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 Texas Department of Aging and Disability Services (DADS) has released two provider and two information letters:
- Guidelines for Reporting Incidents (replaces PL 1999-34)
In a provider letter, DADS notified ICFs/MR about changes in the guidelines for reporting incidents to DADS, effective immediately. The revised guidelines supersede guidelines dated October 1, 1999, for licensed ICFs/MR. Download the five-page letter for more information.
- Expired Licenses (replaces PL 05-49)
DADS informed All Assisted Living Facilities, Adult Day Care Facilities, Nursing Facilities, Home and Community Support Services Agencies, and ICFs/MR, about facility and agency license renewals. Holders must file a renewal application to prevent expiration. Download the provider letter for more information.
- Economic Stimulus Payments — Filing Deadline Extended to October 15, 2008
In a letter to Nursing Facility, Intermediate Care Facilities/Mental Retardation, and Community Program Providers, DADS provided information about the filing extension for the Economic Stimulus rebate. An excerpt from the letter:
Many individuals served by the Department of Aging and Disability Services (DADS) who do not have a federal tax filing requirement and do not usually file an income tax return may be eligible for a rebate through the Economic Stimulus Payment program. These people will need to file a 2007 Income Tax Return to be eligible for the rebate.
The Internal Revenue Service (IRS) has extended the deadline to file IRS Form 1040A so eligible individuals may qualify for a rebate payment through the Economic Stimulus Payment program.
For more information, download the letter.
- Customized Power Wheelchairs Added as Medicaid Nursing Facility Program Service; Additional Information Provided
DADS informed Nursing Facilities about obtaining a Customized Power Wheelchair for an eligible recipient. The 11-page letter and attachment contains details about eligibility requirements, process for requesting, submission, approval process, and other important information. Download the letter and attachment here.
The Texas Department of Aging and Disability Services (DADS) has released a provider and an information letter:
- License Periods and License Renewal Requirements (HCSSAs) [replaces PL 08-06]
DADS informed HCSSAs that beginning May 1, 2008, it will transmit license renewal notices, application forms, and license renewal instructions to current licensees at least 120 days prior to expiration of the current license. Contact the Professional and Technical Review Branch of the Licensing and Credentialing Section at (512) 438-2630 with questions. For more information, download the two-page letter.
- Daily Claims Processing for ICF/MR Service Group 6 Providers
DADS informed ICF/MR Providers, Service Group 6, that all such providers will be able to submit Service Group 6 claims any day of the week, effective April 22, 2008. For more information, call DADS Provider Claims Services (PCS) Provider Hotline at 512-438-2200, Option 1. You may download the letter here.
The following information was obtained from the April 4 issue of the Texas Register:
Notices and Public Hearing
The Texas Health and Human Services Commission (HHSC) has issued a correction to a public notice about its intent to submit Transmittal Number 08-000, Amendment Number 804, to the Texas State Plan for Medical Assistance, under Title XIX of the Social Security Act in the February 1, 2008, issue of the Texas Register (33 TexReg 1001). The correct notice reads:
HHSC announced its intent to submit Transmittal Number 08-006, Amendment Number 810, to the Texas State Plan for Medical Assistance, under Title XIX of the Social Security Act. The proposed amendment is effective February 1, 2008.
Additionally, HHSC issued a notice that it adopted the following per diem reimbursement rates:
Large State-Operated ICF/MR Facilities-Medicaid Only clients
Proposed interim daily rate: $381.26
Large State-Operated ICF/MR Facilities - Dual-eligible Medicaid/Medicare clients
Proposed interim daily rate: $365.09
HHSC will hold a public hearing on April 22, 2008, at 9 a.m. to receive public comment on proposed payment rates for Supported Employment and Employment Assistance Services in the Deaf-Blind with Multiple Disabilities (DBMD) Program waiver. For more information on the notices and the public hearing, see the relevant section of the Texas Register, and scroll down for each entry.
Adopted Rules
HHSC has adopted an amendment to §355.8063, Reimbursement Methodology for Inpatient Hospital Services, which updates the Medicaid reimbursement methodology for freestanding psychiatric facilities, effective January 1, 2008. See the relevant section of the Texas Register for details.
The Texas Board of Nursing has adopted an amendment to 22 Texas Administrative Code §223.1 (Fees). See the relevant section of the Texas Register for more information.
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.
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 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 December 21 and December 28 editions of the Texas Register:
Open Meetings
The Texas Health and Human Services Commission (HHSC) will hold a public rate hearing on January 10, 2008, at 9:00 a.m. in the Palo Duro Canyon Conference Room of the Braker Center, to receive public comment on proposed Medicaid payment rates for Rural Health Clinics and Federally Qualified Health Clinics. For more information, including where to send written comments, see the relevant section of the Texas Register.
HHSC will hold a public hearing on January 14, 2008, at 10:00 a.m. in the Lone Star Conference Room of the Braker Center, to receive public comment on the proposed interim per diem Medicaid reimbursement rate for large, state-operated Intermediate Care Facilities for Persons with Mental Retardation operated by the Texas Department of Aging and Disability Services. For more information, including where to send written comments, see the relevant section of the Texas Register. Additionally, scroll down to read about HHSC’s intent submit two amendments.
As of September 1, 2007, a change has been effected in the Texas Health & Safety Code regarding transport of patients by stretcher:
SECTION 14. (a) Subsection (a), Section 773.004, Health
and Safety Code, is amended to read as follows:
(a) This chapter does not apply to:
(1) [a ground transfer vehicle and staff used to
transport a patient who is under a physician’s care between medical
facilities or between a medical facility and a private residence,
unless it is medically necessary to transport the patient using a
stretcher;
[(2)] air transfer that does not advertise as an
ambulance service and that is not licensed by the department;
(2) [] the use of ground or air transfer vehicles
to transport sick or injured persons in a casualty situation that
exceeds the basic vehicular capacity or capability of emergency
medical services providers in the area;
(3) [(4)] an industrial ambulance; or
(4) [(5)] a physician, registered nurse, or other
health care practitioner licensed by this state unless the health
care practitioner staffs an emergency medical services vehicle
regularly.
(b) Section 773.041, Health and Safety Code, is amended by
adding Subsection (a-1) to read as follows:
(a-1) A person may not transport a patient by stretcher in a
vehicle unless the person holds a license as an emergency medical
services provider issued by the department in accordance with this
chapter. For purposes of this subsection, “person” means an
individual, corporation, organization, government, governmental
subdivision or agency, business, trust, partnership, association,
or any other legal entity.
(c) Not later than May 1, 2008, the executive commissioner
of the Health and Human Services Commission shall adopt the rules
necessary to implement the changes in law made by this section to
Chapter 773, Health and Safety Code.
As the Bill Analysis demonstrates, this does away with the exemption for transport between medical facilities or medical facility and home, and requires a license as an emergency medical services provider issued by the Department of State Health Services (DSHS). I’ll update this when the rules come out.
In a three-page letter, the Department of Aging and Disability Services (DADS) informed Nursing Facilities, Community Services, ICF/MR, and Therapy Providers that the National Provider Identifier (NPI) contingency period ends on March 1, 2008. NPI will replace legacy provider identifiers.
Providers’ claims can’t be paid if they are submitted without NPI data. For more information, download the letter here.