Bulletin: October 29th, 2019

October 29th, 2019




HOSPICE and PALLIATIVE CARE: CMS: Palliative Care and Hospice Can Now Apply to Primary Care First, CMS List Serve, October 24, 2019 – The U.S. Centers for Medicare & Medicaid Services (CMS) will be hosting two new webinars to help you learn more about the model and apply:

HOSPICE and PALLIATIVE CARE: CMS Delays Primary Care First Implementation to 2021, Hospice News, October 28, 2019 – Though the U.S. Centers for Medicare & Medicaid Services is now accepting applications to participate in the agency's new Primary Care First payment models, the agency has delayed the program's launch to 2021, as opposed to the original Jan. 1, 2020 date.

HOME HEALTH and HOSPICE: 2020 Ohio Minimum Wage Increased to $8.70 Per Hour. Ohio Department of Commerce, October 2, 2019 – As of January 1, 2020, the minimum wage for non-tipped employees in Ohio will rise from $8.55 to $8.70 per hour, a 15-cent increase. Any tipped employees will have their base pay go from $4.30 to $4.35 an hour. 

HOME HEALTH: SE19005 – What New Home Health Agencies (HHAs) Need to Know About Being Placed in a Provisional Period of Enhanced Oversight, MLN Matters® Special Edition, October 25, 2019 – CMS will focus on new HHAs in all states and territories during the initial use of the provisional period of enhanced oversight authority. For the provisional period of enhanced oversight authority, “new” providers includes all initial enrollments, changes of ownership (CHOWs) that fall under 42 C.F.R §489.18, and changes of information reporting a100% ownership change.

HOME HEALTH: Request for Anticipated Payment (RAP) Overpayment Demand Letters, Palmetto GBA, Monday, October 28, 2019 – If your HHA has received a Request for Anticipated Payment (RAP) overpayment demand letter dated between October 7, 2019 to October 25, 2019, Palmetto GBA asks that you please disregard that letter and that no further action is required to remit a check payment or initiate a request for immediate offset.


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 are hosting weekly conference calls on RCD that started last week and 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.

The very first RCD call on October 25, 2019 went well. There were a lot of very technical questions, but overall it looks like there has been a decent affirmation rate thus far. The main issue that people are concerned about is with re-certifications. The other primary issue seems to be with the call center staff not knowing the proper regs and procedures, etc. OCHCH has brought these two issues to Palmetto GBA’s attention. When Palmetto has resolutions to these two issues we will share them.

Please read the October 25th RCD Call follow up information that was posted on the listserv.

DON’T MISS THIS OPPORTUNITY!! Please mark your calendars for EVERY FRIDAY @ 10am. THE NEXT CALL WILL BE ON FRIDAY, NOVEMBER 1 AT 10AM. The calls will last no more than an hour.

Call-in info is:

Login - https://web.telspan.com/go/ochch/ochchpdgm


Dial: 888-392-4564

Passcode: 7896828#

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.



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)

Monthly Review Choice Demonstration (RCD) Provider Teleconference Schedule

(11/06/2019 and 12/04/2019)





The following webcasts are hosted by the MACs:

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


By Joshua Wagner

I love writing things for this bulletin!  Why?  Because I get to tell about all the free stuff and discounts!  It's a lot like being Santa Claus!  


The Ohio Council for Home Care & Hospice (OCHCH) is pleased to offer RCTCLEARN.NET to our members at a special introductory price of $199 per agency. RCTCLEARN.NET provides quality continuing education (CE) training to agency professionals, home health care aides, LPNs, RNs, therapists, and volunteers.

This online learning resource provides you with access to more than 100 courses for professionals and paraprofessionals. Each course features a fully-integrated curriculum created specifically for the home care and hospice industry by the Center for Business and Workforce Education at Rochester Community and Technical College (RCTC). Each course features printed certificates, links to further information and quizzes. You can easily track the progress of your individual employees who are using the program.

This is an excellent addition to your on-boarding and training program! Add RCTCLEARN to your training program.

Popular courses include: Medicare 101 for Home Care Professionals, Patient Privacy and HIPAA Overview, Approaching Care for Dementia, Basic Infection Control for the Paraprofessional, Providing Personal Care, Approaching Care for Difficult Behavior and more.

RCTCLEARN is an approved provider of continuing nursing education by the Wisconsin Nurses Association, an accredited approver of the American Nurses Credentialing Center’s Commission on Accreditation.



Joshua Wagner is the Marketing and Communication Director for the Ohio Council for Home Care and Hopsice

HelpDesk Question of the Week


Helpdesk Question of the Week –

HOSPICE: Retired HCPC codes

Question: If an order for RX or CMN is recertified or refilled with the previous active hcpc code that was retired, does that require the provider to redo the order for recertification with the replaced new hcpc code?  

Answer: I reached out to my contact at Palmetto GBA for clarification on this issue. The Palmetto GBA response was “No it is not necessary to change to the new code.”

Regulatory & Policy Digest


HOME HEALTH and HOSPICE: OAHP & MyCare Ohio Plans Long-Term Care Provider Survey, OAHP – The MyCare Ohio Plans, which include Aetna, Buckeye, CareSource, Molina, and United Healthcare, are collaborating on an initiative to identify opportunities to reduce administrative burden for Long Term Care (LTC) providers. This is your chance to request changes to: the Prior Authorization process; plans not following payer of first resort; plans not following the Medicare regulations and Medicaid rules; providers not able to contract with plans; require all plans to standardize process; delayed reimbursement; receiving less than the Medicaid rate; etc. The survey will be open until November 14, 2019. Click here for more info and the link to the survey.

HOME HEALTH and HOSPICE: CMS Pushes Effort to Curb Medicare Fraud, NAHC Report, October 25, 2019 CMS has also released two requests for information (RFI) to obtain input on how to advance their anti-fraud Medicare program. The first RFI, CMS asks for comments on using technology to improve anti-fraud activity and ease provider burdens. In the second RFI, CMS asks for feedback on their program integrity efforts.  Please submit your comments to Beth Foster at beth@ochch.org or to Kathy Royer at kathy@ochch.org by November 15, 2019.

CMS Pushes Effort to Curb Medicare Fraud, pdf

HOSPICE: Register for the Hospice Webinar: Success with the HQRP: Putting the Pieces Together to Meet Compliance CMS List Serve, October 23, 2019

Date: Thursday, November 14, 2019

Time: 2:00-3:00 p.m. ET

Description: The Centers for Medicare & Medicaid Services (CMS) will be hosting a webinar for Medicare-certified hospice providers to provide an overview on Hospital Quality Reporting Program (HQRP) requirements.

Please register HERE.

HOSPICE: Hospice Payment Booklet is Available, NHPCO Newsbriefs, October 24, 2019 The Hospice Payment System Medicare Learning Network booklet is available with updated information about: coverage and certification requirements, Election periods and statements, and caps on payments

Hospice Payment Booklet is Available

HOSPICE: Targeted Probe and Educate Progress Update: Hospice - NCLOS, Palmetto GBA, September 25, 2019--The Centers for Medicare & Medicaid Services (CMS) implemented the Targeted Probe & Educate (TPE) process, effective October 1, 2017. This article provides TPE results statistics from October 1, 2017 - October 1, 2019, for Jurisdiction M Home Health and Hospice - NCLOS. Please review and share with your staff.

HOME HEALTH and HOSPICE: November 2019 JM Home Health and Hospice Medicare Advisory, Palmetto GBA  

HOME HEALTH and HOSPICE: Notification of the 2020 Dollar Amount in Controversy Required to Sustain Appeal Rights for an Administrative Law Judge (ALJ) Hearing or Federal District Court Review, Palmetto GBA 

HOME HEATLH and HOSPICE: Local Coverage Determination (LCD) and Medical Coverage Database (MCD) Article Updates: Home Health and Hospice, Palmetto GBA 

HOME HEALTH and HOSPICE: Active Medical Reviews, Palmetto GBA

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

Upcoming Education & Events


For Upcoming webinars, conferences, workshops and events click HERE

QIRT 5- Part Webinar Series - https://members.ochch.org/ev_calendar_day.asp?date=10/29/2019&eventid=124

(Individual Parts available for purchase)

PDGM Impact on OASIS - https://members.ochch.org/ev_calendar_day.asp?date=11/19/2019&eventid=139

PDGM Clinical Episode Management - https://members.ochch.org/ev_calendar_day.asp?date=11/21/2019&eventid=140


News Clips & Links


PALLIATIVE CARE: Study: Analytics Boosted Palliative Consults 74%, Hospice News, October 23, 2019

HOSPICE: Home-Based Primary Care May Be Hospices’ Next Frontier, Hospice News, October 28, 2019

HOSPICE: Hospices to Focus on Reducing Hospitalizations Under Value-Based Models, Hospice News, October 23, 2019

PALLIATIVE CARE and HOSPICE: CMS Primary Cares to Include New Track for High-Cost Patients, Hospice News, October 23, 2019


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