Author: James Fuccione

Reminder of PECOS deadline

As of October 4, Medicare home health agencies will be receiving warning messages from the Centers for Medicare and Medicaid Services (CMS) in response to claims where the ordering physician is not enrolled in PECOS (Provider Enrollment, Chain, and Ownership System).

Agencies will still be paid for claims, but the warning message will indicate that such payments will be denied as of January 3, 2011.

For more background on this issue, visit previous newsfeed posts here.

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New CMS Proposed Rule Issued on Provider Screening, etc.

The Centers for Medicare and Medicaid Services issued a new proposed rule on September 20 that lays out changes in provider screening, suspension of payments, fraud control, temporary moratorium criteria, and cross program terminations.

A summary of the rule will be made available in this week’s issue of UPDATE for Alliance members.

Those interested in submitting comments, which are due by November 16, can be made electronically by clicking here, or by mail at the address below:

  • Centers for Medicare & Medicaid Services, Department of Health and
    Human Services, Attention: CMS-6028-P, P.O. Box 8020, Baltimore, MD
    21244-8020.

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Boston Globe: Mass. Recasting Health Payments

The Boston Globe reported on the Committee on the Status of Payment Reform Legislation, charged with making a recommendation to the state legislature regarding the formation of Accountable Care Organizations.

The Home Care Alliance sits on the committee chaired by Health and Human Services Secretary JudyAnn Bigby and is representing home care and home health in laying the groundwork for the reform of health payments.

For more info, see the Boston Globe article here or the link to the committee’s work above.

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Cape Cod Times: Taking Steps to Reduce Fall Injuries

The Falls Prevention Coalition hosted the fourth annual Falls Prevention Awareness Day at the State House on Wednesday, September 22. The Home Care Alliance was recognized as one of the founding members of the coalition and spoke at the event, which also included remarks from the Department of Public Health, State Senator Patricia Jehlen, and Secretary of Elder Affairs Ann Hartstein.

The Cape Cod Times reported on the event that promoted Tai Chi as a means for elders to retain balance and strength and the article is available here.

More from this event will be posted on the HCA Facebook page.

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HCA Comments to CMS on Proposed Rule

The Home Care Alliance has submitted comments on behalf of Medicare home health agency members to the Centers for Medicare and Medicaid Services regarding Proposed Rule CMS-1510-P (Medicare Program: Home Health Prospective Payment System Rate Update [CY 2011]; Changes in Certification Requirements for Home Health Agencies and Hospices).

The comments include suggested changes on the case mix adjustment, face-to-face physician encounter requirement, 36-month Rule/Capitalization Requirements, Claims Data Collection and Processing, HHCAHPS, and the Therapy Coverage Requirement. The comments also reflect how Massachusetts agencies have case mix weights well below the national average, but that the Northeast stands to be punished severely for following guidelines set by CMS.

Click here to see the Home Care Alliance’s comments on the Proposed Rule.

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CMS Offers Guidance on Hospice Care for Children in Medicaid and CHIP

The Centers for Medicare and Medicaid Services (CMS) have issued a letter to state health officials and Medicaid Directors  offering guidance on a provision of the Patient Protection and Affordable Care Act (PPACA) dealing with “Concurrent Care for Children.”

Specifically, the provision removes the prohibition of receiving curative treatment upon the election of the hospice benefit by or on behalf of a Medicaid or Children’s Health Insurance Program (CHIP) eligible child.

For more information, see the CMS memo here.

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Letter Examples for CMS Proposed Rule Advocacy

Agencies in Western Massachusetts have stepped up with several letter templates for their physicians to send in to CMS and Administrator Donald Berwick regarding the Proposed Rule on case mix and Physician face-to-face visits.

Please see the letters below and feel free to edit and send as you see appropriate:

As a reminder, comments are due by September 14 to CMS and can be sent:

  1. a. By Mail: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS-1510-P, P.O. Box 1850, Baltimore, MD 21244-1850
  2. b. Or electronically by clicking here, then clicking “submit comment.”

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Alzheimers Disease and Related Disorders State Plan Steering Committee Holding Listening Sessions

Sign up for Teleconference on CMS Proposed Rule

Members of the Home Care Alliance are invited to participate in an open teleconference about the CMS proposed rule and to hear an update on the strategies that the Alliance and the National Association for Home Care & Hospice have developed to oppose the negative changes.

The call is scheduled for Tuesday, September 7, 3:00 – 4:30 p.m and  Bill Dombi, NAHC’s Vice President for Legal Affairs will participate in the call.

Pre-registration is required.  Email Stephanie Drakes at the Alliance to get the call-in information.

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HCA Urges Congress to Comment on Proposed Medicare Rule

The Home Care Alliance has distributed a letter to the Massachusetts Congressional Delegation, including Senators Kerry and Brown, in hopes that they will sign on and forward the comments to the Centers for Medicare and Medicaid Services (CMS) on behalf of the home health industry. The letter is in response to a CMS proposed rule that would severely threaten access to care services.

The letter urges CMS to scale back broad Medicare cuts to home health based on “case mix creep” and “upcoding,” among other factors, and alter the physician face-to-face visit requirement so that it is not a barrier between patients and the care they need.

Please contact your Congressperson TODAY, and urge them to support the comment letter.

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