Programs
Regulatory Updates
Total of 180 Records Returned
State: Texas
Texas – Licensing Requirements for In-home Supportive Palliative Care
Date Adopted : 09/15/2021
Program: Home Health, Hospice, Private Duty
The legislation created Texas Health and Safety Code (HSC) Chapter 142A (relating to Supportive Palliative Care), establishing a definition of "supportive palliative care" and indicating that any reference to "palliative care" in law or the Texas Administrative Code (TAC) means supportive palliative care. The statute did not establish a category of licensure for the provision of supportive palliative care services—either standalone or as a category within an existing care delivery setting. Supportive palliative care services that are delivered in the home or in community settings, such as in assisted living facilities, are currently governed by HSC Chapter 142 (relating to Home and Community Support Services Agencies (HCSSA)). An HCSSA license is required.
Read MoreState: All
Update to ‘J’ Drug Code List for Billing Home Infusion Therapy (HIT) Services
Date Posted : 06/9/2022
Date Effective : 07/1/2022
Program: Home Infusion Therapy
CR 12667 updates the list of home infusion drugs to add J1551 JB (Injection, immune globulin (cutaquig), 100mg) to payment category 2, effective July 1, 2022. The corresponding G-codes for category 2 drugs are G0069 or G0089. Note: We require the JB modifier for subcutaneous injection of the drug.
Read MoreState: All
DMEPOS Accreditation mln Fact Sheet Updated in January 2022
Date Posted : 01/1/2022
Program: Durable Medical Equipment, Prosthetics, Orthotics, and Supplies, Pharmacy
This fact sheet describes Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) suppliers’ accreditation requirements. This includes verifying your business meets the required DMEPOS quality standards, types of eligible professionals exempted from accreditation, updating your enrollment information, and resources. This information applies to all DMEPOS suppliers submitting claims to Durable Medical Equipment Medicare Administrative Contractors (DME MACs) for Medicare patients’ DMEPOS items and supplies.
Read MoreState: All
Update to Chapter 7, “Home Health Services”, of the Medicare Benefit Policy Manual (Pub 100-02)
Date Effective : 01/1/2022
Program: Home Health
In this Article, you’ll learn about:
- Updates to chapter 7 of the Medicare Benefit Policy Manual (Pub. 100-02) to
- incorporate Calendar Year (CY) 2022’s Policy Implementation of the Notice of Admission (NOA).
- The elimination of the Request for Anticipated Payment (RAP) policy.
- Corrections and clarifications regarding who may sign the certification and recertification for home health people with Medicare.
State: All
Face-to-Face Documentation for Home Health Certification: Important Information for Certifying Physicians and Nonphysician Practitioners
Date Posted : 04/14/2022
Program: Home Health
The documentation of clinical findings by the physician/nonphysician practitioner should show:
- The encounter was related to the primary reason for home care;
- How the patient’s condition supports the patient’s homebound status; and
- How the patient’s condition supports the need for skilled services
State: West Virginia
Pharmacy Audit Integrity Act
Date Proposed : 01/17/2022
Date Effective : 06/10/2022
Date Adopted : 03/30/2022
Program:
Relates to the regulation of pharmacy benefit managers; defines terms; updates terminology; prohibits a pharmacy benefit manager from limiting a consumers access to prescription drugs through the designation of specialty drugs; prohibits a pharmacy benefit manager from placing certain requirements or restrictions on a pharmacist or pharmacy; requires pharmacy benefit managers to disclose any sub networks for specialty drugs to the Insurance Commissioner. (4) A pharmacy benefit manager may not require a pharmacy or pharmacist, as a condition for participating in the pharmacy benefit manager’s network, to obtain or maintain accreditation, certification, or credentialing that is inconsistent with, more stringent than, or in addition to state requirements for licensure or other relevant federal or state standards.
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Accreditation Commission for Health Care, Inc.