferring consumers in these cases. You may download the information letter here.
According to an information letter dated June 28, DADS will change the paper CARE Form 3652-A to add Assessor Last Name and checkboxes to indicate whether the Assessor is a Registered Nurse (RN) or Licensed Vocational Nurse (LVN), to reflect that the Texas Medicaid & Healthcare Partnership (TMHP) will verify nurse licensure with the Texas BNE for both the Director of Nurses (DON) and the Assessor signing the Client Assessment, Review and Evaluation (CARE) Form 3652-A for all purpose codes.
The letter is addressed to Nursing Facilities, Community Based Alternatives, Home and Community Support Services Agencies, Hospice Providers, Program of All Inclusive Care for the Elderly Providers, and Consolidated Waiver Program Providers. Download the letter here.