The Texas Health and Human Services Commission (HHSC) will submit Amendment Number 747 to the Texas State Plan for Medical Assistance. From the September 8 Texas Register: Amendment 747 revises the methodology used by the State to estimate the Medicaid Upper Payment Limit (UPL) for hospital inpatient services. The UPL is the federal limit on Medicaid payments to a group of hospitals and is determined under Federal regulations as a reasonable estimate of the amount that would be paid for the … [Read more...] about Texas Register Updates: Medicaid Payment Limits; Patients Rights
Provider Letters: Permanency Planning and Non-Emergency Ambulance Transportation
Effective September 1, the Texas Department of Aging and Disability (DADS) must delegate "the development of a permanency plan to a mental retardation authority (MRA), to a private entity other than an entity providing long-term institutional care, or to DADS personnel" for an individual under 22 receiving services or seeking admission to an institution. DADS will delegate the responsibilities to the local mental retardation authority where the individual or his legally authorized … [Read more...] about Provider Letters: Permanency Planning and Non-Emergency Ambulance Transportation
Provider Letters: Alerts for ICF-MR/RC Facilities
There were several new provider letters issued last week for Intermediate Care Facilities for Persons with Mental Retardation or a Related Condition (ICF-MR/RC). In an August 3 provider letter, the Texas Department of Aging and Disability Services (DADS) described providers' options when an ICF-MR/RC survey team determines that a person living in one of these facilities no longer needs "active treatment services" (standard W 198). To read about these options, download the letter here. In … [Read more...] about Provider Letters: Alerts for ICF-MR/RC Facilities
New Texas Provider Letter on Medicare RX–Jan. 1, 2006 Deadline
Texas DADS has published a new provider letter regarding Medicare Rx. as impacts Nursing Homes and ICF-MRs . The letter addresses dual beneficiaries of Medicaid/Medicare: Effective January 1, 2006, all full-dual Medicare beneficiaries (Medicare beneficiaries who currently receive prescription drug coverage through Medicaid) will be transitioned from Medicaid prescription drug coverage to the new Medicare Rx Prescription Drug coverage (Medicare Rx). We are providing you with … [Read more...] about New Texas Provider Letter on Medicare RX–Jan. 1, 2006 Deadline
Case Managers: Exempt or Non-Exempt?
The cheap answer is: Case Managers' exemption under the Fair Labor Standards Act's (FLSA) overtime requirements must be determined on a case-by-case basis. The tougher analysis is that the Department of Labor (DOL) has apparently continued its earlier position that case managers are typically non-exempt and, thus, entitled to overtime. With all the celebration surrounding the DOL's regulations issued in 2004, providers remained frustrated with the DOL's complete failure to address the exempt … [Read more...] about Case Managers: Exempt or Non-Exempt?
New CPR Guidelines From AHA
KidneyNotes.com posts about the new CPR guidelines. As the post notes, the highlights are: *The ratio of compressions-to-ventilations has been changed to 30:2 *Rescuers now deliver 1 shock (360J monophasic) followed by CPR, not 3 shocks *Lay rescuers no longer check for circulation *Many other algorithms have been simplified These are published in the Nov 29, 2005 issue of Circulation. KidneyNotes has formatted some easy links to the above for you to read. Click here to see … [Read more...] about New CPR Guidelines From AHA
Legislating Ethics: So…Where’s Your Compliance Plan?
You may have heard of them at seminars, seen them referenced in handbooks and vaguely associated them with the 1996 Health Insurance Portability and Accountability Act (HIPAA). But what are Compliance Plans and, more importantly, why don't you have one yet? Do You Want a Compliance Plan? You Bet…And You'd Better! The Office of the Inspector General of the United States Department of Health and Human Services dictates that almost all providers have Compliance Plans. Specifically, the … [Read more...] about Legislating Ethics: So…Where’s Your Compliance Plan?
Clostridium difficile –Some Important Information from MedSleuth
MedSleuth makes some important points about C-Diff and you should all take note of this: Two facts about Clostridium difficile are of increasing concern. First, it is becoming resistant to antibiotic treatment, and second, it is being discovered in otherwise healthy individuals who have neither been hospitalized nor been on antibiotics . MedSleuth goes on to quote some other important facts: In another article in the New England Journal of Medicine, health officials said … [Read more...] about Clostridium difficile –Some Important Information from MedSleuth
Long Term Care Providers and Foreign Drugs
It goes without saying that long term care providers are allowed to administer drugs to patients, and extra care is required when acquiring, receiving, dispensing and administering foreign prescription drugs. The attached letter (PDF) instructs state survey agency directors on what to do when providers administer foreign drugs. Foreign drugs that purport to be the same as Food and Drug Administration-approved drugs may be substandard and/or dangerous. Providers must make sure that foreign … [Read more...] about Long Term Care Providers and Foreign Drugs
PPAT Information On Katrina Relief Efforts
I received an e-mail with the following information from PPAT: Private Provider and Family Assistance: 1.) Mr. Chris Tilly, Executive Director of CARSA (Community and Residential Services Association) in Louisiana shared that several thousand providers have evacuated New Orleans, and a number of their group and community homes were destroyed by the hurricane. Housing is the most immediate need, it is estimated that it will take 6-8 months to rebuild or relocate these individuals … [Read more...] about PPAT Information On Katrina Relief Efforts
