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DADS Provider Alerts — Texas Home Living (TxHmL)

Recordings, Presentations from March CFC and HCBS Webinars now Online

CLASS, DBMD, HCS and TxHmL providers that missed the March webinars regarding amendments to their program rules can now find them on the CFC Webinars and Training webpage.

In addition, providers that missed the HCBS Rules Provider Self-Assessments webinar can find the webinar recording and presentation on the HCBS Events Page. This event was for HCS, DBMD, and CLASS providers.

Questions can be emailed to the respective programs:

(3/29/2016)

Amended HCS, TxHmL Rules Effective March 20

HHSC has authorized amendments to 40 TAC Chapter 9, Intellectual Disability Services — Medicaid State Operating Agency Responsibilities, Subchapter D, HCS Program, and Subchapter N, TxHmL Program, effective March 20, 2016. The adopted rules:

  • implement Community First Choice Medicaid state plan services in the HCS and TxHmL Programs;
  • require an HCS and TxHmL program provider to develop a transportation plan if transportation as a supported home living or as a community support activity is included on the individual plan of care (IPC);
  • add to the eligibility criteria for HCS and TxHmL program services (for consistency with the HCS and TxHmL waiver applications); and
  • increase the dental treatment service limit from $1,000 to $2,000 during an IPC year in the HCS program.

The rules were published as proposed in the Texas Register on Nov. 27, 2015. The adopted rules were published in the Texas Register on March 11, 2016.

Email questions to hcs@dads.state.tx.us.

(3/16/2016)

New Contracting Rules Effective March 20

HHSC has authorized amendments to 40 TAC Chapter 49, Contracting for Community Services, effective March 20, 2016. The adopted rules make Community First Choice Medicaid state plan services available to individuals enrolled in the HCS, TxHmL, CLASS, and DBMD programs.

The rules were published as proposed in the Texas Register on Nov. 27, 2015. The adopted rules were published in the Texas Register on March 11, 2016.

Email questions to beth.skelton@dads.state.tx.us.

(3/16/2016)

New CDS Rules Effective March 20

HHSC has authorized amendments to 40 TAC Chapter 41, Consumer Directed Services Option, effective March 20, 2016. The adopted rules make Community First Choice Medicaid state plan services available through the CDS Option to individuals enrolled in the HCS, TxHmL, CLASS, and DBMD programs.

The rules were published as proposed in the Texas Register on Nov. 27, 2015. The adopted rules were published in the Texas Register on March 11, 2016.

Email questions to cds@dads.state.tx.us.

(3/15/2016)

Q&A from February Webinar Now Online

Questions and answers from the February HCS/TxHmL Form 8510 webinar are now on the CFC website along with the webinar recording and the PowerPoint presentation.

Questions can be sent to hcs@dads.state.tx.us  or txhml@dads.state.tx.us, as appropriate.

(3/15/2016)

Give Us Your Feedback on Proposed Day Habilitation Rules

DADS stakeholders are invited to review and comment on proposed day habilitation rules (PDF format). Comments can be emailed to Sheryl.loera@dads.state.tx.us by COB March 8.

The proposed revisions are to these sections of the TAC:

  • §9.230 Requirements for Active Treatment Not Provided in a Facility
  • §49.313 Day Habilitation Requirements in the HCS Program, the TxHmL Program, and the DBMD Program and Prevocational Services Requirements in the CLASS Program
  • §49.205 License, Certification, Accreditation, and Other Requirements
(3/3/2016)

Changes coming in CARE for Texas Home Living Individual Plans of Care

Beginning February 15, 2016, The Department of Aging and Disability Services (DADS) is implementing changes in the Client Assignment and Registration system (CARE) to indicate that an Individual Plan of Care (IPC) packet must be submitted to DADS for review in the Texas Home Living (TxHmL) program. System edits will apply to all IPCs entered into CARE on, or after February 15, 2016. These edits are similar to the edits already in place in CARE for the Home and Community-based Services (HCS) program. Not all IPCs entered into CARE will trigger a system edit.

Review of IPCs submitted to DADS will include a review of both waiver and CFC PAS/HAB services. If DADS review results in a decision to reduce or deny a service, DADS will adjust the IPC to implement these changes, taking into consideration services already delivered in the plan prior to completion of the review.

The Local Intellectual and Developmental Disability Authority (LIDDA) will be responsible to submit a TxHmL IPC packet to DADS for review when the following messages in CARE appear at the time of data entry:

  • plan exceeds the authorized amount;
  • plan exceeds the previously authorized amount; or
  • no waiver services; needs UR (new for both TxHmL and HCS).

Each of these messages indicates a CARE edit was triggered, and the LIDDA must submit a packet to DADS for review of the IPC. These edit messages are existing messages in use for HCS. CARE will place the IPC on hold until DADS has completed a review of the IPC and manually authorizes it. The provider will be able to continue to enter billing into CARE throughout the review period. Once DADS has completed the review and released the IPC hold, provider payments will process during the next scheduled billing cycle.

When requested, providers must work cooperatively with the LIDDA to share a copy of implementation plans for services. This enables the LIDDA to compile a complete IPC packet for submission for DADS. When DADS makes a decision to reduce or deny services as a result of review, DADS will take into consideration a provider's continued provision of services during the IPC hold period when adjusting the IPC.

DADS conducted training with LIDDAs on February 4, 2016 regarding this change, including how to make IPC submissions to DADS. Emphasis on the need to make packet submissions to DADS timely was shared, along with timeframes for responding to these IPC messages in CARE. LIDDAs were also informed of the need to notify the provider, in writing, of submission of an IPC packet to DADS, and to notify the provider of the date of the submission.

Hold messages in CARE are visible to providers on the C62 IPC inquiry screen. In addition, DADS developed weekly IPC hold reports that will identify holds on IPCs for individuals in a provider's program which will be available to program providers through the legal entity's weekly Globalscape file through Filezilla. There will be two new reports in JHSXPTR:

  • The "HC063951 - TxHmL IPCs on Hold Pending DADS Review" report will identify IPCs needing review due to one of the new edits in the system.
  • The "HC063953 – IPCs with No Waiver Services" report will identify IPCs that have only CFC services and no Waiver services.
  • (2/12/2016)

Some Program Participants Were Mistakenly Sent STAR+PLUS Enrollment Packages

HHSC erroneously sent STAR+PLUS enrollment packets to people enrolled in an intellectual and developmental disability (IDD) waiver who have Medicare and Medicaid (referred to as dual eligible). In addition, some people were enrolled in STAR+PLUS in error. Dual eligible participants in an IDD waiver are excluded from STAR+PLUS.

HHSC is aware of the error and wanted to let stakeholders know that these people will not be enrolled in STAR+PLUS. For those who were enrolled in error, HHSC is working to remove them from STAR+PLUS. Please direct program participants, or those helping them, that may have been affected and have concerns to call the enrollment broker helpline at 1-877-782-6440.

The people who got the letters by mistake receive services through one of these waivers:

  • Home and Community–based Services (HCS)
  • Community Living Assistance and Support Services (CLASS)
  • Deaf Blind with Multiple Disabilities (DBMD)
  • Texas Home Living (TxHmL)

We apologize for any inconvenience this may have caused.

(1/29/2016)

DADS Kicks Off LTSS Child and Family Survey in January

Families of children who receive DADS services may be asked to participate in the upcoming Long-Term Services and Supports (LTSS) Child and Family survey. Randomly chosen families will be sent a letter starting in January inviting them to provide feedback about their experience with DADS programs.

Surveys will be conducted over the phone, online or via regular mail by Texas A&M's Public Policy Research Institute (PPRI). The survey results will be used to improve agency programs for children.

How Are Providers Involved?

Providers are involved in 2 ways:

  1. If you are contacted by a family about the survey, you can reassure them that this is a legitimate part of DADS quality efforts. You also can let them know that their privacy is protected under HIPPA.
  2. If you are asked to provide current contact information for case managers or survey participants, please do so. To verify that the person requesting client information is a PPRI staff member, call Alicia Novoa, project coordinator at 979-862-1891.

As contracted agents of DADS, PPRI and its staff have DADS authorization to obtain confidential participant information. This process meets all the HIPAA privacy requirements. The surveys are part of a national effort to collect information on satisfaction with the quality of services provided to children with intellectual and developmental disabilities and quality of life.

Questions about the survey can be emailed to rebecca.martin@dads.state.tx.us.

(1/15/2016)

CMS Extends Provider Re-enrollment Deadline

CMS has extended the March 24, 2016, deadline for Medicaid provider re-enrollment to Sept. 25, 2016.

Though this extension gives states additional time to ensure providers comply with Patient Protection and Affordable Care Act (PPACA) requirements, Texas Medicaid encourages all providers who have not yet submitted a re-enrollment application to begin this process immediately to avoid potential payment disruptions. More information about re-enrollment can be found on the DADS website.

Additional information will be announced in the coming weeks to assist providers who are working on the re-enrollment process.

Questions can be emailed to DADS Provider Enrollment Mailbox.

(1/15/2016)

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