Tag: MassHealth

Massachusetts Medicare Program.

House Releases Health Care Payment Reform Legislation

Nurses Hall in the State House was crowded with attendees eager to hear highlights of a long awaited bill on health care payment reform.

House Speaker Robert DeLeo and the Health Care Financing Committee’s House Chair Representative Steve Walsh announced their proposal that will be followed soon by a Senate version that will transition the state away from fee-for-service payments.

During his speech, Chairman Walsh said that the bill would save the state $160 billion over fifteen years and would bring full health IT interoperability to Massachusetts within five years. Accountable Care Organizations are not mandated, but are among options that providers can shift into from the current fee-for-service model. Chairman Walsh, in fact, mentioned four payment options that providers can choose: bundled, episodic, global and the patient centered medical home. He added that if there is an innovative model that does not include fee for service payments, a provider or provider group is welcome to bring that to the table as a proposal. Chairman Walsh also mentioned home health during his State House speech in reference to workforce development and although home care was not specifically mentioned in that section of the bill, it appears there would be an opportunity in the form of pilot projects and future policy recommendations.

At a quick glance, here are some other notable sections concerning home care:

  • Section 60: the Home Care Alliance is mentioned by name as having one representative on a special committee that will make recommendations on behavioral health services (page 67).
  • Section 105: Insurance coverage of physician assistant care is established “for purposes of health maintenance, diagnosis and treatment,” which includes “home care setting” as a covered benefit (page 128).
  • Section 109: The bill creates a new medical malpractice section that puts “home health agency” in the definition of a facility (page 133).

News outlets are beginning to release articles on the bill, including this story on Boston.com.

The Home Care Alliance will provide updates and more information as the bill continues to be examined.

Return to www.thinkhomecare.org.

Keeping It Legal, Part 2: Patient Choice

Building on a previous document called “Keeping It Legal” that focuses on what providers need to know when referring patients to home health care, the Home Care Alliance is releasing a series of documents on other legal issues related to the industry.

This new document in the series focuses on “Patient Choice” and what rights a patient has under the Medicare and Medicaid programs.

See the article: Respecting Patient Choice and the Rights of Medicare Patients

Drafted by Robert Markette, Jr., CHC – Of Counsel for Benesch Friedlander Coplan & Aronoff LLP, the Home Care Alliance is pleased to make this series of resource documents available. Agencies are encouraged to pass these documents along to partnering providers and pertinent agency staff to ensure that they are aware of the rules and regulations.

Return to www.thinkhomecare.org.

 

Advocacy Alert: Contact Your State Rep. Today to Support Home Care in FY13 Budget

The Massachusetts House of Representatives begins work on their version of the FY13 State Budget today and the Home Care Alliance needs your help sending emails to support home care’s priorities!

Visit our Legislative Action Center or see the issues below to send any of the pre-written messages that concern you and your agency. It only takes ONE MINUTE to enter your contact information, review your information, and the system will automatically send the message to the state representatives for your area.

Urge your state representative to support the following issues:

Restore Home Health Rates

»  Write Your Legislators    »  Read About This Issue  

Support Telehealth Reimbursement from MassHealth

»  Write Your Legislators    »  Read About This Issue  

Support Certificate of Need for Home Care

»  Write Your Legislators    »  Read About This Issue  

Support Pediatric Home Care

»  Write Your Legislators    »  Read About This Issue 

OR

Compose Your Own Message

»  Write Your Legislators

 

Return to www.thinkhomecare.org.

New Web Resource Available on Dual Eligible Demonstration Projects

Massachusetts is leading the charge with a plan to integrate care for dually eligible individuals and most other states have plans to improve care for that population under an Affordable Care Act Program.

A new web resource has been made available from the National Senior Citizens Law Center (NSCLC) that is a one-stop shop for all information about all the states involved in creating a new service delivery plan for the dually eligible.

The new website is dualdemoadvocacy.org and it consists of recommended background reading, state profiles, and advocacy tools. All of these resources are meant to promote the position of NSCLC, but they are general views that are in the best interests of the individual receiving services. Additionally, those views are in line with preventing unnecessary hospital admissions and keeping people in the community whenever possible.

The site also allows people to comment on NSCLC’s specific recommendations.

The Home Care Alliance is continuing its advocacy on the Massachusetts proposal and will provide more information as it becomes available.

Return to www.thinkhomecare.org.

Reminder: Submit Direct Service Worker Survey to EOHHS

Any home care agency receiving Medicaid funding to deliver services under the state’s Home Care Program is encouraged to fill out the Direct Service Worker Employer Survey distributed by the Executive Office of Health and Human Services (EOHHS).

The survey is a collaborative effort between EOHHS, the Home Care Alliance and the Mass Council for Home Care Aide Services. The survey itself is intended to collect state-specific data on the home and community-based direct service workforce including volume, stability, wages and compensation.

An online version of the survey is available. To access the online survey please go to https://www.research.net/s/MA-DSW-Employer-FE and type in your unique survey ID as provided in packet mailed to agencies by EOHHS.

If you have lost your survey packet with your unique survey ID or if you have any questions about the survey, please contact the Direct Service Workforce Resource Center toll-free at 1-877-822-2647.

More information is also available in this newsfeed post announcing the survey.

Return to www.thinkhomecare.org.

State Budget Update: House Ways and Means Releases Budget Proposal

The House Committee on Ways & Means released its proposal for the state’s fiscal year 2013 budget and while there are few changes in dollar amounts, here are the initial highlights:

  • The MassHealth Managed Careaccount (line item 4000-0500) follows the Governor’s proposal by increasing $183,988,029 over FY12 spending to $4,164,475,376.
  • The MassHealth Senior Care account (line item 4000-0600) also followed Governor’s budget blueprint by increasing $196,976,192 over FY12 spending to $2,763,630,662 .
  • The MassHealth Fee-for-Service Payments account (4000-0700) maintained the Governor’s proposal of increasing $129,850,745 over FY12 spending to $1,939,680,126.
  • Elder Enhanced Home Care Services (9110-1500) was given a bigger increase by House Ways & Means of $827,853 – as opposed to the Governor’s $672,147 – to a total of $47,289,340.
  • The Home Care Purchased Services account (9110-1630) is level funded at $97.8 million.
  • The Elder Nutrition account (9110-1900) is level funded at $6.3 million, which would restore a cut of $1.5 million made by the Governor.

This all essentially means that House Ways & Means followed the Governor when it came to the MassHealth accounts, which were increased with funding, but only to account for anticipated increases in enrollment. This budget proposal also shows a commitment to the state’s Home Care Program and restores the Elder Nutrition Program that funds “meals on wheels.”

What is not seen is increases to MassHealth home health rates or any language related to telehealth services, pediatric home care and a certificate of need process. The Home Care Alliance is pushing for amendments on these matters and will let member agencies, supporters and advocates know when they are officially submitted.

Additional items of note include a special commission to study elder protective services, increase public awareness of elder abuse, and establish reporting mechanisms.

Stay tuned as more information will be reported as it becomes available.

Return to www.thinkhomecare.org.

HCA Encourages Participation in New Direct Service Worker Survey

Organizations receiving Medicaid funding to deliver services under the state’s Home Care Program should be receiving a survey that is part of a study on Direct Service Workers funded by CMS. The Home Care Alliance encourages agencies to complete the survey that will help guide policies towards workforce improvement initiatives.

The Centers for Medicare and Medicaid Services has asked Massachusetts’ Executive Office of Health and Human Services and Executive Office of Elder Affairs to gather and report basic information about the volume, stability, wages, and compensation of the direct service workforce (DSW).

This information will allow state and federal policymakers to:

► Identify and set priorities for long-term support and services reform and systems change.
► Inform policy development regarding direct service workforce improvement initiatives.
► Promote integrated planning and coordinated approaches for long-term supports and services.
► Create a baseline against which the progress of workforce improvement initiatives can be measured.
► Compare workforce outcomes for various programs and populations to better evaluate the impact of policy initiatives.
► Compare state progress with the progress of other states and with overall national performance (where data from other states are available).

According to a cover letter that accompanies the survey, the information in the survey will help agencies and organizations compare themselves to others in Massachusetts and elsewhere in the country.

The survey itself is available online and includes instructions and a summary of purpose. Any questions related to the survey should go to the Direct Service Workforce Resource Center, available toll-free at 1-877-822-2647.

Return to www.thinkhomecare.org.

Comments Due on Dual Eligible Services Proposal

MassHealth’s final proposal for a State Demonstration to Integrate Care for Dual Eligible Individuals was submitted to CMS on February 16, 2012.  The final Demonstration Proposal and accompanying documents are listed on the demonstration’s webpage.

CMS is seeking public comment through a 30-day notice period.  During this time interested individuals or groups may submit comments to help inform CMS’ review of the proposal.   To be assured consideration, please submit comments by 5 p.m. EST, March 19. You may submit comments on this proposal to MedicareMedicaidCoordination@cms.hhs.gov.

The Home Care Alliance has offered formal suggestions prior to MassHealth’s submission of the proposal to CMS and will be submitting comments at this stage as well.  Any members interested in commenting can contact James Fuccione at the Alliance for guidance.

Return to www.thinkhomecare.org.

ABI Waiver Unit Shares Information for Home Care Agencies

As mentioned in a previous newsfeed post, MassHealth is soliciting services for a new waiver to care for individuals with Acquired Brain Injury in the community.

The ABI Waiver Unit at UMass Medical, which is the entity in charge of managing the waiver and disseminating related information, has released three documents (see below) to assist interested home care agencies in learning more and applying for waiver participation. The ABI Waiver Unit has indicated that they are specifically seeking speech, occupational and physical therapy services in the home.

  • ABI Description – One page summary of the state agencies and their roles in the implementation of the ABI Waivers
  • 2012 Technical Assistance Schedule – Statewide information sessions held to provide potential providers the opportunity to learn more about the Provider Enrollment Process
  • Credentialing Supplement – Outlines the submission requirements and the service specific submission requirements and defines the service expectations.

To RSVP for any of the technical assistance sessions, or to ask for more information, contact ABInetwMGr@umassmed.edu or call the UMass ABI Waiver Unit at 866-281-5602.

Return to www.thinkhomecare.org.

 

State Seeking Providers to Enroll in Community Based Service Waiver for Persons with Acquired Brain Injury

MassHealth, The Massachusetts Rehab Commission and UMass Medical School’s Acquired Brain Injury Unit are seeking service providers who work with individuals with Acquired Brain Injury (ABI) that reside in the community.

Two home and community-based services waivers, which MassHealth anticipates will serve 300 people over three years, are available for persons with ABI. These waivers, listed below, could help Medicaid-eligible persons with ABI move to the community from a nursing facility or chronic or rehabilitation hospital and get community-based services.

  • ABI Waiver with Residential Habilitation (ABI-RH) – This waiver is for individuals who need service in a provider-operated residence that has supervision and staffing 24 hours a day, seven days a week.
  • ABI Waiver with No Residential Habilitation (ABI-N)– This waiver is for individuals who can move to their own home or apartment or to the home of someone else.

All waiver participants will work with a case manager to develop a service plan that will reflect the waiver services and support they need in the community.

Services available in the ABI waivers include:

  • day services;
  • supported employment;
  • transportation;
  • community-based substance abuse treatment;
  • occupational, physical, or speech therapy;
  • specialized medical equipment;
  • homemaker;
  • personal care;
  • adult companion;
  • chore;
  • home-accessibility adaptations;
  • individual support and community habilitation; and
  • respite.

Additional ABI waiver services that will be contracted through MRC include:

  • Residential habilitation services; and
  • Transitional assistance services.

MassHealth regulations and provider enrollment forms are available here.

Also, UMass Medical School will be holding a series of technical assistance sessions to provide an overview of the waivers and services offered as well as an in-depth review of the application forms and submission requirements. The schedule for those sessions is below, and RSVP’s or questions can be sent to ABInetwMGr@umassmed.edu or by calling 866-281-5602.

 

 

 

 

 

 

Return to www.thinkhomecare.org.