CMS InformationLetter #1999-11 (Delay in Implementation of Rule on Submission of Claims...)

COMMISSIONER
Eric M. Bost

November 18, 1999

BOARD MEMBERS

David Herndon
Chair, Austin

Carlela K. Vogel
Vice Chair, Fort Worth

Bill Jones
Houston

Anchi Ku
Dallas

Elizabeth D. Seale
San Antonio

Carole Woodard
Galveston

CBA Home and Community Support Service Agencies
CBA/CCAD Adult Foster Care Provider Agencies
CBA/CCAD Emergency Response Service Provider Agencies
CBA/CCAD Residential Care Provider Agencies
CBA/CCAD Respite Care Provider Agencies
CLASS Provider Agencies
Client Managed Attendant Service Provider Agencies
Day Activity and Health Services Provider Agencies
Deaf/Blind Provider Agencies
Home Delivered Meals Provider Agencies
Personal Assistant Service Provider Agencies
Primary Home Care Provider Agencies
Special Services to Persons with Disabilities Provider Agencies
Program of all Inclusive Care for the Elderly Provider Agencie

Long Term Care
CMS Information Letter No. 99011
Delay in Implementation of Rule on Submission of Claims Within 180 Days of Service;
Effective January 1, 2000 Reference CMS Information Letter No. CMS 9906

Effective July 1, 1999, the department adopted rules requiring provider agencies to submit timely claims for services to the Department of Human Services (DHS). These rules were adopted for the purpose of encouraging timely submission of claims, which benefits both the department and provider agencies. To receive payment for services provided, the provider agency's monthly claim for services must be received by the National Heritage Insurance Corporation (NHIC) within 180 days after the end of the service month.

Although these rules were adopted on July 1, 1999, DHS delayed implementation of the rules until January 1, 2000.

At this time, DHS has agreed to delay implementation of this rule until such time as claims data in the Claims Management System becomes more stabilized. Although DHS is delaying implementation of this rule, provider agencies are encouraged to continue to bill for services provided with in these timeframes. Provider agencies will be given adequate notice by DHS prior to the implementation of this rule in the Year 2000.

If you have any questions about this information letter please contact your contract manager.

Sincerely,

[Signature on File]

Becky Beechinor
Assistant Deputy Commissioner
Long Term Care Services

BB:mgm

Attachment:
(1) Chapter 49, Contracting for Community Care Services TAC Section Number(s) §49.9

John H. Winters Human Services Complex • 701 West 51st Street • P.O. Box 149030 • Austin, TX 78714-9030 • (512) 438-3011
Call your local DHS office for assistance.

	To:	CBA Home and Community Support Service Agencies CBA/CCAD Adult Foster Care Provider Agencies CBA/CCAD Emergency Response Service Provider Agencies CBA/CCAD Residential Care Provider Agencies CBA/CCAD Respite Care Provider Agencies CLASS Provider Agencies Client Managed Attendant Service Provider Agencies Day Activity and Health Services Provider Agencies Deaf/Blind Provider Agencies Home Delivered Meals Provider Agencies Personal Assistant Service Provider Agencies Primary Home Care Provider Agencies Special Services to Persons with Disabilities Provider Agencies Program of all Inclusive Care for the Elderly Provider Agencie
	Subject:	Long Term Care CMS Information Letter No. 99011 Delay in Implementation of Rule on Submission of Claims Within 180 Days of Service; Effective January 1, 2000 Reference CMS Information Letter No. CMS 9906
	Effective July 1, 1999, the department adopted rules requiring provider agencies to submit timely claims for services to the Department of Human Services (DHS). These rules were adopted for the purpose of encouraging timely submission of claims, which benefits both the department and provider agencies. To receive payment for services provided, the provider agency's monthly claim for services must be received by the National Heritage Insurance Corporation (NHIC) within 180 days after the end of the service month. Although these rules were adopted on July 1, 1999, DHS delayed implementation of the rules until January 1, 2000. At this time, DHS has agreed to delay implementation of this rule until such time as claims data in the Claims Management System becomes more stabilized. Although DHS is delaying implementation of this rule, provider agencies are encouraged to continue to bill for services provided with in these timeframes. Provider agencies will be given adequate notice by DHS prior to the implementation of this rule in the Year 2000. If you have any questions about this information letter please contact your contract manager. Sincerely, [Signature on File] Becky Beechinor Assistant Deputy Commissioner Long Term Care Services BB:mgm Attachment: (1) Chapter 49, Contracting for Community Care Services TAC Section Number(s) §49.9 John H. Winters Human Services Complex • 701 West 51st Street • P.O. Box 149030 • Austin, TX 78714-9030 • (512) 438-3011 Call your local DHS office for assistance.