-- Registration has opened for Positive Behavior Management Workshops. The first will be held in Abilene on July 8 & 9, 2013, and the second in Denton on August 1 & 2, 2013. See the news alert page for details, including contact information. -- You may download the corrected (4/5/13) "Change of Therapy (COT) Determination Flowchart" here (PDF). -- A news alert excerpt: A recent DADS provider alert and an article in The MDS Mentor have clarified the correct way to complete MDS … [Read more...] about Positive Behavior Management Workshops
TX Register Updates: Fee Schedules and Rates
The following information was obtained from the March 22 issue of the Texas Register. Public Notices HHSC intends to submit an amendment to the Texas State Plan for Medical Assistance to update the fee schedules in the current state plan by including fees for new services and modifying fees for existing services: Dental Services; Durable Medical Equipment, Prosthetics, Orthotics, and Supplies; Early and Periodic Screening, Diagnosis, and Treatment Services; and Physicians and Certain Other … [Read more...] about TX Register Updates: Fee Schedules and Rates
ILs/PLs: Dental Contractor, Asbestos Survey
DADS released two information and two provider letters: NF, Hospice, and ICF/IID: DADS informs providers that when billing for non-Medicare covered services, they're not required to file a claim to determine the liability of a Medicare Supplemental Insurance policy. (Letter) CLASS, CMA DSA: DADS recently contracted with contract with the University of Texas Health Science Center at San Antonio. An excerpt: As part of the expansion of Utilization Management and Review (UMR), the … [Read more...] about ILs/PLs: Dental Contractor, Asbestos Survey
DADS News Alerts: MDS 3.0 Clarification, MDCP Waiver Renewal
-- An excerpt: This revised alert replaces the "Minimum Data Set (MDS) 3.0 Item A0410 Clarification" alert. On a Jan. 15, 2013 national conference call, the Centers for Medicare & Medicaid Services (CMS) staff reiterated that MDS 3.0 item A0410 must be coded correctly. Coding instructions for item A0410 are on page A-9 of the MDS 3.0 RAI Manual. In all states, item A0410 must be set to "3" (federal required submission) when a resident is in a Medicare or Medicaid certified bed, … [Read more...] about DADS News Alerts: MDS 3.0 Clarification, MDCP Waiver Renewal
House and Senate Bills: Criminal History, PPACA
The following recently introduced House and Senate bills could affect long term care providers: HB 729: Relating to access to criminal history record information by certain hospitals and other facilities. HB 658: Relating to interest on damages subject to Medicare subrogation. HB 620: Relating to the regulation of certain health care provider network contract arrangements. HB 624: Relating to the payment for services provided by certain types of health care practitioners under … [Read more...] about House and Senate Bills: Criminal History, PPACA
Medicaid/Medicare News Around the Web
"The US Centers for Medicare & Medicaid Services (CMS) may be duplicating efforts and paying for the same services under multiple programs to test new payment and treatment delivery models, the US Government Accountability Office (GAO) said in a recent report. Better coordination among the programs is needed to prevent the inefficient use of federal resources, GAO said." – Medcape Medical News "In all, Medicare is rewarding 1,557 hospitals with more money and reducing payments to 1,427 … [Read more...] about Medicaid/Medicare News Around the Web
Medicare and Medicaid Court Decisions
Medicare recipients with chronic conditions can no longer be turned down for home health services provided by skilled nurses and therapists, according to a recent settlement between the federal government and consumer advocates. Home care and other long term care providers benefit as well. An excerpt: To receive this coverage, patients must meet specific requirements. First, a doctor must prescribe care from a nurse or therapist. Patients in skilled-nursing facilities also must demonstrate a … [Read more...] about Medicare and Medicaid Court Decisions
Texas Dems and Medicaid Expansion
Democrats in Texas are hopeful that the state will expand Medicaid to cover millions, although Governor Rick Perry said Texas won't broaden the federal program. Rather than striking down Obamacare, the U.S. Supreme Court ruled the law constitutional but gave states the option of expanding Medicaid to carry it out. From the Texas Tribune: Despite Gov. Rick Perry's firm opposition to a key tenet of federal health reform — expanding the state’s Medicaid program for those with low incomes — Texas … [Read more...] about Texas Dems and Medicaid Expansion
TX Register Updates: 10/29 Forum, 11/14-15 Hearings
The following information was obtained from the October 26 issue of the Texas Register. Public Hearings and Notices HHSC will hold a public hearing on Wednesday, November 14, 2012, at 1:30 p.m. to receive comment on proposed Medicaid payment rates for Ambulance Services, case management services provided to children and pregnant women, hearing aids; Medicaid biennial calendar fee review, and vaccine and toxoids (shingles vaccine); on Thursday, November 15, 2012, at 1:30 p.m. receive … [Read more...] about TX Register Updates: 10/29 Forum, 11/14-15 Hearings
TX Register Update: MOU Repeals
The following information was obtained from the October 19 issue of the Texas Register. Proposed Rules HHSC proposed to amend §355.8085, Reimbursement Methodology for Physicians and Other Practitioners to set Medicaid rates for certain evaluation and management services and vaccine administration services equal to the 2013-2014 Medicare rates. See the Texas Register for more information. Adopted Rules The Texas Board of Nursing adopted amendments to Chapter 214, §§214.1 - 214.13, … [Read more...] about TX Register Update: MOU Repeals
