Recent News

Therapy Rate & Policy Changes Delayed Until September 1

By JR Top posted yesterday
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Texas Health and Human Services (HHS) just announced that the effective date for the therapy rate and policy changes will now be delayed until September 1, 2017. This is to align with the expected September 1, 2017 therapy rate changes resulting from the partial rate restoration directed by the 85th Legislature. The Texas Association for Home Care & Hospice (TAHC&H) met with HHS this morning and learned the following concerning the upcoming therapy rate and policy changes. Therapy Rates There will be a rate hearing in sometime in July for the new therapy rates that incorporate the partial rate restoration of SB1. TAHC&H was informed that HHS Executive ...
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A Guide on How to Submit Provider Complaints to Texas Health and Human Services

By JR Top posted yesterday
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Filing a Provider Complaint with Texas Health and Human Services Providers can file complaints or inquiries with HHS Health Plan Management (HPM) for the following programs  STAR, STAR+PLUS, or managed care dental at: HPM_Complaints@hhsc.state.tx.us STAR Health complaints or inquires should be sent to: STAR.Health@hhsc.state.tx.us Complaint Types When a contact is received by HPM complaints, it will be logged/assigned as one of the following action types: Complaint: An expression of dissatisfaction expressed by a provider or member or other individual designated to act on behalf of the Member, verbally or in writing to HHSC, about ...
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New Texas HHS LTSS Policy Email Addresses

By JR Top posted yesterday
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As a result of the continuing transition of the Department of Aging and Disability Services (DADS) Long-Term Services and Support (LTSS) community-based programs to Texas Health and Human Services (HHS), HHS sent an announcement on June 22, 2017 that the LTSS community-based programs email addresses have changed. LTSS Providers and stakeholders who have LTSS policy questions will now need to send questions to the new email addresses below. Adult Foster Care - ccadpolicy@hhsc.state.tx.us Residential Care - ccadpolicy@hhsc.state.tx.us Community Attendant Services - ccadpolicy@hhsc.state.tx.us Primary Home Care - ccadpolicy@hhsc.state.tx.us ...
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Registration is Now Open for the 48th Annual Meeting

By Katie Mills posted 7 days ago
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It is here! You can now register for TAHC&H’s top event of the year – the 48th Annual Meeting . This year’s meeting will take place August 9-10 at the beautiful The Woodlands Waterway Marriott Hotel & Convention Center . We’ve added a new event this year – you don’t want to miss it! If you haven’t been to The Woodlands Waterway before, you are in for a treat! The hotel is walking distance to endless shopping and dining options and of course, the beautiful Woodlands Waterway – a tree lined “river walk” perfect for a scenic stroll and access to area amenities. Our education lineup this year addresses all of your hot button issues – • Avoiding False Claims ...
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HHSC-HIPAA Privacy Breach Notification: Houston-Area Accidental Loss of Client Information

By Marissa Machado posted 7 days ago
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Date: June 16, 2017 Contact: Kelli Weldon, 512-424-6951  The Health and Human Services Commission (HHSC) is notifying people about the accidental loss of protected personal information. The breach may affect 1,842 people in the Houston area. A box of forms containing client information was found beside an unsecured dumpster in Houston at the E. 40th St. complex, an eligibility office. The lost forms contained confidential information including names, client numbers, dates of birth, case numbers and phone numbers. Other potential information includes mailing addresses, Social Security numbers, health information and bank account numbers. ...
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2018 UPDATES for ICD-10 CM and GEMs & Prep for TAHC&H Coding Conference

By Marissa Machado posted 8 days ago
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The Centers for Medicare and Medicaid (CMS) has published the following updates to 2018 International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) files.   Texas Association for Home Care and Hospice (TAHC&H) is very excited to notify you that planning is underway for a conference on ICD-10 competency including the 2018 newly, revised and deleted ICD-10 codes! The conference will be held in September 2017! The date and location to be determined very soon, so please stayed tuned to TAHC&H’s Upcoming Events for more information and please visit TAHC&H’s Upcoming Events  page frequently for other great learning ...
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RCTCLearn.Net to Host Webinars for Agencies/Training Coordinators

By Becky Campbell, CMP posted 8 days ago
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If you have not signed up for RCTCLearn.Net – find out more information HERE . RCTCLEARN.NET will be hosting webinars for agencies or training coordinators new to RCTCLEARN.NET and/or 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.  Below are the webinar dates: ...
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Reminder: CMS Financial System Dark Day Impacting Payment Flow to Medicare Providers

By Marissa Machado posted 10 days ago
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The Centers for Medicare and Medicaid (CMS) will be performing a Financial System Transition starting the weekend of June 16, 2017. Due to these activities, providers will experience the following adjustments in processing and service during this time, including earlier payments. From June 16, 2017, 12 pm ET, through June 20, 2017, 12 pm ET, Palmetto GBA staff will be unable to access the Financial System. This will limit Palmetto GBA’s ability to respond to certain financial inquiries. No payments will be issued to providers dated June 20 and 21, 2017 All claims due to be paid on June 20 and 21, 2017, will be paid early on June 19, 2017 Payments ...
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Medicaid Providers are Subject to Post-Enrollment Site Visits

By Marissa Machado posted 11 days ago
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As part of Federal Regulation (Code of Federal Regulations 455.432), Texas Medicaid & Healthcare Partnerships (TMHP) may conduct a scheduled or unscheduled post-enrollment site visit for providers who are designated as “moderate” or “high” risk. The purpose of a post-enrollment site visit is to verify that providers are in compliance with federal and state enrollment requirements.  During the unscheduled and unannounced pre-enrollment site visits, an audit will be performed to ensure that prospective providers meet enrollment requirements. During post-enrollment site visits, an audit will be performed to ensure that current providers remain operational and ...
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Procedure Codes for Dual Eligible Texas Medicaid Reminders

By Marissa Machado posted 11 days ago
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Texas Medicaid & Healthcare Partnerships (TMHP) posted the following this morning. Please share with appropriate claim staff.   Effective for dates of service on or after August 2, 2016, for services rendered to clients who are dual-eligible for Texas Medicaid and Medicare, procedure code E0248 is now Medicaid-only. It is not necessary to submit procedure code E0248 to Medicare before it is submitted to Medicaid.   Affected claims with procedure code E0248 with dates of service from August 2, 2016, through April 25, 2017, will be reprocessed. Providers may receive additional payment, which will be ...
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Free Webinar Through Value Added Partner Wound Care Education Institute

By Elyse Fulton posted 14 days ago
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The Wound Care Education Institute (WCEI), a value added partner of TAHC&H, is holding an upcoming free webinar about nutrition impacts on wounds. Read more below! June 21, 2017 2:00pm CST Register here! Flyer Webinar: Everything You Always Wanted to Know about Nutrition but Didn't Ask (1 CE) Speaker: Nancy Collins, PhD, RDN, LD, FAPWCA, FAND The media bombards us with information about nutrition, so it seems that we all should know what to eat to be healthy. Yet, many of our patients are malnourished, which contributes to both the development of wounds and chronic nonhealing wounds. This webinar will answer ...
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Action alert: Fix F2F and Support the Home Health Documentation and Program Improvement Act

By Elyse Fulton posted 14 days ago
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An action alert has been added to the TAHC&H action alert center! Congressman Kenny Marchant (R-Dallas) has introduced the bipartisan Home Health Documentation and Program Improvement Act to address and correct the Face-to-Face documentation requirements. This bill, also known as H .R. 2663 , is now working its way through the committee process in the U.S. House of Representatives.  Help fix the Face-to-Face rule & backlog!  Call your Member of Congress today to co-sponsor the Home Health Documentation and Program Improvement Act! Even if your agency does not provide services through Medicare or have to comply with the Face-to-Face ...
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Update: Therapy Rate Changes

By JR Top posted 15 days ago
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There are two things to consider with the July 1 st rate reduction; the new therapy assistant rate and the 15 minute increment rate for PT and OT. If SB 1 (2018-2019 budget bill) is signed by the governor in its current form, the therapy assistant rate will not go into effect July 1 st . Instead, SB 1 changes the therapy assistant rate reduction to be phased in and delays the reduction of rates. The first reduction will begin on December 1, 2017 (15%) and then the second one will go into effect September 1, 2018 (another 15%). Until SB 1 is signed by the governor, HHSC is not communicating their plans for any of the rate changes . Around June ...
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Reminders: QIES Security Notice: Disabling and Deleting Accounts & Downtime Schedule

By Marissa Machado posted 17 days ago
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REMINDERS: QIES security requires each user to successfully login every 60 days, effective June 26, 2017. If this does not occur, the account will be disabled and can only be re-enabled by contacting the QTSO Help Desk at (800)339-9313. Accounts that have no activity for more than 365 days will be deleted. Once your account is deleted, you will not be able to use or re-enable the account. If your account is deleted, you will need to request access through CMS as you did originally; you will be assigned a new User ID and password when the access is granted. QIES users will continue to use QUMA to update passwords as required every 60 days; and use ...
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Emergency Preparedness for the Hurricane Season and Other Emergencies

By Marissa Machado posted 18 days ago
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Assisted living facilities, day activity health services facilities, home and community support service agencies, intermediate care facilities for individuals with an intellectual disability or related conditions, in-patient hospice facilities, and nursing facilities should review their emergency preparedness and response plans for the Atlantic hurricane season, which runs from June 1, 2017 through November 30, 2017. Facilities must also be prepared for the possibility of other potential emergencies such as tornadoes, floods or fires. In consideration of a possible facility evacuation, plans must address: evacuation procedures; procedures for receiving ...
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CMS Published Advanced Copy- Appendix Z, EP Interpretive Guidelines and Survey Procedures

By Marissa Machado posted 18 days ago
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Centers for Medicare & Medicaid Services (CMS) has just released an advanced copy of the interpretive guidelines (IGs) and survey procedures for the Emergency Preparedness, as part of the Conditions of Participations. Emergency Preparedness, as part of the conditions for participation, is available and will be incorporated into the Medicare State Operations Manual under Appendix Z. The IGs apply to all of the 17 provider types listed in the regulation , Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers. The tags for emergency preparedness will be “E” Tags and accessible to both health and safety surveyors ...
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FREE Webinar June 7: Value-Based Purchasing, Where Do You Fit into Delivery Reform?

By Marsha Meier, LSW posted 21 days ago
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FREE Webinar, Value-Based Purchasing- Where Do You Fit Into Delivery Reform ?  Wednesday, June 7.  Medicare is moving rapidly from fee for service payments to payment based on quality clinical outcomes. Learn how your home health agency and hospice can take advantage of initiatives and avoid being left out in the cold. Speakers: Michael Cook and Heidi Kocher,  Liles Parker Attorneys & Counselors at La
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Hospice MLN Issued on Required Workaround to Correct Two Errors & Submit Claims

By Marissa Machado posted 28 days ago
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The Center for Medicare and Medicaid (CMS) has just issued Medlearn Matters Special Edition 17014 , which provides instruction on steps hospices must take to resubmit the claims that contain payment errors.  CMS indicates that hospices may now resubmit claims with RHC and SIA errors for all cases EXCEPT THOSE THAT FOR WHICH PRIOR DAYS USED ARE GREATER THAN 99 (a systems fix for this issue will be installed on August 21).   The Medlearn Matters Special Edition 17014  article also contains information related to a workaround that hospices should employ to address claim payment errors that are related to transfer cases.  Please share this information with ...
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CDC Reports Deaths from Alzheimer’s Disease Increased in Texas

By Marissa Machado posted 28 days ago
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Alzheimer’s disease (Alzheimer’s), an ultimately fatal form of dementia, is the sixth leading cause of death in the United States, accounting for 3.6% of all deaths in 2014. Alzheimer’s deaths can be an indicator of paid and unpaid caregiver burden because nearly everyone in the final stages of Alzheimer’s needs constant care, regardless of the setting, as the result of functional and cognitive declines.   The Center for Disease Control and Prevention, Morbidity and Mortality Weekly Report (MMW ) published on May 26, 2017, shows that the number of deaths are on the rise. Alzheimer’s disease is the most common cause of dementia. ...
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HHS Public Hearing Update on Therapy Rate Changes

By Marissa Machado posted 28 days ago
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On Wednesday, the Health and Human Services Commission held a public hearing on proposed Medicaid payment rates for the physical, occupational and speech therapy provided by Comprehensive Outpatient Rehabilitation Facilities/Outpatient Rehabilitation Facilities (CORF/ORF), Home Health Agencies (HHA) and independent therapists.  This proposed adjustment meets the requirements of House Bill 1 of the 84th Texas Legislature. However, HHSC is closely monitoring the budget decisions being considered this session and will make adjustments to the proposed rates through the public hearing process to align with future appropriations. The written comment period regarding ...
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