Federal News and Information
Centers for Medicare and Medicaid Services (CMS)
Pilot Medicare Part D and Hospice
As you may know, CMS is concerned about hospice related prescription drugs being paid by the Part D benefit instead of the Hospice benefit. The pilot’s goal is to alert the Part D plan of a hospice election. The intent is to address the hospice enrollment and ensure their responsibility for the hospice medications in a timely manner.
In the 2022 Fiscal Year Hospice Wage Index and Quality Reporting proposed rule, published in April 2021, CMS reported that in 2019, the amount of Part D spending, while patients were on hospice care, reached almost $500 million ($498,913,448). A concern identified by CMS Part D is that the hospice election is not reaching the Medicare Part D plan timely. Due to this delay, the Medicare Part D plan does not know that an enrollee has elected their hospice benefit and is continuing to pay for medications that should be paid by the hospice.
CMS Part D has contracted with RelayHealth to design a hospice election notification system to provide the notice of hospice election to the Medicare Part D plans timelier, allowing the Medicare Part D plan to reject medications when a drug may be related to the hospice patient’s condition.
Relayhealth, Transaction Facilitator: https://medifacd.mckesson.com/Hospice/
COVID 19 Emergency Declaration Blanket Waivers for Health Care Providers
CMS released an updated version on the blanket waivers on June 16, 2022. Topics for hospice are: volunteers, comprehensive assessments update timelines, waive non-core services, waive on-site visits for hospice aide supervision, hospice aide competency testing using pseudo patients, 12 hour annual in service training for hospice aides, and annual training. You can access it here:
Texas News and Information
Health and Human Services Commission (HHSC)
HHSC Updates the ALF COVID-19 FAQ Document
The following updates the requirements for assisted living facilities: visitation, PPE, policy and procedures etc.
HHSC Long-term Care Regulation has updated the Frequently Asked Questions About COVID-19 (PDF), for assisted living facilities. https://www.hhs.texas.gov/sites/default/files/documents/govdelivery/alf-faqs.pdf
Reminder: Senate Bill 809/COVID-19 Monthly Reporting Requirement
REMINDER: Completion of the Senate Bill 809/Rider 143 Monthly Report is REQUIRED of all participating providers, regardless of whether a provider or facility has received additional federal funding during the reporting month.
The 87th Texas Legislature directed the Health and Human Services Commission (HHSC) to report federal COVID-19 funding from specific health care institutions, and certain costs those providers have spent related to the COVID-19 public health emergency. HHSC has developed a monthly report to obtain the information required by Rider 143 (2022-23 General Appropriations Act, Senate Bill (S.B.) 1, 87th Legislature, Regular Session, 2021 (Article II, HHSC, Rider 143) and SB 809 (87th Legislature, Regular Session, 2021).
All participating providers must complete the Senate Bill 809/Rider 143 Monthly Report every month, even if they did not receive additional federal funds during the reporting month. The reports are due one month after the reporting period ends. (For example, the report for June 2022 data will be due by 5 p.m. on August 1, 2022.)
HHSC regularly updates the list of healthcare institutions who must submit reports in compliance with Senate Bill 809 or Rider 143. The list can be found here under the SB 809/Rider 143 COVID-19 Reporting Healthcare Institution List dropdown: https://pfd.hhs.texas.gov/provider-finance-communications.
Note: this list is derived at a point in time (currently as of July 1, 2022) and not all-inclusive as providers may enroll or change at various times. The list will be updated every Friday by close of business. Any provider that is identified as a “Health Care Institution” as defined in Section 74.001 of the Civil Practice and Remedies Code is required to complete the reports. The list has been updated to align with licensing agencies.
For more information about the Senate Bill 809/Rider 143 Monthly Report, please review this list of frequently asked questions and responses and visit the HHSC Provider Finance Department Communications web page: https://pfd.hhs.texas.gov/sites/rad/files/documents/pfc/covid-montly-report-sb809-rider143-faqs.pdf .
If you have question(s) about the content of the report or need technical assistance, please email the HHSC Provider Finance Department at [email protected] with “COVID-19 Federal Funds Report” in the subject line
Texas Behavioral Health Executive Council/Social Work Board
Texas Social Workers, please be aware of the following! The BHEC is working on a compact which would allow social workers to work in multi-states, license information can be shared etc.
Texas Behavioral Health Executive Council
The Council of State Governments’ (CSG) National Center for Interstate Compacts is excited to announce that the initial draft of the Social Work Compact has been finalized and posted online for review and public comment at https://compacts.csg.org/compact-updates/social-work/. On this webpage you will also find a list of FAQs and a two-page educational fact-sheet.
Additionally, beginning July 18th, CSG will host weekly review sessions to explain the provisions of the compact. These meetings are open to the general public. A link to register can be found here: https://csg-org.zoom.us/meeting/register/tZYqcOysqjwtHdDXjPkdYBeqaa0im8-kCDjY. To submit comment or feedback on the draft, please fill out the online survey which is linked here: https://www.surveymonkey.com/r/socialworkcompact.
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.