Recent News

Be the first person to recommend this.
To help ensure continuity of care during the COVID-19 response, HHSC has directed TMHP to move forward with processing new and initial prior authorization requests, including recertification requests, by relaxing document submission timeframes for providers if they are unable to provide certain required documentation during the COVID-19 emergency. This direction will remain in effect through September 30, 2021. HHSC will provide more information if there are changes. This guidance applies to all state plan services, including: Acute care services Long-term services and supports Personal assistance services Personal care services ...
0 comments
Be the first person to recommend this.
Members, Please see the following information from TMHP regarding Prior Authorization Forms Updates .  You can access the notice from the TMHP website HERE . "Prior Authorization Forms Are Being Updated Effective September 1, 2021 Note: Texas Medicaid managed care organizations (MCOs) must provide all medically necessary, Medicaid-covered services to eligible clients. Administrative procedures such as prior authorization, pre-certification, referrals, and claims/encounter data filing may differ from traditional Medicaid (fee-for-service) and from MCO to MCO. Providers should contact the client's specific MCO for details. Effective ...
0 comments
Be the first person to recommend this.
We understand that there is a great deal of confusion related to the OSHA ETS medical removal and MRP benefits.  We are aggressively advocating for clarification and that additional employee requirements be added to the ETS to protect home care providers against those employees that choose to act fraudulently.  For now, in an effort to reduce confusion regarding the medical removal and MRP benefit requirements of the OSHA ETS, we have put together the below information: An employer is required to remove an employee from the workplace when the employer knows that the employee: Is COVID-19 positive, meaning that the employee was confirmed positive ...
0 comments
Be the first person to recommend this.
We’ve all seen reports of multinational companies falling victim to cyber-attacks on the news — SolarWinds, Colonial Pipeline and JBS Foods just to name a few — but recently, many of us have started to experience this phenomenon firsthand. The rise in remote work has increased the frequency, sophistication and impact of phishing attacks.  The Risk to Mobile Employees Mobile employees are using mobile devices more than ever to access company data, something hackers are taking advantage of by exploiting security gaps. According to a new survey from IT automation platform, Ivanti , 74% of respondents said their organizations have fallen victim to a phishing ...
0 comments
Be the first person to recommend this.
Members, Please see the following federal report brought to you by your federal lobby group, Akin Gump. Introduction of Choose Home Care Act Senators Debbie Stabenow (D-MI) and Todd Young (R-IN) have officially introduced the Choose Home Care Act of 2021 ( S.2562 ), which would create an add-on to the existing Medicare home health benefit allowing certain Medicare patients to receive post-hospital services in their homes. The new benefit would be available for those eligible for both skilled nursing facility (SNF) and home health agency care, and include a 30-day unit of service combining today’s Medicare Home Health Benefit with additional supportive ...
0 comments
Be the first person to recommend this.
Members,  Please see the notice below regarding home and community support services agencies, now not required to comply with any requirement in HHSC rule that mandates face coverings in response to the COVID-19 disaster. Providers must continue to comply with applicable infection control rules, including those addressing compliance with CDC and CMS guidance. (see complete notice below). As a reminder, although not mentioned in this HHSC's notice, providers are required to comply with Section 5(a)(1) of the Occupational Safety and Health Act (the "General Duty Clause") which requires an employer to furnish to its employees: "a place of employment which are ...
0 comments
Be the first person to recommend this.
On April 12, 2021, Palmetto released an article updating providers on the new transaction numbers associated with CAAP recoupment activity.  A new transaction number with a format starting "CVDA" will appear on the remittance advice for any recoupment activity related to CAAP repayment. This new transaction number will replace the old transaction number formatted with "CVD" that was previously communicated to providers on October 16, 2020. Providers will use this new transaction number when looking up the repayment balance via eServices. Please review the article HERE and share the information with applicable staff.
0 comments
Be the first person to recommend this.
Governor Abbott declared November Home Care & Hospice Month in Texas- it begins next week: we encourage you to advance the ideas of home care and hospice throughout your community during this special month using your media kit! Here are a few words from your new PAC President Chrystal Everett: "   It's an honor to be the newly elected President for the Texas Homecare & Hospice PAC. I am genuinely excited to be an advocate and an example to each individual, encouraging them to understand and contribute to Texans who deserve access to quality home care and hospice services. In our rapidly changing environment, contributing to the PAC is vital ...
0 comments
Be the first person to recommend this.
Palmetto GBA has provided an on-demand webinar on the basics of the RCD process. Learn about eServices and how to submit a review, hear tips from a Medical Review perspective and obtain helpful resources to help you navigate with success. Access to the webinar is immediate, so you can listen to it anywhere, anytime.  Register here to access the on-demand webinar.
0 comments
Be the first person to recommend this.
CMS is encouraging providers to participate in an interoperability pilot to test medical documentation exchanges. The initiatives of this program include reducing administrative burden for providers and improve provider-to-provider communication. The EMDI stakeholders include hospitals, physicians, DME companies, home health agencies, health information exchanges, electronic health record vendors, electronic medical record vendors, laboratories, and other healthcare organizations. The Electronic Medical Documentation Interoperability (EMDI) Initiative  is designed to reduce provider burden by helping you standardize your workflow, so you can send and receive ...
0 comments
Be the first person to recommend this.
On September 3, under the leadership of President Trump, CMS launched Care Compare , a streamlined redesign of eight existing CMS health care compare tools available on Medicare.gov . Care Compare provides a single user-friendly interface that patients and caregivers can use to make informed decisions about health care based on cost, quality of care, volume of services, and other data. With just one click, patients can find information that is easy to understand about doctors, hospitals, nursing homes, and other health care services instead of searching through multiple tools. “President Trump has long recognized that a free and vibrant health care market ...
0 comments

Palmetto GBA RTP 39621

Be the first person to recommend this.
All ACO patients claims RTP 39621. Per explanation, UTN needs to be removed. All these chart Provisionally Affirmed by Palmetto GBA. These are final claims, not LUPA . Does anyone had same issue ?
0 comments
Be the first person to recommend this.
The El Paso Department of Public Health will be holding an informational session on COVID-19 for area assisted living / hospice / nursing etc. agencies/businesses.  They feel that since the older population has been found to be more susceptible to the effects of COVID-19, they want to make time to specifically address caretakers in this community. The meeting will be at 10751 Montana Ave El Paso, TX 79935 (TecH2O Center) on March 16, 2020 at 1:00 pm MT.   There is a lot of space, so they’re hoping to get as many people as possible to attend.  For questions, contact Bri Morales at (915) 212-6502 or at moralesbn@elpasotexas.gov .
0 comments
1 person recommends this.
TAHC&H has developed a number of sample policies for the membership.  The first of these samples include: Avoiding Abandonment of Patients (English/Spanish) Billing & Coding Statement of Employment (English/Spanish) DNR (English/Spanish) Emergency Preparedness Guide for HCCSA’s Family Violence Law/Forms (English/Spanish) General Enforcement Policy Guidance on Nursing Delegation Incident Based Nursing Peer Review Mandatory Reporting Policy Ongoing Pain Assessment Tool Pain Management Flow Sheet Pediatric Nurse Competency Personal Safety in the Community/Workplace Violence Prohibition on Illegal Remuneration Pronouncement ...
0 comments
Be the first person to recommend this.
According to a blog post today from CMS Administrator Seema Verma, CMS is planning to launch a new Medicare Care Compare on Medicare.gov. The new compare tool, which CMS plans to launch in Spring 2020, will combine the eight existing compare tools for Home Health, Hospice, Hospital, Nursing Home, Dialysis Facility, Long-Term Care Hospital, Inpatient Rehabilitation Facility, and Physician. Currently, these eight compare tools are among the most popular and utilized sections of the Medicare.gov website. The new compare tool will be designed to allow “users to access the same information through a single point of entry and simplified navigation to find the information ...
0 comments
Be the first person to recommend this.
More than a thousand seniors in need in Central Texas are expected to receive gifts this year through the program, and there's still time left to give.   Once again, a TAHC&H Member, Tyson Murphy with Home Instead has stepped in to help.  Home Instead Senior Care , has a holiday program called Be a Santa to a Senior .  Participants can go to Walmart’s in Pflugerville, Round Rock and Georgetown, pick up a tag hanging on the Christmas trees, then buy the items you see on a senior's wish list and give them back to customer service. The wish list items range from blankets to slippers and once they're purchased, students from area elementary schools hand ...
0 comments
Be the first person to recommend this.
Texting is a quick and easy way to communicate with colleagues and patients.  Home health providers appreciate the convenience of using text messaging to confirm appointments, answer questions, and address concerns with fellow staff members and their case load.  However, text isn’t always best despite its popularity for convenient communications.  Agencies might be more at risk than they think if staff members are texting each other information about patients.  And, free consumer group messaging apps utilize vulnerable platforms which are unable to address health care-specific needs in terms of security and compliance.  An agency places itself and its patients ...
0 comments
Be the first person to recommend this.
From Texas Health and Human Services: New Features for Hospice Forms 3071 and 3074 Beginning August 23, 2019 Beginning Aug. 23, 2019, providers can monitor and interact with hospice forms 3071, Individual Election/Cancellation/Update and 3074, Physician Certification of Terminal Illness. To do this, go to the Long-Term Care Online Portal and view form status. Besides the existing “Save as Draft” and “Print” form actions, providers also have access to the following form actions (depending on the user’s security permissions or the current form status): Add Note • Correct this Form • Inactivate Form • Reactivate Form • Resubmit Form • Use as Template ...
0 comments
Be the first person to recommend this.
The Centers for Medicare & Medicaid Services (CMS) will hold an Open Door Forum (ODF) on Tuesday, July 9, 2019 from 2:00 PM to 3:00 PM Eastern Time to discuss the latest developments in home health, hospice, and durable medical equipment. Please call in at least 15 minutes before the start of the ODF. The agenda for the July 9 ODF is subject to change, but is scheduled as follows: Opening Remarks Acting Chair – Brian Slater, Center for Medicare Moderator – Jill Darling (OC) Announcements & Updates *DMEPOS Update * Competitive Bidding Implementation Contractor  website and the  Round 2021  DMEPOS Competitive Bidding ...
0 comments
1 person recommends this.
In this update TAHC&H is providing you with a short list of Medicaid bills that deal with the operation and administration of the Medicaid program, especially in regards to managed care. The 86 th session was very different for bills filed to address concerns and fix issues with Texas Medicaid and there was not a shortage of bills filed this session. However, the legislators who filed the majority of the bills did not receive hearings. Only a handful of bills that impact our members made it across the finish line and were signed by the Governor. Below are the key bills that are important to your business and the patients you serve. SB 1207, by Senator ...
0 comments