Rate Changes in Adult Day Health, Adult Foster Care

The state’s Executive Office of Health and Human Services (EOHHS) made an announcement today regarding rates tied to Adult Day Health, Adult Foster Care and Day Habilitation.

Effective March 15, 2011, EOHHS will decrease the payment rates for adult day health (ADH) services by an average of 7.8%. According to a notice issues by the Division of Health Care Finance & Policy, the proposed rate for Basic ADH services will decrease from $53.93 to $49.98 per day (7.3%); the rate for Complex ADH services will decrease from $68.68 to $62.95 per day (8.3%); and the rate for Health Promotion and Prevention (HPP) services will decrease from $27.86 to $25.69 per day (7.8%).

For more information, see the notices below:

More information is available at the Division of Health Care Finance & Policy Regulations and Hearings website.

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HCA Welcomes New Member: Cape Cod Senior Home Helpers

The Alliance is pleased to welcome its newest member, Cape Cod Senior Home Helpers, a private care agency in South Dennis, Massachusetts.

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Federal Funding Available for CMS Care Transitions Program

There is a prime opportunity for home care agencies to apply for federal funding relative to the Centers for Medicare and Medicaid Services “Community Based Care Transitions Program.”

The $500 million CMS-based program was created under Section 3026 of the Patient Protection and Affordable Care Act, which is designed to improve care transitions between settings with the aim of reducing avoidable 30-day re-hospitalizations. The details of the program as well as direction have yet to be released, but it appears that CMS is looking for applications from health system partnerships, which must include a “community based organization.”  The statute establishing this project and the CMS preliminary information also indicates that preferences will be given to applicants that have experience with “Administration on Aging” care transitions activities. Massachusetts is one of 16 states that has such a grant operating through ASAPs/ADRC and the Massachusetts Executive Office of Elder Affairs.

Other preferences, although not stipulations, come from applications focusing on underserved and/or rural communities and applications with a clinical focus on “high-risk” Medicare beneficiaries, which are essentially defined as medically and/or socially complex patients. There is also a general Medicare beneficiary focus and partiality towards hospitals with high readmission rates.

It is essential to reiterate that agencies should start a conversation with the following entities regarding this funding opportunity:

  • Local hospitals – especially those involved in the STAAR Initiative – and/or health systems.
  • Area ASAP’s (Aging Service Access Points)
  • ADRC’s (Aging and Disability Resource Centers).

Interested agencies are urged to contact the Home Care Alliance as updates and guidance will be forthcoming. A conference call will take place next week that should provide some of that guidance, so PLEASE CONTACT US if you’re interested in participating. Again, it is up to provider teams that include a “community based organization” to assemble and submit applications.

CMS has a website with links to informative documents and presentations, which is available here.

Please contact us if you have any questions. For your convenience, the language of Section 3026 of the Affordable Care Act can be accessed here.

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Home Care? Yes, There is an App for That!

Home Care AppThe WSJ profiles four of the best caregiver applications available for your smartphones that allow you to check for common allergies, track care, make appointments, and a host of other functions.

Best of all, some are available at no charge.

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Continue reading “Home Care? Yes, There is an App for That!”

CMS Posts 2011 Regulatory Updates (ICD-10)

The Centers for Medicare and Medicaid Services has posted new links on their ICD-10 page to the 2011 ICD-10-CM and ICD-10-PCS crosswalks, formally referred to as the General Equivalence Mappings (GEMs).

According to the National Association for Home Care & Hospice, The Patient Protection and Affordable Care Act required required the Secretary of Health & Human Services to task the ICD-9-CM Coordination and Maintenance Committee to convene a meeting before Jan. 1, 2011 to receive stakeholder input regarding the crosswalks between ICD-9-CM and ICD-10 for the purpose of making appropriate revisions to the crosswalks. Section 10109(c) of the law further requires that these revisions to the crosswalks be posted to the CMS website and treated as a code set for which the Secretary has adopted a standard.

Here are the specific links:

  • 2011 ICD-10-CM and GEM’s: Information on the new diagnosis coding system, ICD-10-CM, that is being developed as a replacement for ICD-9-CM, Volumes 1 and 2.
  • 2011 ICD-10-PCS and GEM’s: Information on the new procedure coding system, ICD-10-PCS, that is being developed as a replacement for ICD-9-CM, Volume 3.

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HCA Submits Comments on Telehealth for EOHHS Budget Hearing

An article in the January 3rd edition of the Boston Globe highlighted the trouble that Massachusetts and many other states are experiencing when it comes to managing the Medicaid program.

The Massachusetts Executive Office of Health and Human Services had two public hearings on the upcoming fiscal year 2012 budget and how services can be made more efficient while lowering cost. The Home Care Alliance submitted comments on behalf of agencies currently utilizing or interested in becoming involved in home telehealth. HCA’s comments suggested that if MassHealth, the state’s Medicaid program, reimbursed home health agencies for administering the remote patient monitoring service, a significant cost savings could be realized.

See HCA’s comments here. To submit your own comments to EOHHS, see this previous blog post for more information and guidance. Comments can be sent via email to eohhshearings@massmail.state.ma.us or sent by regular mail to:

Secretary JudyAnn Bigby, EOHHS
One Ashburton Place, Room 1109
Boston, MA 02108

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Listen to the Free Excellence in Therapy Forum from Delta Health Tech

Initial Findings from the Delta National Excellence in Therapy Forum

Close to 100 of home care’s leading therapists, all either appointed or nominated by their state associations, participated in an intensive, highly focused effort to generate tips and guidelines that can be shared with the homecare industry.

The Webinar outlined some of the key tips and strategies produced at the Delta National Excellence in Therapy Forum to assist you, your leadership team and your agency clinicians with the care you provide to your patients.

Homecare providers who were unable to attend the Webinar may view a free recording and download the Webinar handout at www.deltatherapies.com/webinar.html.  Approximately 45 minutes.

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Face-to-Face Enforcement DELAYED

Enforcement of the face-to-face encounter requirement from a recent CMS Final Rule will be delayed for three months thanks to a coordinated and effective advocacy effort.

Home Care Alliance has been informed that the Centers for Medicare and Medicaid Services (CMS) has sent instructions to its contractors advising them that home health agencies and hospices are to be allowed to use the first quarter of 2011 to implement procedures to meet face-to-face encounters requirements.

It is vitally important to note that providers should continue to implement face-to-face encounters as soon as possible. Doing so will enable the collection of information about provider and beneficiary problems and pitfalls related to this regulation that need to be addressed with CMS. According to NAHC, CMS has plans to begin meetings with home health and hospice representatives, and other stakeholders, early in January to answer remaining questions and resolve problems as they come to light.

According to VNAA, the 3-month transition period will not be extended and CMS called on national organizations to take action and to work with CMS during the transition period.

This delay represents a victory for home health and hospice and is a prime example of how advocacy is effective in making a difference. The member agencies of HCA joined others nationwide in a great effort and, together with other associations, were able to convince CMS that a delay was necessary. Massachusetts was also fortunate to have great support from the federal legislative delegation.

For the purpose of continuing with implementation, NAHC has outlined the requirements for physician signature and the regulatory basis as to why after January 1, 2011, date stamps will no longer be accepted if the physician does not sign AND date.

Details are available in the Medicare General Information, Eligibility and Entitlement Manual under section 30.1. That requirement is also addressed in this summary.

HCA will provide more information as it becomes available.

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HCA Revives Holiday Radio Ad

The Home Care Alliance is promoting its website and the services provided by member agencies across the state in a new set of online radio advertisements.

WODS 103.3-FM is Boston’s oldies music station and is one of the most popular stations in the region, especially once they turn on the holiday music from mid-November through December 25th. The Alliance is running an ad in a rotation on the WODS home page and is also running a 30-second holiday ad called “Home for the Holidays” the week leading up to Christmas. A shorter 15-second ad, which is more generic, will run the week between Christmas and New Years Day. Both ads are for listeners streaming the station online.

Hear our 30-Second ad here.

Hear our 15-second ad here.

Hear the ad live by streaming 103.3-FM on your computer, or see the HCA ad on the WODS home page.

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National Organizations Weigh in on Face-to-Face Encounter Rule

Arguing that patients could lose access to important services or experience unacceptable delays, a coalition of national organizations advocating for elders sent a letter to CMS Administrator Donald Berwick urging for a six-month transition period relative to the physician face-to-face encounter requirement.

The 26 organizations asking for the delay include AARP, Alzheimer’s Association, American Hospital Association, American Nurses Association, National Association for Home Care & Hospice (NAHC) and Visiting Nurse Associations of America (VNAA).

The transition period requested, according to the letter, urges that home care and hospice  be held harmless while other providers, patients, and caregivers would become better educated on the new rules. Meanwhile, CMS could work out operational issues.

The full letter to Administrator Berwick is available here.

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