Tag: Home Health Care

Money Follows the Person Project Team Hosting Technical Assistance Sessions

University of Massachusetts Medical School, the Department of Developmental Services, and Home and Community Based Services (HCBS) Provider Network Administration Unit is recruiting service providers to serve people with disabilities and/or elders who live in the community and eligible for services under the Money Follows the Person Demonstration project (MFP).

The Provider Network Administration Unit is hosting Waiver Service Provider Technical Assistance Sessions. The sessions will give providers an overview of the HCBS Waivers and services offered, as well as an in-depth review of the application forms and submission requirements/process.

The MFP sessions will be held as follows:

Date

Time

Day

Location

Address

City

Conference Room
8/19/14 2:00-4:00 PM Tuesday Forbes Library 20 West St. Northampton Community Room
8/28/14 2:00-4:00 PM Thursday UMASS Medical School 333 South St. Shrewsbury USA
9/16/14 1:00-3:00 PM Tuesday Taunton Public Library 12 Pleasant St. Taunton See Reception Desk
9/18/14 1:30-3:30 PM Thursday Boston Lower Mills Library 27 Richmond St. Dorchester See Reception Desk
9/30/14 2:00-4:00 PM Tuesday UMASS Medical School 333 South St. Shrewsbury USA
10/7/14 1:00-3:00 PM Tuesday Lenox Library 18 Main St. Lenox Welles Gallery
10/23/14 2:00-4:00 PM Thursday UMASS Medical School 333 South St. Shrewsbury USA

 

Return to www.thinkhomecare.org.

Alliance Comments on Proposed LTC Insurance Regulations

Fresh off the heels of the Department of Labor Standards’ decision to drop private-pay home care licensing, the state’s Division of Insurance is accepting comments on regulations related to long-term care insurance.

The Home Care Alliance offered oral and written testimony on proposed amendments to 211 CMR 65.00 at a public hearing on August 1st. The regulations aim to set new standards for long-term care insurance policies, rate setting and cost controls and creates various consumer protections.

More importantly for home care agencies, they propose that home care agencies must meet standards set by the Executive Office of Elder Affairs in order to be covered under long-term care insurance plans. Given the impending gap in state oversight with DLS’ new regulations, the fact that those agencies with elder services contracts represent a fraction of private pay home care agencies, and that many agencies relying on long-term care insurance do not work with Aging Service Access Points, the Alliance suggested the following measures:

  • The Home Care Alliance’s Accreditation Program and unexpired DLS licenses should be placeholder requirements for long-term care insurance coverage until the state and advocates can pass meaningful licensure measures.
  • Home Care Alliance Accreditation allows workers who are not home health aides/certified nursing assistants to provide certain services in the home and DOI’s regulations should reflect that flexibility.
  • In the “sample definitions,” the Activities of Daily Living do not include “grooming and personal hygiene,” which is a traditional ADL and one that is vital to the well-being of people wishing to avoid facility-based care.

More details are available in the full copy of HCA’s comments, which can be obtained by contacting James Fuccione at the Alliance.

Those agencies or advocates wishing to comment have until 5:00pm on Friday, August 15th. Comments can be emailed to doidocket.mailbox@state.ma.us and the subject line should read “Docket No. G2014-0.”

Return to www.thinkhomecare.org.

New Program Instruction Approved for Home Care Agencies Working with ASAPs

After more than a year of the Home Care Alliance and other stakeholders working with the state’s Executive Office of Elder Affairs, an updated Program Instruction (PI) for the state’s Aging Service Access Points working with home health agencies has been approved and will go into effect on May 1st.

The PI addresses a range of concerns that were raised around assessment, care planning, supervision, payment and   communication between the nurse at the home health agency and the corresponding Aging Service Access Point (ASAP).  It replaces some very outdated PI’s and is the product of several meetings and edits sent through countless emails

A workgroup consisted of Home Care Alliance staff, the Mass Home Care Aide Council, and staff from the Executive Office of Elder Affairs along with several ASAP directors and ASAP nurses.

The Home Care Alliance is very pleased with the updated direction from the state, which will improve communication and collaboration between home health agencies and ASAP’s.

Return to www.thinkhomecare.org.

Advocacy Alert: Help Gather Support for Home Care Budget Amendments

The Home Care Alliance’s priority amendments in the House budget now have numbers, which means you can email or call your state representative and easily ask that they support these important policies to advance home care services!

  • Amendment #968: Rep. Sean Garballey’s amendment to restore the MassHealth rate for home health nursing visits past 60 days of care to the payment level prior to December 1, 2008 so that patients with the most severe conditions can have their care continued and remain independent at home. MassHealth cut the rate once a person was receiving home nursing for more than 60 days, which runs counter to the state’s goal of keeping people in the community and driving down the cost of care.
  • Amendment #89: Rep. Kate Hogan’s amendment to study home health service capacity in the Commonwealth and recommend policy strategies for better state oversight of home care agencies. Massachusetts is one of only five states without either licensure or a “determination of need” process for home health agencies. In recent years the Commonwealth has experienced rapid growth in the number of certified home health agencies. This proposal is in response to that growth and would help to identify the current number of home health agencies and their licensure and ensure high levels of quality home care.
  • Amendment #491: Rep. John Mahoney and Rep. Mark Cusack’s amendment that would establish MassHealth reimbursement for telehealth services provided by home health agencies. This amendment was successfully passed in last year’s budget and this year’s version will ensure MassHealth is statutorily able to finish their work in creating a regulatory and reimbursement structure.
  • Amendment #775: Rep. James O’Day’s amendment to reestablish the Homemaker Wage Increase account. This appropriation would provide an annualized wage increase of approximately 75 cents an hour to over 17,000 homemakers and personal care homemakers.

Our Legislative Action Center makes it easy to advocate. Just click on the FY15 budget message, fill in your contact info, and hit send! The system will automatically send the message to your state representative.

You can also call 617-722-2000 and press “2” to speak to an operator in the House of Representatives to urge your State Rep to support amendments #89, #491, #775 and #968. You can use the talking points above when speaking to an aide or leaving a message.

Contact James Fuccione at the Alliance with any questions.

Return to www.thinkhomecare.org.

ODF on December 11th

Save the Date!

The next Home Health, Hospice & DME Open Door Forum is scheduled for Wednesday, December 11, 2013 at 2:00 PM Eastern Time. If you wish to participate, dial 1-800-837-1935; Conference ID: 70980706.

Tentative Agenda:

I. Announcements & Updates

  • Ordering & Referring Physician
  • HHCAHPS
  • Home Health Rule Publication
  • Q Code Requirement

II. Open Q&A

III. Special Breakout Session with Q & A Hospice Item Set (HIS) and upcoming Training. Session starts promptly at 2:40 p.m.

Visit the Open Door  Forum Website for more information.

Return to www.thinkhomecare.org.

NB: The original post accidentally indicated that the forum was to be on December 11; the post has since been corrected.

Good News! HIPPS Codes for Medicare Advantage Claims Delayed

Health Insurance Prospective Payment System (HIPP)S codes on Medicare Advantage (MA)  plan claims will be delayed until July 2014 according to information from NAHC.  Bellow is an excerpt from a letter CMS sent to the health plan.

”MAOs and other entities were instructed that effective December 1, 2013 dates of service (DOS), the disposition for the HIPPS codes edits would be changed from ‘Informational’ to ‘Reject’ for any Skilled Nursing Facility (SNF) and Home Health (HH) encounters submitted without the appropriate HIPPS codes. The purpose of this notification is to let you know that the December 1, 2013 DOS ‘Reject’ edit will be delayed to July 1, 2014 DOS. The ‘Informational’ edit for HIPPS codes would remain in place until that time.”

Return to www.thinkhomecare.org.

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.

 

Return to www.thinkhomecare.org.

Alliance Submits Comments on PPS Rule

The Home Care Alliance of MA today submitted comments to CMS on the proposed rule setting Medicare home health rates for 2014. CMS has proposed cutting rates by 3.5% for each of the next four years.

Citing data concerns, inadequate allowances for increasing regulatory costs and operating margins, inequities in the proposed wage index, and an incomplete analysis of the impact on both agencies and Medicare patients of CMS’s proposal to cut rates for each of the next four years, the Alliance urges CMS to go back to the drawing board on 2014 rates.

The Alliance’s comments are available here.

Comments to CMS on the proposed rule are due TODAY at 5:00 p.m., and can be submitted online at www.regulations.gov.  Enter “RIN 0938-AR52” in the search box to find the proposed rule.

NHIC- Ask the Contractor- August 15th

The Medicare Administrative Contractor, NHIC. Corp., will hold the Hospice & Home Health Ask the Contractor Teleconference (ACT) on August 15th at 10:00 a.m

Ask-the-Contractor Teleconference is an opportunity to speak directly with the contractor. NHIC staff representing a variety of functions will be available to answer questions. NHIC usually will provide some updates to the home health and hospice community but the majority of this call is dedicated to providers as a question and answer open forum.

Registration is required on NHIC’s website- Education Programs.

Return to www.thinkhomecare.org.

Open Door Forum is Tuesday, July 9th

The next Home Health, Hospice & Durable Medical Equipment (DME) Open Door Forum is scheduled for Tuesday, July 9, 2013 from 2:00pm – 3:00pm ET.

Agenda includes:

  • Announcements & Updates
  • Updated Healthcare.gov Announcement
  • Hone Health CAHPS
  • Hospice Vendor Call
  • Requirements for Long Term Care Facilities & Hospice Services
  • Status Update on Home Health Advance Beneficiary Notice
  • Open Q&A

If you wish to participate, dial 1-800-837-1935; Conference ID: 97842778