Bulletin: December 10th, 2019

December 10th, 2019



HOSPICE: MedPAC Advances Hospice Cap Reforms, FY2021 Payment Recommendations and Initial Findings on Impact of Post-Acute Transfer Policy on Hospice, NAHC Report, December 9, 2019 – On December 5 and 6, the Medicare Payment Advisory Commission (MedPAC) held a public meeting at which members discussed recommendations under consideration for inclusion in its annual MedPAC Report to Congress that is usually released in March. MedPAC will finalize its recommendations at a forthcoming meeting in mid-January. Relative to hospice payment policy MedPAC took the following actions:
  • Considered the following recommendations and gave them preliminary approval:
  • Congress should eliminate the update to hospice base payments in FY2021
  • Congress should reform the aggregate cap in the following ways:
  • Wage adjust the aggregate cap to account for variation in labor costs
  • Cut the aggregate cap value by 20%
  • MedPAC also briefly discussed preliminary findings on a mandated study of the impact of legislation that extended the post-acute transfer policy to early discharges to hospice (which became effective October 1, 2018) on access to care; indications so far are that there have been small savings associated with the change without significant changes in access to hospice services. A preliminary report is due in March 2020 and a final report is mandated to be submitted to Congress in March 2021.

HOSPICE: Average Hospice Length of Stay on the Rise, Hospice News, December 4, 2019 – The average length of stay for hospice patients in the United States rose 5% to 77.9 days during 2018, up from 74.5 days in 2017, according to a new report from health care data analytics firm Trella Health. 

HOME HEALTH and HOSPICE: New Standards for Handling Hazardous Drugs in Health Care Settings, NAHC Report, December 5, 2019 Effective December 1, 2019, all health care providers are required to follow standards for the safe handling of hazardous drugs (HDs). These standards apply to all health care personnel who receive, prepare, administer, transport or otherwise come in contact with hazardous drugs and all the environments in which they are handled. The standards related to preparing, administering, and disposing of HDs are areas that will most likely apply to home health and hospice providers.
HOME HEALTH and HOSPICE: MBI Transition Ends This Month: Will You Be Paid On January 1?, Palmetto GBA – The 21 month transition period will end on December 31; use Medicare Beneficiary identifiers (MBIs) now!
• Providers are currently submitting 86% of claims with MBIs.
• Get MBIs from your patients and through the MAC portals (sign up) now and after the transition period.
• Providers can also find the MBI on the remittance advice.
• Protect your patients from identity theft - use MBIs.
Starting January 1, if you do not use the MBI (regardless of the date of service) for Medicare transactions
• Palmetto GBA will reject your claims with a few exceptions
• Palmetto GBA will reject all eligibility transactions

See the MLN Matters Article for more information on getting and using MBIs 

HOME HEALTH: HHAs: Avoid Payment Delays, Register for iQIES by December 23 Act now!
Home Health Agencies (HHAs) need access to the upgraded Internet Quality Improvement and Evaluation System (iQIES) to submit assessment data beginning January 1. CMS will return claims that cannot be matched to assessments, delaying your Medicare payments. See the MLN Connects Special Edition article SE 19025 for: Background, Step-by-step instructions, Training videos, FAQs, and How to get help

HOME HEALTH: Home Health Prospective Payment System (HH PPS) Rate Update for Calendar Year (CY) 2020, Palmetto GBA – Change Request (CR) 11536 updates the CY 2020 60-day and 30-day base payment rates, the national per-visit amounts, Low-Utilization Payment Adjustment (LUPA) add-on amounts, the non-routine medical supply payment amounts, and the cost-per-unit payment amounts used for calculating outlier payments under the HH PPS. In addition, this CR revises the initial payment percentage for both initial and subsequent 30-day periods of care under the split percentage payment approach for CY 2020. CMS revised this article on December 3, 2019, due to a revised Change Request (CR) which corrected the LUPA add-on factors in the 2020 record layout in manual Section 70.2. Make sure that your billing staff is aware of these changes.

HOME HEALTH: Home Health Quality Reporting Program Updates, NAHC Report, December 5, 2019 – Read about OASIS Considerations for Medicare PDGM Patients, CMS Seeks Public Input, CMS Simplifies Data on Tally Reports, and Information on CY2020 HH QRP Changes Posted.

>>>RCD UPDATES –                                                                                                                  

OCHCH Members: Thank you very much for participating in OCHCH’s December 6th RCD WEEKLY CALL!
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 on October 25th 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.
Next OCHCH Weekly RCD Conference Call - Friday, DECEMBER 13, 2019 at 10am!
DON’T MISS THIS OPPORTUNITY!! Please mark your calendars for EVERY FRIDAY @ 10am. The calls will last no more than an hour.
Call-in info through December 2019 will remain the same as all of the November calls:
Login - https://web.telspan.com/go/ochch/ochchpdgm
Dial: 888-392-4564
Passcode: 7896828#
If you have trouble getting on the Call – PLEASE CALL OCHCH 1-614-885-0434 Ext.206, or e-mail ryan@ochch.org
ATTENTION: Check out the updated RCD Toolkit located in the members’ section of the OCHCH site. Just login to “My Profile” and in the left column under “HELP DESK ONLINE” click on “RCD Toolkit.”
The links to the RCD Call Recordings for the month of November and December 6th are available in the RCD Toolkit.
Dial 855-696-0705
Press “0” at the main menu
Press “0” again
Press “3” for HHH
Press “1” for an RCD agent
REMINDER: 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 and use subject title, “RCD” and include the UTNs, OR call 614-885-0434 Ext 209.
Find RCD Answers through the updated October 16, 2019 Review Choice Demonstration (RCD) for Home Health Services Frequently Asked Questions (FAQs)
Monthly Review Choice Demonstration (RCD) Provider Teleconference Schedule – Next date and call-in information has not been posted.
Quarterly Review Choice Demonstration (RCD) Medical Review Teleconference Schedule – Next date is 12/11/2019
PDGM and the Review Choice Demonstration (RCD)When PDGM starts, HHAs in the Pre-Claim Review (PCR) option will need to submit a PCR request for each 30-day period.


The OCHCH campaign to support your agency’s PDGM needs is up and running!
The first OCHCH Weekly PDGM Conference Call is(was) TODAY – Tuesday, DECEMBER 10, 2019 at 3pm!
DON’T MISS THIS OPPORTUNITY!! Please mark your calendars for EVERY TUESDAY @ 3pm. The calls will last no more than an hour.
Login – https://web.telspan.com/go/ochch/weeklypdgm
Dial: 888-392-4564
Enter: 1115130#
**This PDGM login/call-in information will be the same for each week**
If you have trouble getting on the Call – PLEASE CALL OCHCH 1-614-885-0434 Ext.206, or e-mail ryan@ochch.org
Check out the updated PDGM Toolkit located in the members’ section of the OCHCH site. Just login to “My Profile” and in the left column under “HELP DESK ONLINE” click on “PDGM Toolkit.”

If you have questions PLEASE contact OCHCH by using helpdesk@ochch.org and use subject title, “PDGM,” OR call 614-885-0434 Ext 209.

In addition to the weekly PDGM calls, Beth Foster and Kathy Royer have been and will continue to answer PDGM questions.
OCHCH will have a number of recordings available on our website of previous PDGM education webinars for your purchase or access. Moving forward OCHCH is committed to bringing you continued education on the implementation of PDGM and its impacts on our industry.
The following two webcasts were hosted by the MACs:
Recording of the Home Health Patient-Driven Groupings Model (PDGM) Webcast Part I: November 21, 2019 is now available, but new viewers need to register to view it

Recording of the Home Health Patient-Driven Groupings Model (PDGM) Webcast Part Two: December 5, 2019 is now available. Please share this information with your staff.

Payments and Payment Adjustments under the Patient-Driven Groupings Model, Palmetto GBA – This article provides information on the implementation of the new Home Health Prospective Payment System (HH PPS) case-mix adjustment methodology named the Patient-Driven Groupings Model (PDGM). The PDGM will be implemented for home health periods of care starting on and after January 1, 2020.  This MLN Matters Number: SE19028 is a very comprehensive tool to share with staff so they develop a better understanding of the PDGM.

OASIS Considerations for Medicare PDGM Patients – This document provides PDGM transition guidance for OASIS time points.

Our Take

 OUR TAKE – Joshua Wagner: Director of Marketing
The Ohio Council for Home Care and Hospice NOW has the ability to save you money on things you already buy!

Did you know that the Ohio Council for Home Care and Hospice has an "affinity plan?"  That means that one of the member perks of being part of the OCHCH is that you can save on stuff you already use and buy.  No additional fees to participate either!  You get this for just being a member!  It's basically free money!

So, do you want to start saving now on things like Office Max, Verizon, gloves, cleaning supplies, and even medical machines and equipment?! (See the full list here)

Here is what you need to do:

  1. Follow this link
  2. Sign up
  3. Get your Member ID Number
  4. Use it to get discounts on supplies and services you already use!  

It is just that easy!!!!!!!!

If you have any questions, just email me at Josh@ochch.org and I will be happy to walk you through the process.






Joshua Wagner
Director of Marketing and Communication

HelpDesk Question of the Week

  Helpdesk Question of the Week –
HOSPICE: Volunteer Hours
Question: I have a question about volunteer hours and what can be counted.  Specifically our organization has a funnel cake stand that we take to area festivals as an advertising and marketing devise.  100% of all profits from the sale of the funnel cakes goes toward our hospice, we are not for profit.  Since we are making these for the public not our patients can these hours be captured toward our 5% total care hours as an administrative function? 
Answer: No you could not count the hours toward your 5%.  I have copied the list below from the NHPCO Volunteer Hours Questions and Answers. 
What activities don’t count towards the 5% cost savings calculation?
Hospices may use volunteers in non-administrative and non-direct patient care activities, but CMS has stated that they are not eligible for inclusion in the 5% calculation. Some of these activities include:
  • Craft projects
  • Quilting/ sewing/knitting
  • Cooking and baking
  • Group singing for general patient population
  • Orientation, in-service education
  • Interdisciplinary team meetings
  • Board participation and board meetings
  • Community events (i.e.: health fairs)
  • Marketing activities



Regulatory & Policy Digest


HOSPICE: Update on Hospice CAHPS, NHPCO Newsbriefs, December 5, 2019 –
  • The response rate for the current reporting period, Quarter 1, 2017 through Quarter 4, 2018 is 32%.
  • Updates to the Case-Mix Adjustment (CMA) Methods document which describes refinements to the CMA model, updated coefficients and means from Quarter 2, 2017 to Quarter 1, 2019
  • The state score document for the upcoming public reporting period, Quarter 2, 2017 through Quarter 1, 2019, is available.
  • The National Percentiles document for the upcoming public reporting period, Quarter 2, 2017 through Quarter 1, 2019, is available.
  • The list of ICD-10 codes used for the Case-Mix Adjustment calculations is available. This document will permit a survey vendor or hospice to closely approximate the effect of case-mix adjustment on CAHPS Hospice Survey results.
HOSPICE: Stay on Target with the Hospice Comprehensive Assessment Measure - One Pager Now Available, CMS List Serve, December 5, 2019 – CMS has posted a document that articulates key information about the Hospice Comprehensive Assessment Measure. This one pager provides a visual to understand how the seven HIS measures contribute to the one Comprehensive Assessment Measure, and how to stay on target by completing all seven HIS measures for each patient. The document is now available in the Downloads section of the Current Measures page.
HOSPICE: Update on Preventing and Responding to Ransomware, NHPCO Newsbriefs, December 5, 2019 – The Office of Civil Rights recently posted a newsletter that supplements previously published materials on how the HIPAA Security Rule can help prevent, mitigate and recover from ransomware attacks by providing insight into new developments and trends and how organizations can improve their security in response to this threat.

HOME HEALTH and HOSPICE: Active Medical Reviews, Palmetto GBA

HOME HEALTH and HOSPICE: Home Health and Hospice (HH&H) Medicare Quarterly Updates, Changes and Reminders Webcast Will Be Held on December 19 at 2 p.m. , 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

Click Here to Register!

News Clips & Links

PALLIATIVE CARE: United States Ranks High in Palliative Care Access, Hospice News, December 9, 2019

PALLIATIVE CARE and HOSPICE: Hospice by the Bay CFO: Palliative Care Growth in Time Will Outstrip Hospice, Hospice News, December, 9, 2019

HOSPICE: Suncoast Hospice Expands Healing Oasis Program, Hospice News, December 9, 2019

HOSPICE: Four Seasons Launches Hospice Telehealth Pharmacy Program, Hospice News, December 9, 2019


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