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 Bush administration has agreed to a moratorium on two of seven proposed Medicaid rules, which include limiting Medicaid reimbursements to hospitals and nursing homes run by state and local governments, so lawmakers can discuss and agree to changes. (Medical News Today)

As you may recall, the administration proposed to limit physician reimbursement rates and stopped the expansion of Medicaid programs like the State Children’s Health Insurance Program.

According to U.S. Department of Health and Human Services secretary Mike Leavitt, President Bush would veto any bill that places a moratorium on all seven rules.

“We’re trying to put a package together where the five would remain and we would extend [graduate medical education funding] and [intergovernmental transfers to public hospitals] for a period where we tried to find a solution…We would defer the implementation until August, and if we’re not able to do that, it would be deferred until March.”

The following information was obtained from the April 25 issue of the Texas Register:

Adopted Rules

The Texas Health and Human Services Commission (HHSC) adopted amendments to §§19.208, 19.214, and 19.2112, in Chapter 19, Nursing Facility Requirements for Licensure and Medicaid Certification, which will update terminology and state agency names and correct rule cross-references to reflect changes from health and human services agencies consolidations in 2004 and to make sections consistent with other DADS rules.

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

HHSC also adopted amendments to §§94.2, 94.3, and 94.9 - 94.11 in Chapter 94, Nurse Aides, which will allow the Nurse Aide Registry to deem a nurse aide to be unemployable based on a finding that the nurse aide is listed as unemployable in the Employee Misconduct Registry.

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

The Texas Department of Aging and Disability Services (DADS) released a provider and information letter, and announced joint training sessions:

• Family Council Provisions in Senate Bill (SB) 131, 80th Legislature, Regular Session, 2007 (Replaces PL 08-03)

DADS informed Nursing Facilities that the DADS Council has approved proposed rules for implementation of the provisions of SB 131 related to family councils on December 12, 2007. You may download the letter and a four-page questions and answers attachment.

• DADS Information Letter No. 08-58: Money Follows the Person CBA Demonstration Service; Overnight Companion Services (OCS) [replaces Information Letter 08-43]

In a three-page letter to Home and Community Support Services Agency Community Based Alternatives Providers in Cameron, Hidalgo and Willacy Counties, DADS informed these providers about a new MFP Demonstration Service called Overnight Companion Services (OCS). The letter contains information about authorizing and billing for OCS.

DADS has announced joint training sessions for Nursing Facility administrators, direct care staff, surveyors, and anyone with an interest in long-term care planning:

Dates and locations:
June 24, 2008 - Arlington
June 26, 2008 - Austin
August 14, 2008 - San Antonio

See this section of the web site for more information.

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 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 following information was obtained from the April 11 issue of the Texas Register:

Open Meetings and Notices

The Texas Health and Human Services Commission (HHSC) has announced a hearing on proposed state-owned veterans nursing facility payment rates. The hearing is scheduled for May 6, 2008, at 9 a.m., in the Permian Basin Room of the HHSC, Braker Center, Building H, located at 11209 Metric Boulevard, Austin, Texas.

HHSC will conduct a public rate hearing to receive comment on proposed Medicaid payment rates for Freestanding Psychiatric Facilities. The hearing is scheduled for April 23, 2008, at 9 a.m. in the Lone Star Conference Room of the Braker Center, Building H, at 11209 Metric Boulevard, Austin, Texas 78758-4021.

HHSC has announced its intent to submit Transmittal Number 08-001, Amendment Number 805, to the Texas State Plan for Medical Assistance, under Title XIX of the Social Security Act. An excerpt:

The purpose of this amendment is to initiate a process by which the State will pay managed care organizations who have entered into a Medicare Risk Product Agreement with the Centers for Medicare and Medicaid Services (CMS), referred to as a “Medicare Advantage Health Plan,” or “MA Health Plan,” a monthly capitated payment in exchange for the MA Health Plan’s payment of the cost sharing obligations to health care service providers attributable to dual eligible members enrolled in the MA Health Plan’s Medicare risk product.

For details on where to send public comments for the hearings and information about the amendment, see the relevant section of the Texas Register.

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 four new provider letters and one information letter:

• New HCS and TxHmL Forms 3610 and 3611 for Involuntary Termination of the Consumer Directed Services (CDS) Option

DADS notified Home and Community-Based Services Providers, Texas Home Living Providers, and Mental Retardation Authorities about the process for an involuntary termination of the CDS option for an individual enrolled in the HCS or TxHmL Waiver Programs and the forms that must be submitted to the DADS Access and Intake, Mental Retardation Authorities section, Program Enrollment/Utilization Review staff for review and approval. Download the letter for details.

• MDS Submission Requirements for Section S

DADS informed Nursing Facilities and Minimum Data Set (MDS) Software Vendors that DADS will no longer require nursing facilities to submit MDS Section S, which is the state specific portion, effective September 1, 2008. For more information about the change, download the letter.

• License Periods and License Renewal Requirements for HCSSAs, Adult Day Care Facilities, and Assisted Living Facilities

Senate Bill 1318 authorizes DADS to issue two-year licenses, adjust license fee amounts assess late license renewal fees, and eliminate the opportunity for HCSSAs, Adult Day Care Facilities, and Assisted Living Facilities to renew licenses during the 90-day period after licenses expires. DADS issued separate letters to each provider:

- HCSSAs
- Adult Day Care Facilities
- Assisted Living Facilities

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.