Special Bulletins
The following bulletins are organized into four categories:
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Home Health Agencies
04-25-2008 Provider Letter #08-11 – Expired Licenses (replaces PL 05-49)
02-05-2008 RS&C Letter No. 08-01
01-22-2008
MD STAMPED NO LONGER ALLOWED
CMS has clarified that this change is to be interpreted to mean home health agencies may not use stamped physician signatures on home health POCs or orders. CMS is aware of previous guidance that was given to State surveyors and revisions to the Interpretive guidelines permitting stamped signatures, however, maintains that stamped physician signatures may not be used. CMS also clarified that for hospice certifications of terminal illness the term "written" means hand-written. Electronic and stamped physician signatures are not permitted; however, the certification document may be a faxed copy.
Section 3.4.1.1 of PIM as it currently reads. The changes are in read italics
B. Signature Requirements
Medicare requires a legible identifier for services provided/ordered. The method used may be hand written or an electronic signature to sign an order or other medical record documentation for medical review purposes. Therefore, a signature in some form, needs to be present. Do not deny a claim on the sole basis of type of signature submitted.
Noted Exception: Signature(s) of the physician(s) must be written on the certifications of terminal illness for hospice.
9-17-07 Updated DADS information
Information Letter No. 07-87: and Information Letter No. 07-50: New Convictions Barring Employment Added to Health and Safety Code Chapter 250
08-20-07 Updated DADS information
DADS has issued the following Provider Letter:
Provider Letter #07-21 – What to Expect During Your Agency’s Survey (Replaces Provider Letters #05-47 and #05-28)
DADS has issued the following Provider Memorandum: S&CC 07-17 – Exit Conference Preliminary Findings List and Second Exit Conference (Replaces S&CC 03-14)
2-05-07Updated Provider Investigation Report
Click here to download the form
Click here to download the instructions
12-04-06Initial Start Ups seeking initial Medicare survey
An announcement through a DADS provider letter was released over the weekend stating DADS will no longer be conducting initial state surveys for Medicare.
Click here for more information
10-18-06 Desk review of self reporting
DADS has issued the following Provider Letter:PL 2006-36: Desk Review of HCSSAs' Self-reported Incidents (Replaces Provider Letter #04-27)
10-18-06 HHABN Questions Answered
The Texas Association for Home Care, Inc. has teamed up with Health Care Information Network (HCIN) to bring you video streamed educational sessions, making continuing education available to all of your staff 24/7 wherever they have access to a computer.
The most recent releases are featured below; however, a host of topics for private pay and Medicare agencies, and a special series of Texas HCSSA licensing rule updates, are available through the TAHC website click here: http://www.homecareinformation.net/collateral/TX_Seminars.htm
10-10-06 Remote Patient Care - TeleSeminar
Click here for TeleSeminar information provided by the Home Care Information Network.
9-15-06 Updated Health Advance Beneficiary Notice (HHABN) Forms
Download the English form, Spanish form, and form instructions below.
Instructions
Revised Health Advance Beneficiary Instructions
English
Home Health Advance Beneficiary Notice Form
Spanish
Aviso Anticipado al Beneficiario de los Servicios de Salud en el Hogar
6-20-06 Rule Changes for HCSSA Effective 06-01-06
Click here to see the Rule Changes for HCSSA Effective 06-01-06
6-20-06 DADS Website Update Notice
DADS Regulatory Services has issued the following Provider Alert:
Home and Community Support Services Agencies (HCSSAs) Licensure Criminal History Check Form (DADS Form 2022) Now Available Online
Please be advised that the HCSSA licensure criminal history check form has been posted to the Department of Aging and Disability Services (DADS) website and was assigned DADS form number 2022. This form must be submitted with a request for HCSSA licensure or notification of change in management personnel. The form enables DADS to check the criminal history of required personnel in accordance with 40 Texas Administrative Code Chapter 97. Information submitted on this form is used exclusively for the purpose of meeting licensure eligibility criteria as mandated by the Texas Health and Safety Code, Chapter 142, Home and Community Support Services, §142.004-License Application. The form may be viewed and downloaded at: http://www.dads.state.tx.us/forms/2022/2022.doc and http://www.dads.state.tx.us/forms/2022/2022.pdf.
You are subscribed to to be notified when DADS Regulatory Services updates Provider Alerts.="$line[]";
A listing of Provider Alerts is available on the DADS Website (http://www.dads.state.tx.us/business/ltc-policy/communications/alerts/)
Questions about DADS Content can be sent to the DADS Webmaster.
For more information about DADS services, please visit the DADS Website.
Note: Privileged/Confidential information may be contained in this message and may be subject to legal privilege. Access to this e-mail by anyone other than the intended is unauthorized. If you are not the intended recipient, you may not use, copy, distribute or deliver to anyone this message (or any part of its contents) or take any action in reliance on it. In such a case, you should destroy this message, and notify us immediately. If you="$line[]";
have received this email in error, please notify us immediately by e-mail or telephone and delete the e-mail from any computer.
6-15-06
Electronic Provider Enrollment Notices
5-25-06
New 6/1/06 rules for State of Texas HCSSA
5-23-06 Information on National Provider Identifier (NPI) and the Revised CMS 855 Medicare Provider Enrollment Applications
On May 1, 2006, the Centers for Medicare & Medicaid Services (CMS) introduced the revised CMS 855 Medicare provider enrollment applications. As part of the revised enrollment process, initial enrollees and existing enrollees making changes to their enrollment information must include their National Provider Identifier (NPI) number and a copy of the National Plan and Provider Enumeration System (NPPES) NPI notification with the enrollment application. No initial application can be approved and no updates to existing enrollment information can be made without this NPI information. All health care providers and suppliers who bill Medicare are required to obtain their NPI in advance of enrolling in or changing their Medicare enrollment data.
If you are an individual or sole proprietor, who furnishes health care, you are eligible for one and only one NPI. If you are an individual who is a health care provider and who is incorporated, you may need to obtain an NPI for yourself and an NPI for your corporation or LLC. If you are an organization that furnishes health care, you may determine that you have components, called “subparts,” that need their own NPI. For additional information about the NPI, please go to http://www.cms.hhs.gov/NationalProvIdentStand/.
If you have not yet obtained your NPI number, CMS encourages you to do so soon even if you are not enrolling or making a change to your Medicare enrollment information. An information sheet designed to provide basic information about the NPI, including the three different ways to apply for your NPI is available at http://www.cms.hhs.gov/MedicareProviderSupEnroll/downloads/EnrollmentSheet_WWWWH.pdf. Whatever method you use to obtain your NPI, be sure to keep this information, share it with your health care partners, and update your information with NPPES whenever any of the information used to get your NPI changes.
Starting May 23, 2007, the NPI will replace all of your existing provider numbers that you use to bill Medicare, Medicaid, and other health care payers. Although this date is still a year away, you should begin sharing this information with Medicare, other payers, and your other health care partners in order to make the transition to NPI as smooth as possible.
For more information about the revised provider enrollment process, please contact your Medicare contractor or go to http://www.cms.hhs.gov/MedicareProviderSupEnroll.
3-16-06
Updated Health Advance Beneficiary Notice (HHABN) Forms –
Download the English form, Spanish form, and form instructions below.
2-27-06
Texas Out-of-Hospital Do-Not-Resuscitate (OOH DNR) Updated Forms –
Download the English and Spanish PDF forms below. The forms are also
available at the
Texas Department of State Health Services website.
1-1-06
Important Information From PGBA For Medicare Home Health Providers – The following was received from the Texas Association for Home Care, Inc.:
Palmetto GBA recently revised (November 2005) the Home Health Training Manual as
well as the Hospice training manual as noted in the December Perspective. These
revisions are available online. Today, PGBA posted the Manual
Revision Chart for each manual that lists the pages
that were changed in each section of the manuals. To view or download a copy of
this chart, please click on the applicable links below. For your convenience we
have also included a link to each training manual.
Because several revisions were made throughout the manuals, we recommend that you
print the applicable manual in its entirety to ensure you receive all updates.
Home Health Training Manual - November 2005
Home Health Training Manual - Revision Chart
Hospice Training Manual - November 2005
Hospice Training Manual - Revision Chart
PGBA also released a correction to the Home Health Training Manual
today that will be incorporated into the online version at a later date. The Timely Filing Standards chart in
Section 4.4 of the recently revised Home Health Training Manual is incorrect. Listed below is the correct information:
| Dates of Service |
Last Filing Date |
| October 1, 2002 – September 30, 2003 |
By December 31, 2004 |
| October 1, 2003 – September 30, 2004 |
By December 31, 2005 |
| October 1, 2004 – September 30, 2005 |
By December 31, 2006 |
| October 1, 2005 – September 30, 2006 |
By December 31, 2007 |
MEDICARE PART D INFORMATION FOR BENEFICIARIES
The Centers for Medicare & Medicaid Services (CMS) is providing a “drop-in” graphic
containing quick tips for Medicare beneficiaries using their
Medicare prescription drug coverage in January 2006 (see
below). People with Medicare who enroll by the end of December
will have coverage starting on January 1, 2006. These tips may
help them avoid some of the potential "bumps in the road" that
come with using anything new. People with Medicare still
reviewing their options have until May 15th to enroll.
The tips below may be useful to nurses and staff in the field to share with beneficiaries.
Using your Medicare Prescription Drug Coverage
Quick Tips on your First Pharmacy Trip
Did you enroll in a Medicare Rx plan but have not yet received your ID card? Are
you covered by Medicaid and not sure how to get your medicines
in the New Year? Whatever your question, if you have enrolled in
Medicare Prescription Drug Coverage know you will receive your
medications January 1, 2006.
- An acknowledgment letter will arrive about a week after you enroll. A plan ID card 3 to 5 weeks later.
- If you need to go to the pharmacy before your ID card arrives bring the acknowledgement letter from your plan, your Medicare
and/or Medicaid card and a photo ID.
- Save your receipts from your pharmacist
- Call 1-800-MEDICARE 24/7 for assistance
Reminder: Enroll by the end of December to start coverage in January, 2006.
www.medicare.gov
CMS has also developed a chart of potential situations beneficiaries, especially full benefit dual
eligible beneficiaries, may encounter. This list of scenarios
is designed to assist you to quickly respond to any inquiries or
problems you may receive from your clients.
This link will take you to the document.
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Hospice Providers
05-09-08 PROPOSED MEDICARE HOSPICE WAGE INDEX
Click here for the document
05-06-08 CMS suspends reporting of visit data from non - hospice staff in contracted
facilities
The Centers for Medicare & Medicaid Services (CMS) today reissued Change
Request (CR) 5567 to "temporarily suspend reporting of visit data from
non-hospice staff in contract facilities providing General Inpatient Care."
The reissue was in response hospice industry pleas to forego requiring
hospices to report visits made by non-hospice employees.
Due to the nature of services provided in an inpatient setting, it is
difficult to determine what constitutes a visit. The hospice would have to
assign a nurse to perform the unproductive task of reviewing and assessing
each piece of documentation to determine if any part of any encounter would
qualify as a billable visit. These visit counts would not be consistent or
accurate amongst the various hospice agencies and would jeopardize the
validity of the data. It would also strain the contractual relationship
between the hospice and the facility providing the inpatient level of care.
TAHC had contacted CMS to request that CMS either define "contracted" staff
and/or to specifically remove the requirement for non-hospice staff visits
to be counted. Fortunately, CMS recognized that the original requirement was
unreasonable. Additionally, CMS has removed the word "medically" and
"direct" from the reasonable and necessary patient visit description of a
hospice visit. So, the new language reads, "To be counted as a visit, the
visit must be reasonable and necessary for the palliation and management of
the terminal illness and related conditions as described in the plan of care
. All visits to provide care related to the palliation and management of the
terminal illness or related conditions, whether provided by hospice
employees or provided under arrangement, must be reported. The one exception
is related to "General Inpatient Care." Hospices must report GIP visits
provided by hospice staff in contract facilities and in hospice-owned
facilities.
These changes will be reflected in CMS Pub 100-4, Chapter 11 - Processing
Hospice Claims. They have included examples of what constitutes a visit: "To
constitute a visit, the discipline . must have provided care to the
beneficiary. Services provided by a social worker to the beneficiary's
family also constitute a visit. . phone calls, documentation in the
medical/clinical record, interdisciplinary group meetings, obtaining
physician orders, rounds in a facility or any other activity that is not
related to the provision of items or services to a beneficiary, do not count
towards a visit to be placed on the claim. In addition, the visit must be
reasonable and necessary for the palliation and management of the terminal
illness and related conditions as described in the patient's plan of care."
CMS has related that there will be a new set of Q&As on CR 5567 posted on
their website April 30. This Q&A will also clarify that hospices do not
need to report non-hospice staff visits on the inpatient respite level of
care - only hospice staff visits.
04-15-08 MEDICARE CAP IMMEDIATE ATTENTION IS REQUIRED!
The Center for Medicare & Medicaid Services is requiring hospices to refund
monies that were paid for caring for eligible patients that hit the cap well
before the 6 months the benefit was intended to cover. The yearly CAP
period runs from Nov.1 through Oct. 31. When you receive your cap letter
and you have a cap demand repayment, you must respond within 15 days from
the date of the letter with payment in full or your application for an
extended re payment plan at 12.125% interest. If a hospice does not send the
first payment within that 15 days, all approved reimbursement on present
patients will be withheld until the total is paid or you reach an agreeable
repayment plan. Either way patients or families in hospice care lose.
My plea is that you communicate to your congressional representatives the
importance of the PATH Act in H.R. 5542 and S. 2727 as soon as possible.
12-05-07 Updated DADS information Website Update Notice
Information Letter No. 07-118: Medicaid Hospice Per Diem and Medicaid Hospice Cap
9-17-07 Updated DADS information
Information Letter No. 07-87: and Information Letter No. 07-50: New Convictions Barring Employment Added to Health and Safety Code Chapter 250
9-19-06 Edits to DADS Form 3613 -- Home and Community Support Services Agencies (HCSSA) Provider Investigation Report
Please be advised that DADS Regulatory Services has edited DADS Form 3613 and related instructions used for HCSSA self-reports. The updated form and instructions for self-reports are attached to DADS Provider Letter 06-12, which also provides details about the reporting process and requirements.
HCSSAs must submit DADS Form 3613 within 10 calendar days of making the required oral reports to the Texas Department of Family and Protective Services (DFPS) and DADS. Edits were made for clarity and to better capture information needed for DADS Regulatory Services to review the report and the HCSSA’s investigation of the incident. These changes should reduce the number of instances where a regional surveyor or program manager needs to contact a HCSSA for additional information to complete the review of a self-report.
The revised DADS Form 3613 may also be viewed and downloaded under miscellaneous forms at: http://www.dads.state.tx.us/business/LTC-Policy/forms/index.html.
7-26-06 LTC Providers Using the Long Term Care Online Portal – REMINDERS
Third Party Software Testing -
As Providers using the current DOS-based CARE Form System (CFS) software are aware, CFS is being upgraded to a web-based online system.="$line[]";
The LTC Online Portal will become effective August 21, 2006.="$line[]";
This is a reminder that Third Party Software vendors submitting forms to TMHP on behalf of providers MUST successfully complete testing for the new LTC Online Portal by August 1, 2006. It is extremely important that this testing be completed no later than this date.="$line[]";
If successful testing is not completed by August 1, 2006, the providers represented by the vendor will NOT be able to transmit their forms to Texas Medicaid & Healthcare Partnership (TMHP) until after August 21, 2006.="$line[]";
Email any questions about testing to careformsupport@tmhp.com.
Portal Registration -
To access the LTC Online Portal on Monday, August 21, 2006, providers must create a Provider Administrator account.="$line[]";
This is a reminder that these accounts MUST be created as soon as possible to ensure forms can be transmitted on August 21, 2006.="$line[]";
Unless a Provider Administrator account is created, providers will NOT be able to transmit forms on August 21, 2006.="$line[]";
Instructions for creating, maintaining, and using Provider Administrator accounts can be found in the Website Security Training Manual on the TMHP website at www.tmhp.com.
To create an account, Hospice providers will need their contract number, EDI Submitter ID, Texas Identification Number and an ICN.="$line[]";
Nursing Facilities and Waiver Program providers will need their contract number, four-digit Vendor/Site ID Number and Vendor Password (Formerly known as Micro-ECS password).="$line[]";
The Provider Administrator will then have the ability to create other users at their facility.
6-20-06DADS Website Update Notice
DADS Regulatory Services has issued the following Provider Alert:
Home and Community Support Services Agencies (HCSSAs) Licensure Criminal History Check Form (DADS Form 2022) Now Available Online
Please be advised that the HCSSA licensure criminal history check form has been posted to the Department of Aging and Disability Services (DADS) website and was assigned DADS form number 2022. This form must be submitted with a request for HCSSA licensure or notification of change in management personnel. The form enables DADS to check the criminal history of required personnel in accordance with 40 Texas Administrative Code Chapter 97. Information submitted on this form is used exclusively for the purpose of meeting licensure eligibility criteria as mandated by the Texas Health and Safety Code, Chapter 142, Home and Community Support Services, §142.004-License Application. The form may be viewed and downloaded at: http://www.dads.state.tx.us/forms/2022/2022.doc and http://www.dads.state.tx.us/forms/2022/2022.pdf.
You are subscribed to to be notified when DADS Regulatory Services updates Provider Alerts.="$line[]";
A listing of Provider Alerts is available on the DADS Website (http://www.dads.state.tx.us/business/ltc-policy/communications/alerts/)
Questions about DADS Content can be sent to the DADS Webmaster.
For more information about DADS services, please visit the DADS Website.
Note: Privileged/Confidential information may be contained in this message and may be subject to legal privilege. Access to this e-mail by anyone other than the intended is unauthorized. If you are not the intended recipient, you may not use, copy, distribute or deliver to anyone this message (or any part of its contents) or take any action in reliance on it. In such a case, you should destroy this message, and notify us immediately. If you="$line[]";
have received this email in error, please notify us immediately by e-mail or telephone and delete the e-mail from any computer.
06-01-06
DADS has issued an Information Letter to inform Hospice Providers that effective June 1, 2006, Provider Services-Community Services Contracts
unit under Rosalin Willis will be responsible for the enrollment of Medicaid Hospice providers and the administration of the Hospice contracts.
To contact Rosalin Willis, Community Services Contracts Unit Manager, call (512) 438-4722. The letter reads as follows:
Date: May 31, 2006
To: Medicaid Hospice Providers
Subject: Texas Department of Aging and Disability Services (DADS) Provider Services
Information Letter No. 06-49 -- Transfer of Contact Enrollment and Administration of DADS Medicaid Hospice Contracts
This is to notify you that, effective June 1, 2006, the responsibility for enrollment of Medicaid Hospice Providers and the administration
of the Hospice contracts will transfer from the Provider Services - Institutional Services Contracts unit to the Provider Services - Community
Contracts unit.
Please contact Rosalin A. Willis, Community Services Contracts Unit Manager, at (512) 438-4722 if you have any questions.
Sincerely,
Kim Wedel
Section Director
Community Services
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CBA
9-17-07 Updated DADS information
Information Letter No. 07-90: Personal Care 3 Reimbursement Rates Effective September 1, 2007
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