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PACSTX Members, 

With the holidays coming up, we didn't want all the regulatory news to get lost in the mix. See below for valuable data and important regulatory up-dates from DADS and HHSC.
In This Issue

SSLC Transitions and Enrollment Data 

 To view the most recent data on SSLC transitions click here. 

 

To view the most recent data on HCS and TxHmL interest list and enrollment data click here.

 

As a reminder, all data received from DADS is also posted on the PACSTX webpage at: www.pacstx.org/government-relations/   

HHSC Eligibility Policy Handbook Updates 

Eligibility policy handbooks for Texas Works and Medicaid for the Elderly and People with Disabilities have been updated with the following bulletins:

Texas Works 
Texas Works Bulletin 15-04: 2015 Federal Cost-of-Living Adjustment (COLA): Retirement, Survivors, and Disability Insurance (RSDI); Supplemental Security Income (SSI); Railroad Retirement (RR) Benefits; Medicare Part B Premiums



Medicaid Eligibility for the Elderly and People with Disabilities

MEPD Bulletin 15-02: 2015 Cost-of-Living Adjustment (COLA) for Federal Benefits

Please note that a provider applicant may submit only one application for one facility.

 

DO NOT CONTACT HHSC-PCS (or HHSC) OR DADS REGARDING THIS ANNOUNCEMENT PRIOR TO THE OFFICIAL POSTING ON THE ESBD WEBSITE AND IN THE TEXAS REGISTER REFERENCED ABOVE.

HCS/TxHmL/ICF Provider Responsibilities in Managed Care

DADS has released Information Letter 14-81 to address the impact of the carve-in of acute medical care services for certain individuals enrolled in the HCS and TxHmL programs and the impact the carve-in will have on the expectations for HCS and TxHmL program providers.

  • Provider Letter 14-16: ICF/IID Expectations Related to Managed Care Organizations (MCOs)
    • Addressed to:
      • ICF/IID Providers

DADS: Up-date on Home Home/Companion Care and Day Habilitation IL and FAQs 

As discussed in previous PACSTX meetings, DADS released the information letter and accompanying FAQs clarifying HCS Billing Guidelines related to host home/companion care providers and their ability to provide day habilitation services.  

 

The IL clarifies that a host home/companion care provider may not also be the provider for in-home day habilitation nor may the host home/companion care provider be the provider for day habilitation out of the home unless he/she works for or owns a separate business for the provision of day habilitation services.  

 

Providers have until January 1, 2015 to modify contracts with host home/companion care providers to avoid recoupment.  

 

For more information and further clarifications, click here to view the IL and FAQ. 

 

Final HHSC "Listening Session" on Acute Care Transitions for Individuals with IDD to Managed Care in Longview on December 16

 

December 16 - Longview
Location:
Community Connections
501 Pine Tree Rd
Longview, TX 75604
Time: 9a.m.- Noon
Conference Line - 1-877-226-9790
Phone Access Code - 5413391

 

During these sessions, people with IDD, their family members, advocates, and acute care and long-term care providers will be able to give their feedback about the STAR+PLUS transition. HHSC will not present information during these sessions, but instead will collect feedback and ideas that may affect future managed care initiatives.

 

Information about these sessions will be available on the HHSC website at http://www.hhsc.state.tx.us/news/meetings.asp. Questions can be directed to Heather Kuhlman at 512-462-6356 or through email at Heather.Kuhlman@hhsc.state.tx.us.


Other DADS Up-dates:

Period Review Date Added to CARE Screen C63

A new field, Periodic Review Date, has been added to CARE Screen C63. The Periodic Review Date is the due date for a Medicaid recipient's annual redetermination.

 

People enrolled in HCS and TxHmL who don't receive SSI will get a redetermination packet from the Texas Health and Human Services Commission (HHSC) about 90 days before their periodic review date. They will be given a limited amount of time to complete and return the packet to HHSC. Failure to return the packet may result in loss of Medicaid benefits.

Providers and local authorities are encouraged to monitor this date in CARE and help people who are enrolled in their program, or their authorized representative, complete and return the packet on time. Denial of Medicaid benefits may result in termination of waiver program services and non-payment to the provider for services rendered.

 

Questions about this can be emailed to Wesely Marcinowski at wesely.marcinowski@dads.state.tx.us.

 

Register Now for Infection Control in Long-term Care 2015

DADS and DSHS are hosting a series of joint training conferences around the state to increase awareness of infection control and regulatory requirements in assisted living facilities, nursing facilities and intermediate care facilities.

This training will be offered at the following venues:

  • Jan. 21, 2015 - Harlingen, Rio Grande State Center
  • Feb. 10, 2015 - Houston, St. Luke's Medical Center
  • March 19, 2015 - Abilene, Abilene State Supported Living Center
  • April 7, 2015 - Denton, Denton State Supported Living Center
  • Date Pending - Austin, Pickle Center

More information, including registration links, is on the DADS Quality Matters website. Space is limited; register early.

 

Email questions to NF.policy@dads.state.tx.us.

 

 

Provider Letter PL 14-33 / Information Letter Number IL 14-80 - Pre-admission Screening and Resident Review - Quality Service Reviews

Addressed to:

  • Local Authorities
  • Medicaid-certified Nursing Facilities
  • Home and Community-based Services Providers
  • Texas Home Living Providers
  • Community Living Assistance and Support Services Providers
  • Deaf Blind and Multiple Disabilities Providers
  • STAR+PLUS Providers
  • Intermediate Care Facilities for Individuals with Intellectual Disabilities 

Amended United States Department of Labor Regulations Effective January 1, 2015

The purpose of this notification is to inform providers in the following programs or services that amended U.S. Department of Labor (DOL) regulations will go into effect on January 1, 2015.

Medically Dependent Children Program;


Primary Home Care, Community Attendant Services, and Family Care;
Consumer Managed Personal Attendant Services;
Community Living Assistance and Support Services;
Deaf Blind with Multiple Disabilities;
Home and Community-based Services; and
Texas Home Living.

 

The amended regulations prohibit third party employers (which includes private entities) of domestic service employees, from claiming the companionship services exemption or the live-in domestic service employee exemption to the Fair Labor Standards Act. The regulations may be found at 29 CFR Part 552. Consequently, effective January 1, 2015, the regulations require you to pay at least the federal minimum wage and overtime pay to your domestic service employees, regardless of the employees' duties.

 

For information about the amended DOL regulations, including DOL Fact Sheets, please see the following DOL website: http://www.dol.gov/whd/homecare/; call DOL's toll-free information and helpline, 1-866-4USWAGE (1-866-487-9243), available 8am to 5pm in your time zone; or consult your legal counsel.  

 


Information Letter 14-78 - Relocation of the Health and Human Services Commission Document Processing Center from Midland to Austin

 

Addressed to:

  • Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Condition Program Providers
  • Home and Community-based Services Program Providers
  • Texas Home Living Program Providers
  • Community Living Assistance and Support Services Program Providers
  • Deaf-Blind with Multiple Disabilities Program Providers
  • Local Authorities

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