Bulletin October 22nd, 2019

October 22nd, 2019

   
 

HOME HEALTH and HOSPICE: Ohio Department of Aging (ODA) News Release: Take advantage of National Prescription Drug Take-Back Day, Saturday, Oct. 26, 2019. The state agencies encourage older adults, families, to take advantage of the prescription drug Take-Back Day! Share this information with you staff and the individuals you serve.

 

HOME HEALTH and HOSPICE: New Medicare Card: MBI Transition Ends in Less Than 10 Weeks, CMS MLN Connects, October 17, 2019 – The 21 month Medicare Beneficiary Identifier (MBI) transition period ends on December 31, 2019. Are you ready?

Starting January 1, 2020, you must use the MBI when billing Medicare regardless of the date of service:

  • Medicare will reject claims submitted with Health Insurance Claim Numbers (HICNs) with a few exceptions
  • Medicare will reject all eligibility transactions submitted with HICNs

Many providers are using the MBI for Medicare transactions. For the week ending October 4, providers submitted 80% of fee-for-service claims with MBIs. Protect your patients’ identities by using MBIs now for all Medicare transactions.

 

HOME HEALTH and HOSPICE: White House Proclamation on Immigrants Could Limit Home Care Workforce, NAHC Report, October 18, 2019 On Friday, October 4th, President Trump issued a Proclamation outlining new guidance for the handling of immigrant visa applications. Starting November 3, 2019 the new requirement will mandate that immigrant visa applications be rejected if the government determines the immigrant in question will not be able to afford health insurance or cover the cost of their care. Applicants must be able to demonstrate their ability to obtain insurance within one month of their arrival. Alternatively, they would need to demonstrate financial resources sufficient to cover “reasonably foreseeable medical costs.”

 

HOSPICE: OIG Updates Work Plan for Hospice, NAHC Report, October 17, 2019 On October 4, 2019, the Medicare Payment Advisory Commission (MedPAC) began discussions around potential reform of the hospice Aggregate Cap (Cap). MedPAC is considering a recommendation under which the Aggregate Cap would be wage adjusted for the first time in history but may also consider a reduction in the Aggregate Cap amount: at the October meeting staff presented the findings of a simulation under which the Aggregate Cap would be wage adjusted but also reduced by 20 percent.

More recently, the Department of Health and Human Services Office of the Inspector General (OIG) announced that, as part of its Work Plan, its Office of Audit Services is undertaking a review of both Hospice Inpatient and Aggregate Cap calculations.

 

RCD UPDATES –                                                                                                                      

ANNOUNCEMENT: OCHCH Weekly RCD Conference Calls

OCHCH recently launched an awareness campaign to provide your agency with the assistance, information, resources, and training you need to tackle the challenges of RCD and PDGM. This campaign is called OPERATION: tackle.

As part of OPERATION: tackle we will be hosting weekly conference calls on RCD beginning this week that will continue for the foreseeable future. These conference calls will provide an opportunity for us to share the latest developments of RCD, for you to share your challenges, and for our members to share best practices in a real time environment. Even better you will hear from national leaders and experts such as Bill Dombi, President of NAHC, as well as people in other RCD states.

DON’T MISS THIS OPPORTUNITY!! Please mark your calendars for EVERY FRIDAY @ 10am. THE FIRST CALL WILL BE ON FRIDAY, OCTOBER 25 AT 10AM. The calls will last no more than an hour.

Call-in info is: 605-472-5491, passcode is 473521.

Give us a call if you have any questions. Talk to you soon!

The RCD Demonstration started on September 30, 2019. All episodes of care, both initial and recertifications starting on or after this date are subject to the requirements of the choice selected.

DO YOU HAVE A RCD QUESTION?

FOLLOW THESE INSTRUCTIONS FOR THE QUICKEST WAY TO A LIVE RCD AGENT.

Dial 855-696-0705

Press “0” at the main menu

Press “0” again

Press “3” for HHH

Press “1” for an RCD agent

All RCD provider questions must go through the Palmetto GBA Provider Contact Center (PCC) at 855-696-0705. However, if your questions are not being answered, you are not receiving a call back in a timely manner, or you need assistance to contact Palmetto GBA, PLEASE contact OCHCH by using helpdesk@ochch.org OR call 614-885-0434.

Find RCD Answers through the Review Choice Demonstration (RCD) for Home Health Services Frequently Asked Questions (FAQs)

STAY TUNED FOR FUTURE OCHCH EDUCATIONAL EVENTS!

 

NEW>>> PDGM UPDATES –

Home Health Patient-Driven Groupings Model (PDGM) Webcast Part One: November 21, 2019

This is the first of two collaborative webcasts about the Home Health Patient-Driven Groupings Model (PDGM), hosted by your Home Health Medicare Administrative Contractors (MACs), CGS, National Government Services and Palmetto GBA. This presentation will begin on Thursday, November 21, 2019 at 02:00 PM Eastern Standard Time. During this webcast, you will receive information to help your agency prepare to implement billing changes for the PDGM on January 1, 2020. PDGM is the Medicare payment model used to reimburse home health agencies. Please plan to attend.

Home Health Patient-Driven Groupings Model (PDGM) Webcast Part Two: December 5, 2019

This is second part of two collaborative webcasts about the Home Health Patient-Driven Groupings Model (PDGM), hosted by your Home Health Medicare Administrative Contractors (MACs), CGS, National Government Services and Palmetto GBA. This presentation will begin on Thursday, December 05, 2019 at 02:00 PM Eastern Standard Time. During this webcast, you will receive information to help your agency prepare to implement clinical changes for the PDGM on January 1, 2020. PDGM is the Medicare payment model used to reimburse home health agencies. Please plan to attend.

Our Take

  

OUR TAKE!!!  
By Alexandra Weingarth

EVV Updates

The EVV update last Wednesday was full of updates. Literally. For non-agency providers 63% of them have not completed training. 44% of Agency providers have not completed training. However, even if they did get trained, there are still visits not being logged. If you are trained, please start logging your visits! As you know there are a few different ways to log your visit. Currently, EVV mobile devices are being the most used method (thus far) to log visits instead of Telephony or manual entry. If you are having issues, please contact ODM, sooner rather than later.

More updates ! The Department of Aging has announced that they will be providing two different items to help providers easily and quickly access the system. They will be giving “provider client cards” to put on the fridge of the homes of the individuals. This can be used as a quick reference guide for questions. More details to come in later meetings.

Even more updates! The Department of Disabilities provided data that depicted the claims that require EVV and the results are in: out of 60,000 claims per week 15% of those are processed. There are still a good amount of claims with NO EVV validation. However, They have good news! Recently, The ones that are submitted are mostly 100% validated. DoDD has shown the improvement overtime for validating claims data- improving the 100% EVV validation weekly.

IMPORTANT: Process changes for Alternate EVV Certification.

OHAltEVV@sandata.com; 844-289-4246; help desk live NOW.

Zen desk is the new ticketing system that will help with communication for the Alternate EVV process. This process change is to help vendors to communicate with Sandata on behalf of agencies and also for quality improvement . Use this number for certificate initiation and support requests. Communication will NO LONGER come through eTRAC no does the Vendor have to be listed on eTRAC. You can CC them on the email for all process help.

Additionally, if you are in the process of certifying the alternate EVV system, or if you are using an alternate system, you are now required to complete a demonstration. You must submit this request by November 15th, 2019. If you do not schedule a demo or successfully complete one, it may lead to decertification of the Alternative vendor. An ODM staff member, the alternative vendor, Sandata, and the provider all must be in attendance during the demonstration. ODM will then provide the results and a “checklist.” If the demonstration fails, the vendor must update the system and schedule another demo with ODM. The reason for the demonstration is to help providers make sure that they are in compliance with ODM be able to provide all the required functionality, including the ability to send information to Sandata.

 

 
Alexandra Weingarth is the Policy and Advocacy Director for the Ohio Council for Home Care and Hospice

HelpDesk Question of the Week

 
 

Helpdesk Question of the Week –

EVV Our Take

The EVV update last Wednesday was full of updates. Literally. For non-agency providers 63% of them have not completed training. 44% of Agency providers have not completed training. However, even if they did get trained, there are still visits not being logged. If you are trained, please start logging your visits! As you know there are a few different ways to log your visit. Currently, EVV mobile devices are being the most used method (thus far) to log visits instead of Telephony or manual entry. If you are having issues, please contact ODM, sooner rather than later.

More updates ! The Department of Aging has announced that they will be providing two different items to help providers easily and quickly access the system. They will be giving “provider client cards” to put on the fridge of the homes of the individuals. This can be used as a quick reference guide for questions. More details to come in later meetings.

Even more updates! The Department of Disabilities provided data that depicted the claims that require EVV and the results are in: out of 60,000 claims per week 15% of those are processed. There are still a good amount of claims with NO EVV validation. However, They have good news! Recently, The ones that are submitted are mostly 100% validated. DoDD has shown the improvement overtime for validating claims data- improving the 100% EVV validation weekly.

IMPORTANT: Process changes for Alternate EVV Certification.

OHAltEVV@sandata.com; 844-289-4246; help desk live NOW.

Zen desk is the new ticketing system that will help with communication for the Alternate EVV process. This process change is to help vendors to communicate with Sandata on behalf of agencies and also for quality improvement . Use this number for certificate initiation and support requests. Communication will NO LONGER come through eTRAC no does the Vendor have to be listed on eTRAC. You can CC them on the email for all process help.

Additionally, if you are in the process of certifying the alternate EVV system, or if you are using an alternate system, you are now required to complete a demonstration. You must submit this request by November 15th, 2019. If you do not schedule a demo or successfully complete one, it may lead to decertification of the Alternative vendor. An ODM staff member, the alternative vendor, Sandata, and the provider all must be in attendance during the demonstration. ODM will then provide the results and a “checklist.” If the demonstration fails, the vendor must update the system and schedule another demo with ODM. The reason for the demonstration is to help providers make sure that they are in compliance with ODM be able to provide all the required functionality, including the ability to send information to Sandata. 

Regulatory & Policy Digest

 

HOME HEALTH and HOSPICE: Key Senate Committee Approves Funding for Community-Based Programs, NAHC Report, October 17, 2019 – Recently the Senate Appropriations Committee announced legislation funding the departments of Labor, Health and Human Services (HHS), and Education. This legislation outlines discretionary spending limits allowable to HHS as well as recommendations from the Congress on how the money is allocated within agencies and programs.  While much of home health and hospice spending is mandatory and not subject to appropriations there are several programs of interest that are subject to this annual process.

Included within this package is funding for the Administration for Community Living (ACL) to carry out the Older Americans Act. For the ACL, the committee is recommending an overall allocation of $2.175 billion. Within the ACL there are four programs receiving funding of note to home health and hospice providers.

They are as follows:

  • Home and Community-Based Supportive Services ($385 million)
  • National Family Caregiver Support Program ($181 million)
  • Lifespan Respite Care Program ($6 million)
  • State Health Insurance Assistance Program ($49 million)

There is still much work to be done for this legislation to become law. It will still need to be approved by the full Senate Appropriations committee, as well as the entire Senate. Previously, in July the House of Representatives approved their package of similar legislation. Any differences between the two chambers versions will need to be aligned for a final package to present to President Trump.

 

HOME HEALTH and HOSPICE: CMS Provides Direction to MACs on Use of Adjustment Codes, NAHC Report, October 18, 2019 Via Transmittal 4415/Change Request (CR) 11113 – Medicare Administrative Contractor (MAC) Guidance Related to Use of Adjustment Codes on Adjustment Claims – the Centers for Medicare & Medicaid Services (CMS) directs the MACs to refine the claims adjustment reporting process to categorize adjustments by the origin of the adjustment request.

The implementation date is January 6, 2020.

 

HOSPICE: Hospice Industry Seeks Solutions to Issues in OIG Reports, Hospice News, October 21, 2019 – Debate continues about how the hospice industry, as well as regulators, should respond to the reports on hospice care issued in July by the U.S. Department of Health and Human Services Office of the Inspector General (OIG) that included recommendations to the U.S. Centers for Medicare & Medicaid Services (CMS) on changing their processes for evaluating compliance.

 

HOME HEATLH and HOSPICE: MedPAC Pushes for Aligning Payments, Regs, Benefits, NAHC Report, October 16, 2019 – The Medicare Payment Advisory Commission (MedPAC) recently convened for a session furthering their work on the development of a unified post-acute care prospective payment system (PAC PPS). In this most recent session, a focus was placed on the applicability of co-pays and potential requirements to access post-acute care (PAC) care via a required hospitalization.

The IMPACT Act of 2014 directed the MedPAC to develop a unified system where different care settings would be reimbursed the same amount dependent upon patient characteristics rather than unique payments that vary by the setting. Congress’ goal in this directive to MedPAC was to lessen the likelihood of patient selection by the different PAC providers based on what might drive profits.

OCHCH will keep you informed on any changes that may occur due to MedPac and regulations.

 

HOME HEALTH and HOSPICE: LCD and Medical Coverage Database Article Updates, Palmetto GBA
 

HOME HEALTH and HOSPICE: Appeal Levels and Timely Filing Limits: Helpful Information, Palmetto GBA 
 

HOME HEALTH and HOSPICE: ePass is Available to Ease the Burden of Repeated Authentication When Calling Palmetto GBA's Provider Contact Center, Palmetto GBA
 

HOSPICE and HOME HEALTH: Hospice and Home Health Claims Processing Issues Log, Palmetto GBA
 

HOSPICE and HOME HEALTH: Ohio BWC Provider eNews - October 2019 BWC distributes Provider eNews monthly via email to keep providers up to date on the latest workers' comp news that impacts them. Here you'll find an archive of past editions.

 

Upcoming Education & Events

 
For Upcoming webinars, conferences, workshops and events click HERE
 
 
 

News Clips & Links

 

HOSPICE: CMMI Strategy Officer: Private Sector Will Emulate Primary Care First, Hospice News, October 16, 2019

HOSPICE: Complementary Therapies Can Build Hospice Market Share, Hospice News, October 16, 2019

HOSPICE: Hospice Leads to Higher Satisfaction for Kidney Disease Patients, Hospice News, October 21, 2019

   
 

Ohio Council for Home Care & Hospice  1105 Schrock Rd., Suite 120, Columbus, OH 43229
(614) 885-0434   www.ochch.org