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Patient Preferences Generally, patients prefer home health care options as they would prefer to recover at home instead of in a hospital bed or busy healthcare setting as the home setting is more comfortable for one’s well-being and convenient for being able to return to one’s day-to-day schedule.  Leveraging patients’ preferences for the care setting is beneficial.  The Alliance for Home Health Quality and Innovation (AHHQI) contends that patients who are receiving care in their preferred location are more likely to adhere to care management plans, improving their overall health while preventing avoidable readmissions and costs. Patient expectations in ...
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(Feb 15, 2019) This week, the Texas Legislature began considering two major bills relating to Governor Abbott’s emergency items: Senate Bill 10 and Senate Bill 2. On Tuesday, February 12, the Senate Health and Human Services Committee considered Senate Bill 10, which creates the Texas Mental Health Care Consortium. Once created, the Mental Health Care Consortium will leverage the expertise of health-related institutions to bolster mental health options for Texas children and adolescents. The Committee discussed issues relating to the reliance on medicine as a primary treatment of mental illness and the stigma surrounding the connection between mental health patients ...
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Dear Members,  Please note that HHSC has added an appendix to the STAR Kids Program Support Unit Operational Procedures Handbook for the denial of medical necessity in the Medically Dependent Children's Program (MDCP). Appendix XXVII explains the eligibility requirements for MDCP and describes the client's right to an appeal process; this update makes this information available to clients in both English and Spanish. STAR Kids was implemented statewide in November 2016 to serve Medicaid clients with disabilities aged 20 and younger as a result of   S.B. 7, 83rd Legislature, Regular Session 2013 , which directed HHSC to implement cost-savings measures ...
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(Feb. 08, 2019) - Governor Gregg Abbott’s State of the State address this week celebrated Texas tenacity and encouraged the Legislature to continue their efforts to “… fulfill the promise of Texas”. In his address, Governor Abbott declared several emergency items for the 86th legislative session including: school finance reform, property tax reform, school safety reform, mental health funding and Hurricane Harvey relief. As emergency items, these issues are no longer limited by the Texas Constitution’s prohibition of passing legislation in the first sixty days of session. The Governor’s speech also highlighted funding for anti-human-trafficking and anti-gang ...
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Dear Members,  This week, HHSC announced that providers may request visit maintenance be opened on historical MEDsys data in order to make corrections beginning February 11, 2019 . Providers will not be able to create new MEDsys visits as a result of the transition to DataLogic for EVV. HHSC has set the following rules and deadlines for these changes: Providers have 60 business days from Feb. 11 to request visit maintenance be unlocked from the appropriate payer. DataLogic has 60 business days from the received approval date from the payer to open visit maintenance to make the approved changes and export the changes to the payer. Managed Care ...
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Dear Members,  This week, HHSC announced via Provider Letter PL 19-02  that they will no longer maintain handbooks with Rules in them, referring instead to the Secretary of State (SOS) website where the online version of the Texas Administrative Code may be found. Downloadable, searchable copies of the Rules may be requested from the SOS, as described in the provider letter; HHSC will no longer provide this service. PL 19-02 states that HHSC will no longer maintain handbooks containing these Rules: Day Activity and Health Services Requirements, 40 TAC Chapter 98 Denial or Refusal of License, 26 TAC Chapter 560 Employee Misconduct Registry ...
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Wednesday, February 13 th , 2019 at 11:00 a.m. CST (12:00 p.m. EST, 10:00 a.m. MST, 9:00 a.m. PST) RCTCLEARN.NET will again be hosting webinars for agencies or training coordinators new to o the program or/and new to the My CEU tool for tracking course completions.  The webinars provide an excellent opportunity to learn about the new features on the system as well as discuss ideas on how to introduce or re-introduce the programs.   While designed for new users, they may also be beneficial for existing agencies and training coordinators as well.  Webinars typically last around 15 minutes or a little longer depending on user questions. Click here to ...
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This week in Texas politics was highlighted by Governor Greg Abbott, Lieutenant Governor Dan Patrick, and Speaker of the House Dennis Bonnen’s unveiling of a united proposal to curb property tax growth on Thursday. The proposal, which has been introduced in both the House and the Senate, caps the annual growth of local property taxes from 8% to 2.5%. Under the new legislation, if local government entities – such as counties, cities, and school districts – wish to exceed the cap, they must first get voter approval through what’s called a rollback election. With property taxes high on the agenda, this legislation is expected to be center stage for this legislative ...
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Dear Members,  CMS has announced that they received approval for a new Medicare Enrollment Application in December 2018, the CMS-855I . CMS believes this new version of the application will simplify the process for providers by offering the following changes: Expanding instructions for individual and group affiliations to simplify reporting;  Making it optional to list a contact person; Adding electronic storage information for those who no longer keep paper records; and Creating a more logical data flow. This application is available for use effective immediately. Thank you!
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Dear Members,   The   State Medicaid Managed Care Advisory Committee   will meet on Monday, February 25, 2019, at 1:00 pm . This committee provides recommendations and ongoing input to HHSC on the operation of Medicaid managed care throughout the state of Texas. The committee also guides policy related to Medicaid managed care, and serves as the central source for stakeholder input to HHSC. Webcasting   is available for this meeting, or you may attend in person. This meeting will be held at: Health and Human Services Commission  Brown-Heatly Building, Public Hearing Room 4900 North Lamar Blvd. Austin ,   TX  ...
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Dear Members,  HHSC has posted Module 2 of its Electronic Visit Verification (EVV) Tool Kit for use by contracted providers, Consumer Directed Services (CDS) employers, and Financial Management Services Agencies (FMSAs) who will be transitioning into the EVV program as part of the Commission's implementation of the 21st Century Cures Act . This module will be presented in two parts; part one covers the roles and responsibilities of participants in the EVV program. HHSC's EVV Operations team provides Tool Kit updates on the 1st and 22nd of each month.  Please mark your calendars for their live webinar on Friday, February 22, 2019, from 1:00 pm to 3:00 pm ...
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Dear Members, Please be advised that, as employers, you may be required by the Occupational Safety and Health Administration (OSHA) to post a summary of work-related illnesses and injuries in a location viewable by the public for calendar year 2018 from February 1, 2019 until April 30, 2019. Home health care services (NAICS code 6216) are on the list of industries who must report work-related illnesses and injuries to OSHA, and post a summary of these via the 300A (Summary of Work-Related Injuries and Illnesses), unless they meet the requirement for an exemption based on small size (10 or fewer employees in the entire company).  Members are encourage ...
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Dear Members, On January 22, TAHC&H staff attended the quarterly meeting of the HHSC STAR Kids Stakeholder Workgroup. The group discussed many of the same issues raised during the STAR Kids Managed Care Advisory Committee meeting earlier this month, including: HHSC’s Pay for Quality Initiative Preferred Provider Agreements Access to Care, Therapy Waiting Lists HHSC’s Pay for Quality Initiative HHSC’s Denbigh Shelton presented the Commission’s proposed Pay for Quality Program measures for the STAR Kids program, explaining that 3% of the MCO’s capitation will be at risk for recoupment if these requirements are not met. One workgroup ...
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Highlighting the week was Speaker Dennis Bonnen’s announcement of House committee assignments. Assignments were given largely on a bipartisan basis, with no clear preference for particular ideologies or regions. This was highlighted by the assignment of Rep. Joe Moody, an El Paso Democrat, as Speaker Pro Tempore, who serves over the chamber when the speaker is not present. Additionally, three major committees received new chairmen: Ways and Means is now chaired by Rep. Dustin Burrows (R-Lubbock), State Affairs is now chaired by Rep. Dade Phelan (R-Beaumont), and in the powerful Calendars Committee, Rep. Four Price (R-Amarillo) is replacing Rep. Todd Hunter (R-Corpus ...
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Dear Members,  Palmetto GBA has recently issued guidance on a known issue related to hospice date overlaps, noting: Palmetto has discovered that some claims are incorrectly rejecting for reason code C7010 (a hospice overlap) when the date of service is equal to a hospice election date or revocation date. Services which occur on the effective date of the hospice election, but prior to the actual election on that day, and on the revocation date, after the actual revocation on that day, are separately payable by Medicare. Unless appropriate, providers should not change the dates of service or use Condition Code 07 to bypass this issue. Misuse of Condition ...
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Dear Members,  CMS recently issued Medicare Learning Network Article (MLN) 11049, Ensuring only the Active Billing Hospice Can Submit a Revocation , to notify providers of an edit that has been included in the Common Working File (CWF) effective for claims received on or after July 1, 2019. This edit will only allow Notices of Revocation/Termination Type of Bill (TOB) 8xB if the provider's CMS Certification Number (CCN) on the notice matches the CCN on the hospice election period. As described in the MLN article, providers should be aware that Palmetto GBA will reject a TOB 8xB if: The provider CCN matches the CCN on the hospice election period; AND ...
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The Texas Association for Home Care & Hospice is pleased to offer RCTCLEARN.N et, an on demand, internet-based program. These courses are offered at  NO COST  to TAHC&H members! That's right - no extra fees to access the courses! Each course features fully-interactive curriculum created by the Center for Business and Workforce Education at Rochester Community and Technical College (RCTC) The RCTCLEARN.Net program offers you convenience because the courses can be taken anytime, anywhere. Each RCTCLEARN.Net course features printed certificates, links to further information, and quizzes. You will be able to track the progress of your individual employees ...
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Dear Members,  Did you know that CMS offers a wide range of free educational materials on their programs and policies?  The Medicare Learning Network  is a fantastic online resource for news articles, policy information, webcasts and web-based training sessions, and videos.  We highly recommend that you bookmark this page, and sign up for the weekly MLN Connects newsletter . It's news you can use! As always, send us any questions you may have: heather@tahch.org. We're here to help! Thanks, Heather
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Dear Members,  Many of you have sent us questions about the Centers for Medicare and Medicaid Services' (CMS) upcoming Patient-Driven Groupings Model (PDGM) initiative. Please mark your calendar for their upcoming webcast for home health agencies, administrators, clinicians and stakeholders. A Q&A session will be held at the end of the event. Home Health Patient-Driven Groupings Model (PDGM) Call — February 12, 2019 Tuesday, February 12, 2019 from 12:30 to 2 pm CT Join CMS and learn about the Patient-Driven Groupings Model (PDGM) that will be implemented on January 1, 2020. CMS will use the PDGM to reimburse home health agencies for providing home ...
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Dear Members,  2019 started with a bang here at TAHC&H and I know you have all been just as busy! Here is a reminder of an upcoming webinar you won't want to miss! KEPRO Beneficiary and Family Centered Care Quality Improvement Organization Webinar  Tuesday, January 29, 2019, from 1:00 pm to 2:00 pm CT Palmetto GBA will host a webinar for providers with  KEPRO , our regional Beneficiary and Family-Centered Care Quality Improvement Organization (BFCC-QIO). KEPRO provides care information and assistance to Medicare beneficiaries and their families in Texas and more than 30 other states.  This webinar will cover KEPRO's free services for beneficiaries, ...
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