Last Call for Presentations: New England Home Care Conference and Trade Show

The New England Home Care Conference & Trade Show is issuing a LAST CALL for presentations. Event organizers are looking for faculty with expertise and experience to present at this year’s conference, which will take place at MGM Grand Foxwoods in Mashantucket, Connecticut on May 31st and June 1st.

Last year’s event saw 400 attendees from the home care industry representing the New England Region.

The presentation application is available here or on

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NewMMIS Announcement of Grace Period for Electronic Claims Submission Policy

All Provider Bulletins 212  from May 2011 (“Important Claims Submission Policy Changes”) and 217  from September 2011 (“Waiver Policy for Claim Submissions”) both announced an important change in the claims submission policy. Effective January 1, 2012, all MassHealth claims must be submitted electronically unless a provider has an approved electronic claim submission waiver.

Effective January 1, 2012, MassHealth will implement a 90-day grace period of the claims submission policy to allow providers additional time to convert to electronic claims submission and to apply for the electronic claim submission waiver. MassHealth will issue an all provider bulletin in January that further explains this grace period.

Questions can be directed to MassHealth Customer Service at or 1-800-841-2900.

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Twas the Night Before …

This past week, Helen Siegel, our Director of Regulatory and Clinical Affairs retired after 17 years of supporting our member agencies in all issues clinical, QI,  and regulatory.  Helen took more calls than anyone in our office and responded to any and all questions sent her way.  Her knowledge and presence will be missed.

As part of her send-off, her peers at the Alliance prepared this for her:


Twas the night before Christmas, At the Alliance, Park Square
Not a creature was stirring, was noone there?

No stockings were on the desks or the walls
Not even the blue tree with disco glitter balls.

No TPL calls, no help me to start
No meetings, no minutes, not a single faxed chart.

The staff were all quietly digesting  the news
Helen’s departing, who’ll fill her shoes?

No visions of sugar plums, no candy canes
Can sweeten the blow, can help ease the pain.

When all appeared lost, Tim said, I have a plan
We’ll write to Santa, yes, Santa’s our man.

We’ll ask him to find someone…not naughty but nice
Who can take all these calls, and give good advice.

And if he could, perhaps someone who knows,
face to face and QI, and maybe the SCOs.

The email was sent and then we waited and waited
I guess even we knew our wish too inflated.

For even for Santa the task proved too rough
A replacement for Helen, that’s just not his stuff.

Skills like these, well the fact that years to hone,
Good thing Helen still has her cell phone!

But tis the season of miracles and light
One by one, the eight candles bring hope, and burn bright

So with hope for the future, and a fate we can’t fight

Happy Retirement, Helen
And to all, a good night! 

Happy Holidays and Peace and Joy in 2012.




CMS Announces Independence At Home Demonstration Program

CMS continues to roll out initiatives from the Affordable Care Act in an attempt to test new ways to improve health care and lower cost.

The latest in this line of programs and funding opportunities is the Independence At Home Demonstration (Section 3024 of the ACA), which aims to test a service delivery model that utilizes physician and nurse practitioner-directed primary care teams to provide services to certain Medicare beneficiaries with multiple chronic illnesses in their homes.

According to the Independence At Home (IAH) Program Solicitation, in order to be involved in the Demonstration, “practices must be individual physicians or nurse practitioners or interdisciplinary teams composed of various members such as physicians, nurse practitioners, physician assistants, pharmacists, social workers, and other supporting staff.” The program itself is designed to provide comprehensive, coordinated, continuous and accessible care to high-need patients and to coordinate health care across all treatment settings.

Even though primary care is the lead in the IAH demo, the focus is on delivering care to patients in their homes and getting beneficiaries what they need to remain independent. In other words, the program could actually be of significant benefit to the home care industry as a whole because primary care practitioners will be making check-ups in the home and witnessing how patients function in their day-to-day environment. Based on those visits, the practices will be identifying services – like home care and other community based services – that help keep people out of costlier settings and the ER.

Practices are required to use electronic health systems and remote patient monitoring, both of which are used by many home health agencies. Also, practices must be available 24 hours per day, seven days per week to carry out plans of care. Applicable beneficiaries must have at least two chronic illnesses, must need human assistance with two or more Activities of Daily Living (ADL’s), have had a non-elective hospital admission within the last 12 months and have used acute or sub-acute rehabilitation services within the last 12 months.

HCA encourages agencies to see the other guidelines, which are laid out in the IAH Solicitation and a summary is provided in a PowerPoint provided on the IAH program webpage.

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MassHealth Releases Dual Eligible Demo Proposal for Public Comment

After months of stakeholder meetings and public presentations, MassHealth has released their official proposal for the “State Demonstration to Integrate Care for Dual Eligible Individuals” to the Centers for Medicare and Medicaid Services (CMS).

The initiative seeks to combine Medicare and Medicaid funding to contract with an Integrated Care Organization (ICO) that will pay for coordinated and comprehensive care for dually eligible individuals ages 21 to 64. Massachusetts was one of 15 states to be awarded a planning grant for the project and has been in contact with CMS on crafting benefit design, enrollment processes, and payment processes.

The release of the draft proposal initiates a 30-day public comment period that will remain open until 5:00 pm, January 10, 2012. Two public hearings are also planned at the following dates and locations:

  • December 16, 2011, 1 pm – 4 pm, at the Worcester Public Library, Saxe Room, 3 Salem Square, Worcester, MA
  • January 4, 2012, 9 am – 12 noon, at the State Transportation Building, Conference Rooms 2 & 3, 10 Park Place, Boston, MA

For any agencies caring for dually eligible patients, we strongly encourage you to look at the proposal and send in comments. The Home Care Alliance would also like any case studies of these patients that agencies have been successful in keeping in the community.

Agencies can send comments to:, or mailed to:

Executive Office of Health and Human Services
Attn:  Lisa Wong
One Ashburton Place, Rm. 1109
Boston, MA 02108

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“That’s Democracy”

Anyone interested in a little insight into CMS under Dr. Don Berwick and what the legacy of  his short tenure might be can find a lot to consider in the online Health Affairs post:  “Now Departed From The Centers For Medicare And Medicaid Services…” written by Harris Meyer.    The article looks at Berwick’s efforts to both transform the health care delivery system, as well as the CMS agency and the 5,400 people it employs.    “We’re working on the agency culture and habits,” he said in an interview between meetings.  “We’re seeking boundarylessness, speed and agility, unconditional teamwork, innovation, and customer focus. ”  All indications are that the large bureaucracy was beginning to respond.

Interestingly, Berwick’s “that’s democracy” quote comes not in response to the partisanship in Washington DC that laid ruin to any chance he had at a permanent appointment.  Berwick used the phrase in reflecting on the outpouring of (mostly negative) comments received at CMS from health care stakeholders with the release of his preliminary proposal on Medicare Accountable Care Organizations.  “What happened is what should have happened,” he said. “We took our best shot, and smarter people than we are responded. That’s democracy.”

Democracy indeed. Read it for yourself and decide.

CMS Care Transition Program Update and Guidance

Masspro, the state’s quality improvement organization, held a conference call on the CMS Community Based Care Transitions Program and provided some useful guidance for those looking to apply or reapply for funding.

Based on a CMS call with QIO’s, there were three common elements that tripped up applications from community based organizations, hospitals and other partners:

  • Firstly, in many applications, CMS said that it was not clear that the community-based organization was eligible and did not fit the criteria laid out in the solicitation, fact sheets and Q&A’s.
  • Second, many applications included budget items that were outside of what CMS would fund. For instance, CMS will only fund activities directly related to the intervention and not indirect costs like data collection. CMS is also said to be aiming for an across-the-board 20 percent reduction in readmissions for the program collectively as an attainable and reasonable target. Budgets within an application should reflect that element.
  • Lastly, CMS found that there were a lack of community partnerships in the applications they reviewed. Looking at the seven successful applications, it is clear that there is a large group of partners serving a relatively broad geographic region.

In addition to the Masspro call, CMS has once again updated their CCTP webpage to include panel review dates for incoming applications through March 27th. Also, summaries of all seven of the successful applications are now posted.

The Home Care Alliance will continue to provide guidance and assistance to home care agencies interested in applying and will connect any hospital or community partners looking for home care agencies in their area.

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