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 Massachuetts Quality and Cost Council (QCC) has begin to track progress against six goals established by the Council pursuant to their charge as established in Chapter 58 of the Acts of 2006. The Goals Scorecard includes measures around improving the screening for and management of chronic illness in the community and developing new measures to track progress in adhering to patients’ wishes at end of life. The latter will include tracking – as recommended by the state’s Expert Panel on End of Life care – the percentage of hospitals, SNFs and home health agencies with palliative care programs. The Advisory Committee to the QCC will seek input on these goals, and the associated measures, at their May meeting. What is your feedback?
The 2010 rates are available for download on our Regulatory Center.
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Yesterday more than 40 Alliance members participated in a workshop on making the business care for home care to be at the enter of efforts to introduce better management of chronic illness to the US health care system. Beth Hennessey of Baptist Home Care provided the agency template for matching the core competencies of home care to the policy and programmatic changes that are envisioned in federal health care insurance and delivery system reform.
One take away message is that Massachusetts may see opportunities in this area even quicker than the rest of the country as this state is moving into Phase II of reform (system realignment) while most other states are still on Phase I (universal coverage). An immediate challenge to home care to deliver services in a new and different way may well present itself when the state releases its RFP – this spring or summer – for a broad Medical Home pilot.
All home care agencies should be familiar with the state’s plans – as described in their Patient Centered Medical Home Framework for Design and Implementation. Help physicians to see how a new home care partnership can make a medical home work.
– Pat Kelleher
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Medline’s recent article on Unraveling the Pressure Ulcer and Wound Care Sections of OASIS-C is available for download. Other news & information regarding the new standards are available on our OASIS-C page.
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MassHealth has revised their hospice regulations to reflect changes in CMS hospice rules. The new rules require hospice providers to coordinate their hospice services with the Medicaid personal care benefit, as appropriate. MassHealth members no longer have to waive their PCA services if they elect the hospice benefit.
Also, physicians signing the hospice certification statement will be required to personally compose a narrative explaining the clinical findings that support life expectancy of six months or less.
MassHealth has also revised the billing guide for the UB-04 which is posted on the MassHealth website.
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The CHAMP (Collaboration for Homecare Advances in Management and Practice) team has become a good industry go-to site for comprehensive evidence based practices and tools. CHAMP has just released free resources and downloadable tools under the topic: family caregivers. Some of the tools on the CHAMP website were developed in New York as part of the Next Step in Care project. This comprehensive Care Transitions website includes family and agency guides and checklists on everything from medication management to HIPAA – many are in English, Russian, Spanish and Chinese. All free of charge to interested users.
Through the end of March, Alliance members who order our Standards of Home Health Clinical Practice Manual will receive a free copy of Home Health Care Emergency Preparedness Handbook.
The Standards of Practice manual represents the professional consensus of experienced home health practitioners in the fields of nursing, physical therapy, hospice, and quality improvement. Each standard was developed by a subcommittee and reviewed by the full workgroup and subject-matter experts. Each order includes a printed copy of the manual, as well as a CD containing the complete text in an Adobe PDF format. The table of contents is available for preview
The Standards of Practice Manual normally retails for $225, but is available to Alliance members for just $65.
The Alliance developed the Home Health Care Emergency Preparedness Handbook jointly with the Department of Public Health.
This essential reference not only covers what home care agencies can do to protect and care for their own clients in an emergency, but also details how their unique skills and knowledge base can help their entire communities.
Like the Standards of Care Manual, the Emergency Preparedness Handbook is neatly bound in a sturdy ring folder. The table of contents is also available for preview.
To order a copy of both guides, sign into our website and order a copy of the Standards of Care Manual; we will include a copy of the Emergency Preparedness Handbook at no additional charge. To order just a copy of the Emergency Preparedness Handbook, call HCA Membership coordinator Tom Meyer at (617) 482-8830.
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