Volume XXX, Number 3,
March 2015

Managed Care resources

STAR+PLUS Medicaid Managed Care Has Begun

HHSC has set up a Command Center to assist with implementation issues.  If you have questions, need clarification, or need assistance with the implementation of Managed Care in Texas, you can send an email by clicking here:

ManagedCareExpansion2015
@hhsc.state.tx.us

Links to Web Resources

DADS — STAR+PLUS Nursing Facility Services

http://www.dads.state.tx.us/providers
/NF/managedcare/inquiries.html

HHSC — Texas Medicaid and CHIP — STAR+PLUS (Nursing Facility Services)

http://www.hhsc.state.tx.us/
medicaid/managed-care/mmc
/starplus-adding-nursing.shtml

Billing Q & A

THCA Question to HHSC:  When a nursing facility is ready to bill for Medicaid payment for a resident(s) who has not been assigned to a plan, who should they bill and who should they expect to receive payment from?

Answer from HHSC:  The nursing facility should verify the resident’s eligibility and enrollment on MESAV. If managed care is not indicated on the MESAV, the NF should bill Fee for Service (FFS) as they have previously.

President’s Report

• Regulations, Rates and Readiness

Legislative Update

• Three Strikes Bill heard in Senate Committe

• Warren urges budget writers to remember Long Term Care

• THCA members pounding the pavement at the Texas Capitol

State News

• Managed Care resources

• THCA MEMBER ADDED VALUE:  Fact Sheet on STAR+PLUS Managed Medicaid for Physicians / Practitioners

• Nursing facility upper payment limit / Minimum payment amount –  Program update

• Nursing facility administrators can now complete licensing tasks online

• TMHP schedules system maintenance

• Distribution of resident days by RUG level

Federal News

• CMS announces changes to Five-Star Quality Rating System

• Focused dementia care survey pilot in Texas

• Surveyor guideline from CMS on CPR certification

THCA Membership Contribution

• “Maintain a Competitive Edge – Enhance Clinical Capabilities”

Announcements & Recognitions

• Newly appointed / elected THCA Board members!
• THCA welcomes our newest facility members
• THCA facility contact information sheet
• THCA Facebook & Twitter pages

• Call for Presentations for the 2015 THCA 65th Annual Convention & Trade Show

• Activity Professional Award Nominations due March 26th

THCAPAC

• THCAPAC “500 Club” recognition

• How to submit your contribution to THCAPAC

• THCAPAC Spring golf tournament

Region News

• “Step Back, Have a Seat and Take Care of Yourself”

• Region Information / Updates

Education

• THCA Spring Conference and Resource Fair April 20-22, 2015 – Omni Barton Creek Conference Center
  Austin, Texas

• THCA 65th Annual Convention and Trade Show – “65: Commitment & Devotion” – September 21-24, 2015 – The Gaylord Texas – Grapevine, Texas

• Nursing facility webinars to assist with the transition to Managed Care

• DADS and DSHS conference: Infection Control in Long-term Care 2015

If you have suggestions for education sessions or questions about THCA education, please contact Sue Wilson at the THCA office swilson@txhca.org.

Calendar

• March 2015

• April 2015