Provider Letter PL 2018-20 (Replaces PL 13-04 and PL 18-07) This letter gives directives to the following provider types: Assisted Living Facilities (ALFs), Day Activity and HealthnServices (DAHS) Facilities, Home and Community Support Services Agencies (HCSSAs), Intermediate Care Facilities for Individuals with an Intellectual Disability (ICFs/IID), Prescribed Pediatric Extended Care Centers (PPECs) Nursing Facilities (NFs) A provider (as listed above) must include in an initial … [Read more...] about Provider Letter Regarding Incident Reporting Requirements
Provider Letter: Feeding Assistance Rules for Nursing Facilities
Provider Letter PL 18-17 (NF) This letter addresses feeding assistance care for nursing home residents and staffing requirements to implement rules. HHSC and Long Term Care Regulatory (LTCR) determined that the topic of feeding assistance required an updated and consolidated communication to providers. The letter details: Policy Details & Provider Responsibilities: A paid feeding assistant is an individual who meets the requirements specified in the Texas Administrative Code who is … [Read more...] about Provider Letter: Feeding Assistance Rules for Nursing Facilities
Notification Requirements in Response to an Emergency or Disaster
Provider Letter 18-16 - This Long-Term Care regulatory provider letter is to inform a Home and Community Support Services Agency (HCSSA or agency) of notification requirements for temporary agency changes in response to an emergency or disaster. The letter details provider responsibilities regarding initial or renewal application changes due to an emergency or disaster, temporarily relocation of a place of business as a result of an emergency or disaster, providing services to clients who … [Read more...] about Notification Requirements in Response to an Emergency or Disaster
Fiscal Year 2018 Cutoff Dates for Fee-for-Service Year-end Closeout Processing
Information Letter 18-08 & No. 18-09 This letter announces several dates regarding Fiscal Year 2018 Claims Processing for claims to be paid by the Texas Health and Human Services Commission (HHSC). August 24, 2018 by noon is the cutoff date for Home and Community-based Services Providers and Texas Home Living Providers . For all other agencies, providers and facilities listed below, the cutoff dates are as follows: • Fiscal Year 2016 Miscellaneous Fee-for-Service (FFS) Claims Cutoff: … [Read more...] about Fiscal Year 2018 Cutoff Dates for Fee-for-Service Year-end Closeout Processing
Proposed Rule for Permanent Risk Adjustment Program for 2018
A new Centers for Medicare & Medicaid Services (CMS) Press release details the proposed additional rule to address risk adjustment program for the 2018 benefit year. The rule would give payers the ability to receive 2018 risk adjustment payments by resolving legal contentions of the program’s operation and give CMS the ability to issue risk adjustment payments without interruptions for the current plan year. According to reports the risk adjustment payments also reimburse health insurers … [Read more...] about Proposed Rule for Permanent Risk Adjustment Program for 2018
New Web-based Licensure System – Texas Unified Licensure Information Portal (TULIP)
Provider Letter : PL 18-15 - Texas Unified License Information Portal (TULIP) is a new web-based licensure system designed specifically for licensed long-term care providers it will begin on Sept 4, 2018. All licensure applications will be electronic, including those for initial licenses, renewals and changes of ownership. The provider letter out lines important dates and information related to TULIP’s benefits and features, as well as instructions for making a successful transition to … [Read more...] about New Web-based Licensure System – Texas Unified Licensure Information Portal (TULIP)
HHS Releases Report on Hospice Care Fraud in US
A report released recently released by the Office of Inspector General (OIG) at the US Department of Health titled: Vulnerabilities in the Medicare Hospice Program Affect Quality Care and Program Integrity has highlighted that hospice care fraud is a nationwide problem in the US. The report found that hospices do not always provide needed services to beneficiaries and sometimes provide poor quality care for Nursing home residents and other patients. When care is provided hospices’ inappropriate … [Read more...] about HHS Releases Report on Hospice Care Fraud in US
HCSSAs that Contract with Management Companies
Provider Letter 18-13 - Home and Community Support Services Agencies (HCSSAs) are issued the clarifications and requirements and regarding the role of management companies. Providers are notified that if an HCSSA contracts with a management company or other organization, the HCSSA must comply with all rules and regulations that relate to such a contract, which is addressed in the provider letter. HHSC has statutory authority to adopt rules that specify the ownership interests and other … [Read more...] about HCSSAs that Contract with Management Companies
Annual Mandatory Training for Assisted Living Facility Manager
Long-Term Care Regulatory Provider Letter PL 18-12 (ALF) - Texas Health and Safety Code, Section 247.066(h) directs the Health and Human Services Commission (HHSC), to require that facility managers complete an annual training on aging in place and retaliation. The ALF rule is found at Texas Administrative Code, Title 40, Part 1, §92.41(f)(6). HHSC has developed a web-based training that meets this requirement. The creation of this course was required by House Bill (HB) 2109, … [Read more...] about Annual Mandatory Training for Assisted Living Facility Manager
PPAT Notice-Proposed Changes to the ICF/IID Administrative Penalties Rules
HHSC published the proposed changes mandated by House Bill (H.B.) 2025 to the ICF/IID rules which calls for changes to rules governing administrative penalties, license terms and related policies in various programs including the ICF/IID program, DAHS, ALFs, NFs and Pediatric Extended Care Facilities. HB 2025 is the act relating to the regulation of certain long-term care facilities, including facilities that provide care to persons with Alzheimer ’s disease or related disorders; authorizing an … [Read more...] about PPAT Notice-Proposed Changes to the ICF/IID Administrative Penalties Rules