Federal News and Information:

Office of Inspector General (OIG)

The OIG published the Spring 2022 Semiannual Report to Congress.  Areas addressed were:

  • Trends that indicated Medicare could be paying twice for items and services provided to beneficiaries in hospice care – Hospice beneficiaries should receive all their medical care needs through the Medicare hospice benefit.
  • Medicare Improperly Paid Suppliers an Estimated $117 Million Over 4 Years for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies Provided to Hospice Beneficiaries – it is indicated that hospices or their suppliers should have provided or arranged for these services.
  • Medicare Payments of $6.6 Billion to Nonhospice Providers Over 10 Years for Items and Services Provided to Hospice Beneficiaries Suggest the Need for Increased Oversight – there is an increase in Medicare nonhospice payments for beneficiaries.  If providers bill Medicare for nonhospice items and services that potentially should be covered by hospices, Medicare could pay for the same items or services twice.

To review the report, go to:  https://oig.hhs.gov/reports-and-publications/archives/semiannual/2022/2022-spring-sar.pdf.

CMS Publishes Revised Guidance on The Emergency Preparedness Exercise Exemption

  • The Centers for Medicare and Medicaid Services published revised QSO-20-41-ALL.  The revised memo announces that if a facility is still currently operating under its activated emergency plan or reactivated its emergency plan for COVID-19 in 2021 or 2022, they are exempt from the next required full-scale community-based or individual facility-based functional exercise.
  • Facilities must show, through written documentation, that they activated their program due to the emergency. Facilities that resumed normal operating status (not under their activated emergency plans) are required to conduct their testing exercises based on the regulatory requirements for their specific provider or supplier type.
  • This guidance applies for any subsequent 12-month cycles in the future if facilities continue to operate under their activated emergency plans for COVID-19 response activities.
  • The QSO can be accessed at:  https://www.cms.gov/files/document/qso-20-41-all-revised-05262022.pdf.

Palmetto

Palmetto GBA No Longer Supports Mozilla Firefox for eServices Users: Edge, Chrome Recommended for Accessing eServices

As of June 15, 2022, Palmetto GBA’s eServices Portal will no longer support Mozilla Firefox. After this date, eServices will officially support Microsoft Edge (most current version) and Google Chrome (Version 87.x). Please review this information and share it with your staff.

 

Texas News and Information

HHSC Publishes New HCSSA Vaccine Rule

HHSC adopted a new permanent vaccine rule for Home and Community Support Services Agencies. It was effective June 1, 2022.   The rule:

  • Allows a HCSSA to purchase, store or transport a vaccine approved by the Food and Drug Administration to treat or mitigate the spread of a communicable disease.
  • Must have established policies and procedures that makes sure a sealed portable container is handled properly with respect to storage, transportation, and temperature stability according to the manufacturer’s instructions.
  • Must also adhere to guidance issued by the Centers for Disease Control and Prevention and HHSC.

The new HCSSA rule is in Title 26 of the Texas Administrative Code Chapter §558.303: https://texreg.sos.state.tx.us/public/readtac%24ext.TacPage?sl=R&app=9&p_dir=&p_rloc=&p_tloc=&p_ploc=&pg=1&p_tac=&ti=26&pt=1&ch=558&rl=303.

Preadmission Screening and Resident Review (PASRR)

As a reminder, ALL hospice providers are required to comply with the PASRR process regardless of your patient’s payor source!!!  TNMHO has a FAQ on the Members Only website (https://www.txnmhospice.org/).  Please review to ensure you are up to date.

Reminder: NFs Will Be Able to Admit Individuals on Preadmission PL1 Forms With Negative PE

Beginning June 30, 2022, nursing facility (NF) users will be able to admit individuals to the facility by clicking the Admitted to NF button, which will be displayed on the Preadmission Screening and Resident Review (PASRR) Level 1 (PL1) form with admission type Preadmission. The Admitted to NF button will be present after an associated negative PASRR Evaluation (PE) form is successfully submitted. The NF will no longer be required to certify their ability to serve the individual on the PL1 in this case. With this change, the system will update the status of the Preadmission PL1 to Individual Placed in NF – PE Confirmed upon confirmation of the status change, and the form history notes of the PL1 will be updated to indicate that the individual has been admitted to the NF.

Public Health Emergency or Disaster Rules

The Texas Administrative Code Chapter 570 has been posted to the TAC website.  Home and Community Support Services Agencies (HCSSA) rules are contained in Subsection D.  As a reminder, these new rules cover:  visitation and essential caregiver visits. You can access TAC rules at:  https://texreg.sos.state.tx.us/public/readtac$ext.ViewTAC?tac_view=3&ti=26&pt=1.

Texas Medicaid Healthcare Partnership (TMHP)

Provider Information Validation on LTC

Beginning June 10, 2022, provider information on long-term care (LTC) claims will be validated using data stored in the NPPES (National Plan and Provider Enumeration System) and the TMHP Provider Enrollment and Management System (PEMS). This enhancement will ensure the consistency of provider information and help avoid claim rejection. Attending provider information will be validated on nursing facility and ICF claims. Referring provider information will be validated on hospice claims. The following data will be validated for attending and referring providers:

  • National Provider Identifier (NPI)
  • Dates of service on the claim (must be within the Texas Medicaid Enrollment period)
  • Provider type qualifier
  • First and last name

Providers must be enrolled in Texas Medicaid; otherwise, LTC claims could be denied or rejected because of a mismatch in the claim information. Mismatches may cause submitted claims to be assigned one of the explanations of benefits (EOBs).

To access more information, go to:

All professional licenses under the BHEC, please note the following: Texas Behavioral Health Executive Council

Moving Dates Have Changed!

The Council will now be moving from its current office location in the William P. Hobby Jr. State Office Building to its new office in the George H.W. Bush State Office Building beginning on Thursday, July 7th. Effective Monday, July 11th, 2022, the Council’s physical and mailing address will change from 333 Guadalupe St., Ste. 3-900, Austin, Texas 78701 to:

Texas Behavioral Health Executive Council

George H.W. Bush State Office Bldg.

1801 Congress Ave., Ste. 7.300

Austin, Texas 78701

In connection with this move, agency staff will not have access to the Council’s network or internet connection beginning on Wednesday, July 6th at 4pm. This planned outage will extend through Monday, July 11th, but may extend through Wednesday, July 13th if difficulties are encountered. Agency staff will not be able to access:

  • The network or respond to emails during this planned outage and the Council’s website, this include the Contact Us webpage; or
  • Be able to receive or make phone calls during this period.

Therefore, members of the public should plan accordingly and expect staff to be unavailable during this time frame.

Board of Nursing (BON)

Please ensure that your nurses are aware that several position statements were updated by the BON during the spring of 2022. Agency nurses are responsible for keeping up with changes to their rules, position statements etc.  The information can be accessed at:   https://www.bon.texas.gov/ under Education and Rules & Laws. Please make them aware of the following:

  • Position Statement 15.1, Nurses Carrying out Orders from Physician Assistants
  • Position Statement 15.3, LVNs Engaging in Intravenous Therapy, Venipuncture, or Peripherally Inserted Central Catheter (PICC) Lines
  • Position Statement 15.5, Nurses with Responsibility for Initiating Physician Standing Orders
  • Position Statement 15.7, The Role of LVNs & RNs in Management and/ or Administration of Medications via Epidural or Intrathecal Catheter Routes
  • Position Statement 15.8, Role of the Nurse in Moderate Sedation
  • Position Statement 15.10, Continuing Education: Limitations for Expanding Scope of Practice
  • Position Statement 15.11, Delegated Medical Acts
  • Position Statement 15.25, Administration of Medication & Treatments by LVNs
  • Position Statement 15.27, The Licensed Vocational Nurse Scope of Practice
  • Position Statement 15.28, The Registered Nurse Scope of Practice

 

Disclaimer:  The Texas and New Mexico Hospice Organization publishes the Regulatory Update as an information only item.  TNMHO has no attorneys nor does it represent the state and federal governments.  All legal questions or concerns should be directed to your attorney or the governments involved.