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Members, Please see the following notice just released by HHSC.  The notice is for Medicaid Hospice providers and details an upcoming webinar on August 17 th  to review the new rules in TAC Chapter 266.  The link to register for the webinar is in the notice below. MEDICAID HOSPICE PROVIDER WEBINAR SLATED FOR AUG. 17 HHSC will host an informational webinar on Aug. 17 for hospice providers to review the newly implemented Medicaid Hospice Program rules found in Texas Administrative Code Title 26, Chapter 266, effective July 26. Wednesday, Aug. 17 1–2:30 p.m. Register ...
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Members, Please see the below notice just released by HHSC.  The notice directs providers to IL 2022-43, which details important claims processing cutoff dates for Fiscal Year 2022. Please see the entire notice and link to the information letter below.   HHSC HAS PUBLISHED FISCAL YEAR 2022 CUTOFF DATE FOR YEAR-END CLOSEOUT PROCESSING IL 2022-43  is posted on the Adult Foster Care Providers, Assisted Living Facilities, Community Attendant Services Providers, Community Living Assistance and Support Services Providers, Consumer Managed Personal Attendant Services Providers, ...
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Members, Please see the below notice just released from HHSC.  The notice shares public comments and HHSC responses to those comments related to the HB 4 draft policies, which were previously posted for public comment. HB 4 (87th Legislative Session, 2021) allows covered services through telemedicine, telehealth and audio-only delivery if clinically appropriate and cost effective. Please see the entire notice below. HOUSE BILL 4 TELECOMMUNICATIONS COMMENTS AND RESPONSES AVAILABLE FOR COMMENT In alignment with   HB 4 (87th Legislative Session, 2021), HHSC has developed ...
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National Nurses Week begins each year on Nurses Day, May 6 th   and ends on May 12th, Florence Nightingale's birthday. This year the American Nurses Association (ANA) is recognizing May as Nurses Month. During National Nurses Week, we honor and celebrate the extraordinary men and women who have devoted themselves to ensuring Texans receive care in their homes. Nurses have been challenged in the past few years in the delivery of care to our patients and have shone brightly once again.  The contributions our nurses have made to the health and wellbeing of our most vulnerable Texans has been exponentially magnified. ANA is recognizing a  month-long celebration ...
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The installation of PDGM in 2020 rewired the Home Health care production and delivery model under the Impact Act's Volume to Value (V2V) reforms. The V2V specifics of the HH reforms address traditional areas of the previous PPS Model that failed to produce increased outcomes. OASIS accuracy, splitting the 60-day certification period, and reduced payments for Community-based referrals were all included in the Patient-Driven Groupings Model. But the changes to HH Rehab services were the most impactful, as Providers found that the value of the patient episodes were no longer defined by the number of rehab visits on the case. Prior to PDGM's installation, most ...
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Members, Yesterday, January 11, 2022, TAHCH met with HHSC regarding HCSSA staffing shortages and the contradictions and inconsistencies between the revised CDC guidance for   Managing HCP   and   Mitigating Staffing Shortages , and the   HHSC emergency rule   and   HHSC provider FAQ's .  We pointed out the growing need for HCSSA agencies to implement contingency (when a shortage is anticipated) or crisis (when a shortage is occurring) level staffing shortage plans and how providers are conflicted about whether to follow the CDC guidance or risk being non-compliant with the HHSC emergency rule due to the 14 day contact screening criteria and no allowance ...
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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 ...
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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 ...
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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 ...
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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 ...
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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 ...
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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 ...
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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.
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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 ...
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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.
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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 ...
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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 ...
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Palmetto GBA RTP 39621

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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 ?
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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 .
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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 ...
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