Tag: Medicare

Alliance Statement on CMS’ Final Rule Slashing Home Health Care Payments

The following is a statement from the Home Care Alliance regarding the CMS Final Rule on Home Health Rebasing. The Alliance invites its members and advocates to share this with their local media:

In a final rule released last Friday, the Centers for Medicare and Medicaid Services (CMS) have implemented a home health payment that will result in a 3.5 percent cut per year for the next four years.

It would be easy based on history to view the recent final rule from the Centers for Medicare and Medicaid Services (CMS) as “another year, another cut.” This year, however, is different.

The home health industry has absorbed $78 billion of cuts since 2009, which will be executed over the better part of the next decade. Those cuts come from the Affordable Care Act, other CMS final rules over recent years, and sequestration. The latest cuts amount to an additional and an untenable 14 percent – or $22 billion – reduction over the next four years.

These total reductions since 2009 and including the CMS final rule are comparable to the combined 2013 budgets of the federal departments of education and homeland security.

With an aging population and home health agencies caring for sicker patients that are released from the hospital at an earlier stage of recovery, the federal Medicare program is making it nearly impossible for quality providers to continue delivering effective services that end up saving taxpayers by preventing costlier facility-based health care under these circumstances.

The Home Care Alliance of Massachusetts joined providers and associations from across the country, as well as many members of Congress, in urging CMS to revisit what they had proposed back in July. Those calls and letters went disregarded and it is evident that CMS is trying to attain a numerical target in their budget ignoring logic at the expense of American seniors who benefit from care at home. CMS claims the cuts amount to a 1.05 percent reduction, which is a slight improvement over the proposed rule, but the cumulative impact of continued cuts scheduled for 2015, 2016, and 2017 drive the cut deeper.

The Home Care Alliance will be assembling with other advocates in Washington DC and online in a campaign to persist in opposing the cuts from CMS.

About the Home Care Alliance:

With a mission to unite people and organizations to advance community health through care and services in the home, the Home Care Alliance of Massachusetts is a non-profit trade association and advocacy group representing the voice of the state’s home-based health and care services. Founded in 1969, the Alliance represents 200 home care and home health agencies. For more information, visit www.thinkhomecare.org.

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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.

Home Health ODF: Ask-the-Contractor Teleconference

National Government Service’s  Home Health Open Door Forum: Ask-the-Contractor Teleconference (ACT) is scheduled for Tuesday, December 10, 2013 from 1:30-3:00 pm  This teleconference will provide updates to the home health provider community and a forum for questions and answers. The ACT is an opportunity to speak directly to the contractor, so please have your questions ready for the contractors to answer!

Date: Tuesday, December 10, 2013
Time: 1:30-3:00 p.m. ET

Register for session

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.

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

Return to www.thinkhomecare.org.

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.

Return to www.thinkhomecare.org.

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.

 

Return to www.thinkhomecare.org.

In Choosing A Healthcare Provider, It’s “Your Care, Your Choice”

Last week, the Alliance published its “Keeping It Legal” brochure to educate health care providers about lawful referral practices.

This week, we’re following up with a companion guide on the subject, designed for patients and families titled “Your Care, Your Choice,” which reminds patients of their right to choose their own providers, and empowers them to report facilities that attempt to violate these rights.

To download the brochure, click the down arrow button immediately above this text.  Please feel free to distribute it to everyone who can benefit from it.

Return to www.thinkhomecare.org.

Revised Publication Available for Reporting Fraudulent Home Care Referral Practices

In an effort to help home health agencies educate their partners in the provider community about lawful referral practices, the Home Care Alliance has revised and updated the first in a publication series called “Keeping It Legal.”

The document below is intended for distribution to hospitals, physicians, skilled nursing facilities and other sources that refer patients for Medicare-certified home health services. The Alliance has updated contact information for oversight entities so that providers, patients or the families of patients can accurately report fraudulent activity if they wish to do so. The document also lays out some of the basic examples of wrongful activity that should be reported.

With the help of HCA members and those they work with and work for, the Alliance hopes that this document will be passed along and posted prominently in an effort to promote home health services that are high-quality and ethical.

 

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.