In an effort to alert physicians referring patients for Medicare home health services about PECOS (Provider Enrollment, Chain and Ownership System), the Home Care Alliance has drafted an “Important Notice to Physicians“ document for members to use.
The document summarizes the PECOS issue as well as instructions for physicians on the enrollment process.
For more information and background on PECOS, visit this blog post.
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For those looking to comment on the PECOS (Provider Enrollment, Chain and Ownership System) issue, visit this link on regulations.gov and click on “submit comment.”
HCA strongly suggests that members also send a message to Congress (scroll all the way down to the last message on the list) and call the office of Senator John Kerry and US Representative to follow up on the Alliance’s letter and alerting their offices to the timeliness and urgency of the matter.
If you’re unsure who represents you in the US House of Representatives, click here.
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A provision in the Patient Protection and Affordable Care Act published recently by the Centers for Medicare and Medicaid Services (CMS) states that, as of July 6th, home health agencies will be prohibited from submitting claims for reimbursement from physicians who have not enrolled in a new online system.
Failure to register in the Medicare Provider Enrollment, Chain and Ownership System, or PECOS, would also block these physicians, who can still see Medicare patients, from referring new patients for Medicare-covered home health services.
At issue is that CMS has not adequately educated physicians about this new requirement. The result is that as many as 50% of physicians in Massachusetts (NAHC estimates 20-40 percent nationally) have not registered on PECOS. Moreover, the registration and approval process can take several weeks, so even if physicians were to register immediately, their status would not be approved by the July 6 deadline.
HCA, along with the VNA of Boston and other agencies and organizations are urging the Centers for Medicare and Medicaid Services and Congress to delay implementation of the rule until such time as physicians have ample time to enroll and also to hold harmless the home health providers that will suffer from the abrupt transition.
What to do:
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The Home Care Alliance is applauding the state Senate’s passage of the Nurse Delegation bill (S.860) and is urging the House of Representatives to follow suit.
S. 860 would refine the Commonwealth’s Nurse Practice Act (NPA) to allow appropriate nurse delegation practices to include delegation of medication administered by home health aides in the home setting.
Thanks to the advocacy of HCA members and the work of supporting organizations, the bill moves one step closer to the Governor’s desk and lobbying efforts are now directed at the House.
An NEW email message aimed at State Representatives is available in the Legislative Action Center. Just click on the message regarding Nurse Delegation. If you choose to call your local State Representative, a fact sheet is also available as a guide.
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Organization leaders supportive of the Home Care Alliance’s Nurse Delegation bill (S.860) signed onto a letter aimed at Senate President Therese Murray and urging her to bring the proposal before the full Senate for debate.
The joint letter initiated by the Home Care Alliance is also copied to Senator Frederick E. Berry, who is Chairman of the Senate Committee on Ethics and Rules, which is where the bill currently sits. The next step for the legislation would be a formal session where state senators would debate the matter, but with time running down the Alliance and the bill’s supporters are working to advance the issue to that vital step.
Go to the HCA Legislative Action Center and click “Please Advance S.860 for Better Home Health” to send a letter to the Senate Committee on Ethics and Rules, or call Senator Berry’s office at 617-722-1410.
Some organizations, including the Massachusetts Association of Registered Nurses and the Massachusetts Association of Nurse Executives, are in support of S.860, but were not able to sign onto the letter.
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The Home Care Alliance Board of Directors has sent a letter to US Senator Scott Brown, joining advocates and health providers from across Massachusetts who are urging Congressional support for an extension of Federal Medical Assistance Percentage (FMAP) funds.
Massachusetts is one of 30 states relying on the federal matching funds for MassHealth and has already budgeted for the money as part of the state budgeting process. Many US Senators, including Massachusetts Sen. Scott Brown, are against the extension with a belief that it would add to the federal deficit.
Unlike the federal government, Massachusetts must present a balanced budget at the end of the fiscal year. Governor Deval Patrick announced that the budget would have to be reduced another 3.6% if the matching funds are not approved and state legislative leaders are preparing for a scenario where the federal matching funds would not be available.
The Federal Medical Assistance Percentages (FMAPs) are used in determining the amount of Federal matching funds for State expenditures for assistance payments for certain social services, and State medical and medical insurance expenditures. This year, such funds are worth at least $608 million to Massachusetts.
A message is available on the HCA’s Legislative Action Network that can be sent to federal elected officials. Just scroll down until you see the FMAP message under the “Medicaid” heading.
Contact Senator Brown’s office to urge that he support the FMAP extension.
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The Home Care Alliance has sent letters to all members of the state legislature’s conference committee, including the two chairs of Ways & Means, that is charged with hammering out differences in the budget proposals of the House and Senate.
The Senate budget contained an outside section, Amendment #607, which directs the Massachusetts Technology Collaborative to conduct a review of the effectiveness of telehealth on patients with chronic conditions. Help advocate to keep that amendment in the final version of the state’s budget by emailing the members of the conference committee! You can also call using the contact info on each legislators web page:
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The Home Care Alliance’s “Nurse Delegation” bill, S.860, has been reported to the Senate Committee on Ethics and Rules, which is the last step before the bill can be debated before the full Senate.
In an effort to have the bill reported out as quickly as possible with the legislative calendar coming to a close, the Alliance has already sent a letter to the committee’s chairman, Senator Frederick E. Berry.
A new message is posted on HCA’s Legislative Action Center for those who reside in the district of a committee member. Just click the message “Please Advance S.860 for Better Home Health,” fill out the form with your contact info, review the message and send it off. You may also call the committee chairman’s office at 617-722-1410.
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Help us stand up for home health and home care!
The Home Care Alliance has two major priorities filed in the Senate budget, which will be debated this week.
Please call your State Senator today, or send them an email, and urge them to support the following amendments:
HCA has an email message uploaded to our Legislative Action page that are ready to be sent. All you have to do is type in your contact information and the advocacy system will identify your senator and show the message you can send.
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Congresswoman Allyson Schwartz of Pennsylvania has submitted a major legislative priority of the National Association for Home Care & Hospice (NAHC) that would help ensure home health patients have timely access to care services.
The Home Health Care Planning Improvement Act (H.R. 4993) would allow nurse practitioners, physician assistants, certified nurse midwives, and clinical nurse specialists to order home health services. For more information, see NAHC’s fact sheet or click the link to the bill language above.
Help advocate by calling the office your Congressional representative to have them sign on. If you are unsure who represents you in the US House, click here and enter your zip code in the top left hand corner.
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