HCS Administrative Penalties, Survey, Billing Guideline’s Update, and Provider User Guide for CARE

by | Sep 5, 2021

September 5th, 2021

Now Called Billing Requirements Not Billing Guidelines!!!!

HHSC Publishes Revision 21-3 of the HCS and TxHmL Program Billing Requirements and CFC Billing Requirements

HHSC Publishes Revision 21-3 of the HCS and TxHmL Program Billing Requirements and CFC Billing Requirements

This revision, effective Sept. 1, changes the name from Billing Guidelines to Billing Requirements, and all revisions are outlined in the 21-3 Revision Section of each document.

The Billing Requirements are located on the Long-term Care Providers webpage and Handbooks webpage and are outlined below:

Email questions to TxHmL Policy.

September 5th, 2021

Very Important!!!  HHSC Releases Guidance Booklet for HCS/TxHmL Providers

Section 4 of House Bill 3720, 87th Legislature, Regular Session, 2021, requires HHSC to develop guidelines for regulatory staff and providers regarding the imposition of administrative penalties. To implement this provision, HHSC is offering training to regulatory staff and providers regarding the certification principles and the administrative penalty criteria and process. In conjunction with these training opportunities, HHSC has developed a comprehensive guidance booklet (PDF) that captures the training content in a user-friendly format. This booklet is available to training participants and on the HCS and TxHmL provider portals.  See the registration link below for training webinar presented on September 9th, 2021.

Register for HCS/TxHmL training here.

September 5th, 2021

HHSC Publishes Revised Informal Dispute Resolution (PL 2021-07)

HHSC published a revised version of Provider Letter 2021-07, Informal Dispute Resolution (PDF). A revision was made to update the contact phone number.

August 15th, 2021

HHSC Publishes Revised Guidance for HCS/TxHmL Providers Regarding:             How to File a Survey Complaint (PL 20-21)

HHSC has updated PL 2020-01, How to File a Complaint Regarding a Surveyor and Report Survey Inconsistencies (PDF).

The letter has been revised to include information for how HCS and TxHmL program providers can file a complaint regarding a surveyor, how to report survey inconsistencies related to the interpretation and application of regulations and rules, and to provide updated contact information for Long-term Care Regulatory HCS and TxHmL regional program staff.

April 26th, 2021

            HHSC’s WS&C Portal

 

Additional changes are coming to address Surveys and violations received from surveyors.  These include contacting WSC staff concerning violations and submitting EOC’s and POC’s to WSC through the WSC Portal!

On April 27th and 29th 2021:  HHSC hosted a webinar on WSC Portal Training for HCS/TxHmL providers.

Here are the handouts:

This portal will only be used to enter final PIR Reports, Submit EOC’s (Evidence of Correction), Submit POC’s (Plans of Correction) as well as communicate with WSC staff about POC’s/EOC’s, and Report a Death of an Individual in the program.

 

March 29th, 2021

March 19 Recording of Clarification of Administrative Penalties and Related Processes Webinar Available

A recording of the March 19, 2021 Clarification of Administrative Penalties and Related Processes for HCS and TxHmL Providers webinar is available for those unable to attend.

Listen to the webinar recording here.

March 28th, 2021

March 16 Recording of Clarification of Administrative Penalties and Related Processes Webinar Available

A recording of the March 16, 2021 Clarification of Administrative Penalties and Related Processes for HCS and TxHmL Providers webinar is available for those unable to attend.

Listen to the webinar recording here.

January 10th, 2021

Jan. 5 Recording Webinar Available – HCS and TxHmL Changes to Survey Process and “Hold Harmless Period” Overview

A recording of the Jan. 5, 2021, HCS and TxHmL Changes to Survey Process and Hold Harmless Period Overview webinar is available for those unable to attend.

Listen to the webinar recording here.

Jan. 7 Recording of HCS and TxHmL Administrative Penalties and Amelioration Available

A recording of the Jan. 7, 2021 HCS and TxHmL Administrative Penalties and Amelioration webinar is available for those unable to attend.

Listen to the webinar recording here.

December 28th, 2020

Letter: PL 20-55  Administrative Penalties HCS & TxHmL

https://apps.hhs.texas.gov/providers/communications/2020/letters/IL2020-19.pdf

December 23rd, 2020

Upcoming HCS and TXHmL Webinars For:

“Hold Harmless” Period & Administrative Penalties & Amelioration

Hold Harmless Period Overview

This webinar will cover the “Hold Harmless” period for the new survey process for HCS and TxHmL.

Jan 5, 2021
2 p.m. – 4 p.m.

Here’s the link to record session:

https://attendee.gotowebinar.com/recording/4225828217950682891

For a copy of the handouts, you can email: Shelley.Gusky01@hhs.texas.gov

Administrative Penalties and Amelioration

This webinar will review the new survey process for HCS and TxHmL which begins on March 1, 2021 and will include and overview of administrative penalties and amelioration.
Jan 7, 2021
1 p.m. – 4 p.m.
Register for the webinar.

For a link to the recording of this session and a copy of the handouts, you can email: Shelley.Gusky01@hhs.texas.gov

HHSC Publishes Administrative Penalty Process for HCS & TxHmL Program Providers (PL 20-55)

November 25, 2020

HHSC Long-term Care Regulation has published PL 20-55 – Administrative Penalty Process for Home and Community-based Services (HCS) and Texas Home Living (TxHmL) Program Providers (PDF). The PL provides guidance to providers on the rules regarding administrative penalties.

 Billing Guideline Changes

September 1, 2020

The HCS, TxHml, and CFC billing guidelines have been updated effective September 1, 2020. A summary of the revisions can be found on page 25 of the CFC (PDF), page 146 of the HCS (PDF)  and page 122 of the TxHmL (PDF). Send questions about the billing guidelines to HCS.TxHml.BPR@hhsc.state.tx.us.

 

June 20, 2020

Survey Process:  Timelines

As everyone is aware, due to the COVID pandemic, the past several months have affected the Long-Term Care survey and enforcement processes and activities that are unrelated to the virus. As of June 15, 2020, Survey Operations has begun to resume some normal survey activity, and Enforcement is also resuming enforcement processes and activities, such as complaints or issues related to COVID-19.  No other regular survey activities have begun for HCS/TxHmL programs.
Please contact Enforcement Director Derek Jakovich by email at derek.jakovich@hhsc.state.tx.us if you have questions.
In response to questions regarding what normal survey and enforcement activities are resuming as of June 15 and what programs are affected, HHSC replied as follows:
To clarify, as of June 15, 2020, Survey Operations is resuming some survey activity such as complaints with lower priorities, and possibly some licensure and certification surveys. For Enforcement, due process notice letters such as denials, revocations, and imposition of administrative penalties will be issued and the opportunity to appeal will be provided. Of course, the COVID circumstances may affect these activities.
At this point, since we’re not enforcing administrative penalties in HCS/TxHmL until September, the notice applies to NF, ALF, DAHS, PPECC, HCSSA, and ICF/IID.

HHSC Provider User Guide (CARE)       

Please go to the following link:

https://hhsportal.hhs.state.tx.us/helpGuide/Content/16_CARE/WaiverPDF/HCS%20Provider%20User%20Guide.pdf

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