Deadline Approaching for OSHA’s Hazard Communication Standards Training

To better protect workers from hazardous chemicals, the U.S. Department of Labor’s Occupational Safety and Health Administration (OSHA) has revised its Hazard Communication Standard (HCS) aligning it with the United Nations’ global chemical labeling system. There will be new labeling and data sheets on chemicals according to the Globally Harmonized System (GHS). GHS is an international approach to hazard communication, providing agreed criteria for classification of chemical hazards, and a standardized approach to label elements and safety data sheets.

OSHA is requiring all employers, including home health and hospice, to train all employees on the revised hazard communication labels and data sheets elements (e.g., pictograms and signal words) by December 1, 2013. The Hazard Communication Standard, will be fully implemented in 2016 and benefit workers by reducing confusion about chemical hazards in the workplace, facilitating safety training and improving understanding of hazards, especially for low literacy workers. OSHA’s standard will classify chemicals according to their health and physical hazards, and establish consistent labels and safety data sheets for all chemicals made in the United States and imported from abroad.

Further information can be reviewed at OSHA’s Hazard Communication Safety and Health which includes links to OSHA’s revised Hazard Communication Standard and guidance materials such as Q and A’s, OSHA fact sheet and Quick Cards.

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Regional Trainings on MOLST Being Held

For those home health agencies looking to implement or simply learn more about MOLST (Medical Orders for Life Sustaining Treatment), the MOLST outreach and education team is hosting a series of regional meetings detailed below.

The Region 3 meeting will be held on November 18 at Lahey Hospital & Medical Center in Burlington, MA.  Click here to register.  Registration will close on November 13.

The Region 4 meeting will be held on December 6 at Newton-Wellesley Hospital in Newton, MA.  Click here to register.  Registration will close on November 29.

The Region 5 meeting will be held on November 13 at New England Sinai Hospital in Stoughton, MA.  Click here to register.  There are just a few seats left.  Registration will close this Wednesday, November 6.

If you are (or will be) involved in implementing MOLST at your institution, or involved in training others about MOLST, come to these meetings to:

•    Learn more about MOLST
•    Become familiar with the MOLST process in order to communicate and honor your patients’ life-sustaining treatment decisions
•    Understand how to use available MOLST resources for implementation, including across the continuum of care

More information is available on the MOLST website.

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MeHI Hosting Free Regional Health IT Meetings

The Massachusetts e-Health Institute (MeHI) is hosting free regional meetings to help attendees keep up-to-date on how they can gain the benefits of connected EHRs and the Massachusetts programs to support their adoption and use.

The sessions will include information about how MeHI, the Mass HIway and others are helping providers comply with Chapter 224 requirements for physician licensure and Stage 2 Meaningful Use.

The workshop will take place in Worcester on November 4th and will run from 8:00am to 11:30am. The event is free, but registration is required. More information on registration and the agenda for the event are available here.

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CMS Posts Clarification of the Definition “Confined to Home”

On October 18th, Centers for Medicare & Medicaid Services (CMS) released Change Request 8444– Home Health Clarification of Benefit Policy Manual Language on Confined to Home.  This Change Request requires Medicare contractors to be aware of the clarification of the definition “confined to the home” as stated in the revised section 30.1.1 of Chapter 7 of the “Medicare Benefit Policy Manual”. In addition, CMS removed vague terms, such as “generally speaking”, to ensure the definition is clear and specific. CMS has also release a MLN Matters for provider reference. The implementation date for this clarification is November 19th, 2013

CMS is amending its policy manual as follows:

For purposes of the statute, an individual shall be considered “confined to the home” (homebound) if the following two criteria are met:

Criteria-One:

The patient must either:

Because of illness or injury, need the aid of supportive devices such as crutches, canes, wheelchairs, and walkers; the use of special transportation; or the assistance of another person in order to leave their place of residence

OR

Have a condition such that leaving his or her home is medically contraindicated.

If the patient meets one of the Criteria-One conditions, then the patient must ALSO meet two additional requirements defined in Criteria-Two below.

Criteria-Two:

There must exist a normal inability to leave home;

AND

Leaving home must require a considerable and taxing effort.

 

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Advocacy Alert: Out-of-State MD Orders Legislation

A state legislative priority of the Home Care Alliance will be considered by the state legislature’s Joint Committee on Public Health at their hearing on October 29th in hearing room B-1 of the State House.

The bill is S.1042, An Act to allow out-of-state physicians to order home care in the Commonwealth, and would allow an out-of-state physician in a bordering state to order home care services for a resident of Massachusetts.

Under the bill, the out-of-state physician will not be required to obtain a license form the Massachusetts Board of Registration in Medicine. However, the Massachusetts home health agency will obtain and keep documentation that the out-of-state physician’s license is in good standing. The home health referral must also be the result of an in-person examination. The legislation is intended to remove a significant barrier to home based services by increasing access to physicians and specialists for residents living on or near a border with a neighboring state, those with vacation homes in other states, and those traveling in other states.

Any agencies or advocates interested in submitting written comments or testifying in person can contact James Fuccione at HCA.

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Private Care Members Survey Open

survey_clipartIn order to help us identify needs and set our priorities for the coming year, the Alliance is asking its Private Care members to participate in our special Private Care Survey.  The survey asks 15 questions concerning priorities, benefits of membership, and the Private Care Guide.

The more input we have from our Private Care members, the better we can serve.  Please respond by October 23.

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Government Shutdown Delays Quarterly OASIS Q&As

Due to the government shutdown, the CMS OASIS Quarterly Q&As will not be released on October 16, 2013 as previously expected. As soon as the government reopens for business, the Q&A release will be rescheduled and the HCA will post the results in our Update

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CMS Issues HHA Reporting Requirements- CR-8441

HHA Reporting Requirements for the Certifying Physician and the Physician Who Signs POC

CMS has issued Change Request 8441 which instructs home health agencies to report the NPI and name of the physician who certifies the patient for home health services and to also report the NPI and name of the physician who signs the POC. CMS is instructing agencies that both the attending physician and the other physician fields should be completed even if the certifying physician is the same as the physician who signed the plan of care. The additional reporting requirements do not go into effect until July 1, 2014.

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Deadline to Register for MAC Satisfaction Survey is September 30th

Let your voice be heard!

Time is running out to participate in the MAC Satisfaction Indicator (MIS).  Registration will close on Monday, September 30th. Your opinion counts so please participate by completing the  Registration Form

Medicare Administrative Contractor Satisfaction Indicator

CMS strives to continually refine its processes, systems and services in the pursuit of excellence which is our commitment to continuous improvement. In living this commitment, we are providing a tool, the Medicare Administrative Contractor Satisfaction Indicator (MSI), to measure the level of satisfaction providers and suppliers experience with their Medicare Administrative Contractors (MACs).  The MSI allows providers the opportunity to influence CMS’ understanding of Medicare contractor performance.  The goal of the MSI is to evaluate these experiences and determine the key drivers of customer satisfaction.  In addition, CMS will use the results of the MSI to monitor trends, improve oversight and increase the efficiency of the Medicare program.

 

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HCA Statement on Indictment of Waltham Home Health Agency Owner

Home Care Alliance of Massachusetts Decries Fraud Renews Call for Stricter Oversight or New Agencies, Moratorium

Boston, MA – The arrest on September 16th of the owner/proprietor of a Massachusetts home health agency on charges of defrauding the federal Medicare program should be seen as a wake-up call to federal and state officials that unlimited expansion of home health agencies is threat to the Medicare program and its beneficiaries.  The Home Care Alliance applauds the efforts of the federal Office of the Inspector General in identifying the aberrant behavior of this agency and reiterates its call for the federal government to do more to target abusive agencies.

“Home health agencies in Massachusetts work hard to comply with all federal and state rules and are an integral part of building a more patient centric, cost effective health care system,” said Patricia Kelleher, Executive Director of the Home Care Alliance of Massachusetts, a trade association for more than 190 Medicare certified and private pay home care agencies.  “We have been calling for more directive enforcement efforts aimed at outlier agencies, as opposed to blanket enforcement that burdens the high quality, highly ethical providers.

The Home Care Alliance has met with staff at CMS regularly over the past four years urging that there be: 1) More active enforcement of existing Medicare program rules, and 2) A more rigorous set of rules for entry into the industry in order reduce the growth of unqualified agencies.

The Alliance wrote to Health and Human Services Secretary Kathleen Sebellius in 2011 and 2012 urging her to immediately place a moratorium on the enrollment of new home health providers into the Medicare program. The Medicare Payment Advisory Commission (MedPAC) also made this recommendation in their March 2011 report to Congress, and the Secretary was granted the authority by the Patient Protection and Affordable Care Act to suspend payments to providers or establish a moratorium on new provider enrollment.

The Alliance has also filed state legislation to require any new agency to file and be granted a state “certificate of need” before applying for federal Medicare certification.

“The home health agencies in Massachusetts have worked hard to gain the trust of patients and families, as well as our physician and hospital partners,” said Beverly Pavasaris, President of the Home Care Alliance and Executive Director of the Brockton VNA. “Agencies such as mine, with more than 100 years of proving home based care, will not sit idly and let our good work and reputation be damaged by individuals intent on committing fraud.” Continue reading “HCA Statement on Indictment of Waltham Home Health Agency Owner”