In response to an opportunity presented to states by the federal Center for Medicare and Medicaid Innovation within the Centers for Medicare and Medicaid Services (CMS) in July 2011, HHSC has developed a draft proposal to integrate care for Medicaid and Medicare (dual) eligible individuals. The goal of this demonstration project is to achieve savings and reduce costs through integrated and improved care management for Medicaid and Medicare services for these individuals. Participating states will negotiate with CMS to retain a portion of the savings achieved through implementation of this initiative.
TAC CHANGES
DADS is in the process of revising Title 40 of the Texas Administrative Code Chapters 98, 51 and 48 in order to implement the new 1915i state plan service and include DAHS as a waiver service for Community-based Alternatives and Medically Dependent Children Program.
These changes will be effective 9/1/12. In order to meet the rule revision deadlines and ensure stakeholder feedback, DADS is requesting that DAHS providers review the draft rule packet available at Adult Day Care and Day Activity and Health Services Rule Changes. DADS is planning to discuss the rule packet at the DAHS stakeholder meeting scheduled for March 6th. Please plan to provide comments at the meeting or in writing by March 6th.
ADCAT REGIONAL MEETING RIO GRANDE VALLEY
We will be having an ADCAT Regional meeting in the RGV on Thursday, February 9 from 11:30-2:30 at Pappadeaux, 1610 W. Expressway 83, Pharr, TX 78577.Members and non-members are invited to attend.
IF you have not yet received a contract from one of the managed care companies please let us know! We want to be sure your contract is in place and you are ready to bill on March 1!
Please also let us know any specific concerns or issues you are experiencing so we can be sure they are addressed at the regional meeting.
REGISTER HERE
ADDITIONAL TRAININGS SCHEDULED IN SOUTH TEXAS
The Texas Health and Human Services Commission (HHSC) is hosting a series of provider trainings in the Managed Care Expansion service delivery areas. These meetings will allow HHSC to present information ensuring a successful expansion of the STAR and STAR+PLUS Medicaid managed care programs, managed care pharmacy benefits, and Medicaid and CHIP dental managed care. Providers will be given an opportunity to have questions answered relevant to Medicaid services. This will allow providers to make an informed decision on executing contracts with the Managed Care Organizations.
There is no cost to attend these trainings. Trainings are conducted in half-day segments in select cities across the state between September and November 2011. Please click here to read the rest of this alert.
Interested in starting an Adult Day Care?
Do you want to learn more about the Adult Day Care Business?
It is not too late to sign up for ADCAT's "Adult Day Care 101" course
This course will be offered starting at 8:30 am on Thursday, October 20 at the Hilton Garden Inn South Padre Island.
Adult Day Health Care is an exciting industry with excellent growth. Come learn the basics from an expert!
Topics will include:
- How to determine if Adult Day Services is the right Business Opportunity
- Location, Location, Location: Determining where to put your Adult Day Center
- Selecting a Building (Leasing v. Building)
- The A-Z of State Regulation Requirements for DAHS
- Funding Sources for Businesses
12th Annual ADCAT Training and Conference
PASSPORT to Excellence: New Horizons
October 20-21, 2011
Network, learn about trends in our industry to best serve our clients and grow our business!
This year’s conference includes presentations on:
Regulatory Changes & Updates from HHSC and DADS
Food Program Contracting
Intake, Contracting and Licensing- Managed care and your new relationship with DADS
Activities and programing
Managed Care billing- Hands on training- How not to miss a beat during your transition
Labor Law: New Developments
Risk Management/Insurance- What you need to know
Creative and Innovative Programing for Clients with Alzheimer's disease and other forms of Dementia
Making QuickBooks Work for you-How to get the data/reports you need to run your business and to prepare your cost reports
AND MUCH MORE!!
Check back for updates and Conference Agenda!
DADS Provider Letter No. 11-80
Ensuring Health and Safety at Day Activity and Health Services Facilities
This letter is being issued to provide procedures for handling threats to health and safety at a Day Activity and Health Services (DAHS) facility. Click on the link below to read more about the latest Provider Letter.
PROVIDER TRAINING WORKSHOP
08/17/2011 - NOTICE: LOCATION CHANGE
The Workshop has moved! The RGV Training Workshop will be held at:
Casa de Palmas Renaissance Hotel
101 N. Main Street
McAllen, Texas 78501
The next RGV training workshop will be on September 9, 2011. The purpose of these training workshops is to help Adult Day Care owners and operators prepare for doing business with the Managed Care Organization that will be serving the RGV. We will discuss contracting issues and focus on authorizations as well as basic billing options and strategies
Lodging
To book a room & receive the special ADCAT group rate, reservations can be made by:
1. Calling 1-800-HOTELS-1
2. Booking online at: www.renaissancehotels.com/mfebr
When making reservations please enter/mention the following codes to receive the ADCAT group rate:
1. Standard Room w/ King - $99/Night, enter group code: ADCADCA
2. Double Guest Room w/ Courtyard View - $109/Night , enter group code: ADCADCB
**Reservations must be made by SEPTEMBER 1, 2011 in order to receive special rate.**
New Medicaid Eligibility Verification Process
The Texas Health and Human Services Commission (HHSC) is introducing a new system that uses digital technology to streamline the Medicaid eligibility verification process and provides access to Medicaid health history. The two main elements of the system are:
- The Your Texas Benefits Medicaid card, which replaces the paper Medicaid ID letter (Form 3087) that clients receive in the mail monthly.
- A website for Medicaid providers that supplies up-to-date information on a patient’s eligibility and history of services and treatments paid by Medicaid.
HHSC will begin mailing the Your Texas Benefit Medicaid cards to Texans covered by Medicaid in August. Medicaid clients can begin using the cards immediately. The new plastic card will be the client’s everyday Medicaid card.
Medicaid providers can begin using www.YourTexasBenefitsCard.com to verify patient’s Medicaid eligibility. Providers can opt to purchase equipment, such as a card reader, to use the card’s magnetic stripe that contains the client’s Medicaid ID number. Providers also can continue verifying eligibility through existing channels, which do not require the purchase of any additional equipment.
STAR+PLUS expansion timeline
August 1, 2011 Health & Human Services Commission awards contracts to HMO
September 9, 2011 ADCAT Training Workshop (Contacting & Authorization)
October 1, 2011 Enrollment Packets to be sent out to Medicaid Members
HMO Publish Provider Network
October 20-21, 2011 ADCAT Annual Conference and Training (billing)
January 31, 2012 Enrollment DEADLINE for Medicaid members
March 1, 2012 Star Plus Rollout Start Date
Materials related to the ADCAT meeting in Weslaco can be found here.
Rio Grande Valley ADCAT Meeting
What you need to know about the Managed Care Rollout in the Valley
2:00pm, Friday, July 22 2011
Nuestra Familia Adult Day Care, Inc.
621 E. Bus. Hwy 83
Weslaco, TX
For more information call 956-279-0050
Please join us for ADULT DAY HEALTH SERVICES Lobby Day, March 8, 2011.
The legislature is in session and Legislators need to hear your concerns about DAHS and funding cuts!
- The State of Texas faces a shortfall of $26 billion. The current budget proposal cuts DAHS rates by 10%.
- The current budget anticipates expanding the STAR+PLUS Managed Care program to the counties contiguous to current STAR+PLUS service areas as well as South Texas and the RIO GRANDE Valley. This expansion will have a major impact on the way we do business and provide services to our clients.
- Legislation is proposed that will further regulate how we hire employees and conduct background checks, run our business and treat our clients. Some of these regulations will create further burdens and costs that will erode our already low reimbursement rates.
Together, we can make a difference for our industry and the clients and families we serve!
Then help us spread the word so Texans and their families know what’s at stake. Together, we can protect the most vulnerable Texans.
Congratulations to 2011 ADCAT Board
President: Troy Carter
Vice President: Ernest Lugo
Secretary: Joyce Lauck
Treasurer: My-Lynh Nguyen
Lawsuit: Disabled Wrongfully Housed in Nursing Homes - by Emily Ramshaw December 20, 2010
"Thousands of Texans with severe mental and physical disabilities, many of them young adults, are confined in nursing homes with no access to rehabilitative care, according to a lawsuit being filed in U.S. district court today.
The class-action suit, filed by disability rights advocates and six institutionalized plaintiffs between the ages of 26 and 46, alleges that Gov. Rick Perry and state social services officials have violated the Americans with Disabilities Act by failing to provide appropriate treatment to some 4,500 people living in nursing homes."
Read the article in its entirety here.
Lawmakers Discussing Dropping Health Care Program - by Emily Ramshaw November 6, 2010
"Some Republican lawmakers — still reveling in Tuesday’s statewide election sweep — are proposing an unprecedented solution to the state’s estimated $25 billion budget shortfall: dropping out of the federal Medicaid program.
Far-right conservatives are offering that possibility in post-victory news conferences. Moderate Republicans are studying it behind closed doors. And the party’s advisers on health care policy say it's being discussed more seriously than ever, though they admit it may be as much a huge in-your-face to Washington as anything else..."
Read the article in its entirety here.