Bulletin: May 5th, 2020

May 5th, 2020


COVID-19 Resource Center

HOME HEALTH and HOSPICE: Trump Administration Issues Second Round of Sweeping Changes to Support U.S. Healthcare System During COVID-19 Pandemic, CMS, April 30, 2020At President Trump’s direction, and building on its recent historic efforts to help the U.S. healthcare system manage the 2019 Novel Coronavirus (COVID-19) pandemic, CMS issued another round of sweeping regulatory waivers and rule changes to deliver expanded care to the nation’s seniors and provide flexibility to the healthcare system as America reopens. These changes include making it easier for Medicare and Medicaid beneficiaries to get tested for COVID-19 and continuing CMS’s efforts to further expand beneficiaries’ access to telehealth services.

HOSPICE: CMS Issues New 1135 Waivers for Hospice Training,Won't Pay for Telehealth, Hospice News, May 4, 2020 – The U.S. Centers for Medicare & Medicaid Services (CMS) has issued new 1135 waivers that temporarily release hospices from having to comply with certain requirements related to training. The agency also indicated that for the time being hospices cannot bill CMS for telehealth visits or include those visits on their cost reports. 
PALLIATIVE CARE and HOSPICE: CMS Allows Advance Care Planning Codes to be Used with Audio-only Telehealth, NHPCO NewsBriefs, April 30, 2020CMS previously announced that Medicare would pay for certain services conducted by audio-only telephone between beneficiaries and their doctors and other clinicians. On April 30, CMS broadened that list to include many behavioral health and patient education services. CMS is also increasing payments for these telephone visits to match payments for similar office and outpatient visits. This would increase payments for these services from a range of about $14-$41 to about $46-$110. The payments are retroactive to March 1, 2020.
HOME HEALTH: CMS Issues New COVID-19 Waivers, Interim Final Rule for Home Health, NAHC Report, May 1, 2020 – CMS has issued a second round of regulatory waivers in an Interim final rule with comment (IFC), with several notable flexibilities for home health agencies:

  • NPPs and Home Health Services

  • Home Health Value Based Purchasing Model

  • OASIS-E - CMS is delaying implementation

CMS Issues Additional Home Health 1135 Waivers for Duration of COVID-19 Emergency:

  • Training and Assessment of Aides

  • Quality Assurance and Performance Improvement (QAPI)

  • 12-hour Annual In-Service Training Requirement for Home Health Aides.

  • Detailed Information Sharing for Discharge Planning for Home Health Agencies.

  • Clinical Records

HOME HEALTH: New Codes for Therapist Assistants Providing Maintenance Programs in the Home Health Setting, Palmetto GBA – CR 11721 informs you of the changes to Home Health (HH) billing and processing instructions, including new G-codes that describe therapy assistant services. It also makes a correction to the processing of HH claims that receive episode sequence edits. Make sure that your billing staffs are aware of these changes.
HOME HEALTH and HOSPICE: COVID-19 RECOMMENDED OPERATIONAL PROTOCOLS The Recommended Operational Protocols are the result of a collaborative effort among several of the leading providers in the home health and home care industries to help providers of all types and sizes respond to the COVID-19 crisis in a responsible way that protects the vulnerable patients and clients they serve and protects the fearless direct care workers who risk their own safety and the safety of their families to provide essential services.
HOME HEALTH and HOSPICE: HHS Begins Release of Additional Funds to Providers, NAHC Report, April 27, 2020 – The Department of Health & Human Services has begun releasing additional funds to health care providers impacted by the COVID-19 pandemic. The CARES Act legislation provides relief to American families, workers, and the healthcare providers on the frontline of the COVID-19 outbreak. Among its provisions, the Act appropriated $100 billion for distribution to health care providers impacted by the ongoing public health emergency.

>>>RCD/PDGM UPDATES –                                                                                                                  

If you have PDGM or RCD QUESTIONS PLEASE SEND THEM TO helpdesk@ochch.org
Use PDGM or RCD as the subject title.
If you need OCHCH to contact Palmetto GBA regarding a PCR NON-AFFIRMATION,
Please e-mail a short description and the UTN and your provider number.
DO NOT e-mail any info that could be non-compliant with the HIPAA regulations
Please check out the toolkits for PDGM and also RCD!

>>>RCD UPDATES –                                                                                                                  

New: RCD Tip: PCR Task Signed Documentation, Palmetto GBA – The Medical Review (MR) team has noticed an increased number of providers in Pre-Claim Review (PCR) who are submitting documentation (plan of care, therapy orders, etc.) that are not signed. As a reminder, for tasks 1 through 4, a signature is required. Documents submitted without a proper physician signature will result in a non-affirmation. Oral orders must be countersigned and dated by the physician before the home health agency submits the final bill.

We Are Going Green with RCD Cycle Results eLetters, Palmetto GBA – Palmetto GBA is going green with RCD Cycle Results eLetters. We will send home health agencies their RCD Cycle Results via eLetter in eServices. Please review and share with your staff.

RCD Tip: Using the Correct Provider Transaction Access Number (PTAN), Palmetto GBA – If you are a part of a Home Health Agency (HHA) with more than one location and multiple PTANs, please make sure you are using the correct PTAN when submitting Pre-claim Review (PCR) requests.
RCD for Ohio’s Home Health Services Has Been PAUSED
Ohio Providers Transition to Review Choice Demonstration (RCD) Cycle Two, Palmetto GBABeginning May 1, 2020, you will be able to choose the next round’s review option. Typically, the selection period is open for a two-week period. Due to the current Public Health Emergency (PHE) related to COVID-19, the last day to make a selection has not yet been determined. Palmetto GBA will announce the last day to make a selection as soon as possible on their website and via email update. If you are not signed up for the Palmetto GBA email updates, please visit https://tinyurl.com/GetListserv to sign up.

Our Take

PPE Update
First, hats off to all of our providers. You have done an amazing job during this unprecedented time. We hope that you have been navigating the ever changing waters- we know that there are countless updates from the state and federal government. OCHCH has been doing the best we can to help your agency and keep you informed (please keep checking the resource guide on the website for the most up to date information).

Speaking of help, last week OCHCH shipped out 40,000 gloves to our providers across the state with our friends at Molina. The Molina glove donation was able to help over 80 different agencies both large and small. We hope this donation made a significant impact to keep the front line caregivers safe while they care for the vulnerable patients in their homes.

Additionally, OCHCH helped facilitate a group order with our members of over 5,000 N-95 masks. The team was able to distribute and meet our members all over Ohio! We enjoyed seeing you at a safe distance, and helping source the supplies that you needed.
OCHCH has been very fortunate to receive donations from the community. It has been amazing to see the companies and individuals who want to support home care and hospice agencies.

I would love to give a special shout out to those who didn’t mind being named:
-L. Brands donated hand sanitizer and soaps- they smell amazing!
-The Asian Indian Alliance donated over 1,000 KN-95 masks
-Molina donated thousands of bottles of hand sanitizer (and gloves)
-Anonymous donations of N-95s, gloves, hand sanitizers, and sanitizing wipes
More donations to be forthcoming!

We truly hope that these items have helped your agency stay SAFE and PROTECTED. If you need any more information on donations or purchasing PPE, please contact me at alex@ochch.org and I would be happy to help! Stay SAFE!


By Alexandra Weingarth, Advocacy Director

HelpDesk Question of the Week

HOSPICE and HOME HEALTH: Staff member exposed to COVID-19
Question: If a healthcare worker takes off work because they have been exposed to COVID-19 or think they may have it, are they eligible for unemployment?  Do they have to provide the agency with a doctor's excuse that they are in quarantine or proof they have COVID-19?
Answer: I found the following information of the Ohio Jobs and Family Services website:
Who is eligible to receive benefits through the Pandemic Unemployment Assistance  (PUA) program offered through the federal CARES Act?
To be eligible for PUA, the individual must NOT be eligible for regular unemployment benefits. Additionally, individuals must meet one of the following circumstances:
  • The individual has been diagnosed with COVID-19, or is experiencing symptoms and is seeking medical diagnosis;
  • A member of the individual’s household has been diagnosed with COVID-19;
  • The individual is providing care for a family member or member of the household who has been diagnosed with COVID-19;
  • A child or other person in the household for which the individual has primary caregiving responsibility is unable to attend school or another facility is closed as a direct result of the COVID-19 emergency, and the school or care is required for the individual to work;
  • The individual is unable to reach the place of employment because of a COVID-19 quarantine;
  • The individual is unable to reach the place of employment because a healthcare professional has advised him or her to self-quarantine due to COVID-19 concerns;
  • The individual was scheduled to commence employment and does not have a job or is unable to reach the job as a direct result of COVID-19;
  • The individual has become the breadwinner or major support for a household because the head of the household has died as a direct result of COVID-19;
  • The individual has quit his/her job as a direct result of COVID-19;
  • The individual was laid off as a direct result of COVID-19;
  • The individual’s place of employment is closed as a direct result of COVID-19.
There is no minimum income requirement for PUA.
Here is the link:


Regulatory & Policy Digest


HOSPICE: Call to Sign COVID-19 Letter, NHPCO Council of States List Serve, May 1, 2020--NHPCO has created a “Commitment to Caring” sign-on letter to demonstrate our community's commitment to addressing the extraordinary needs brought on by the COVID-19 pandemic. Robust participation will show policymakers, grant makers, and our professional community that hospice and palliative care providers are rising to the challenge and providing the person-centered interdisciplinary care that is exactly what is needed during these times. You will find the letter with the link to add your organization's name at nhpco.org/sign-on.
 OCHCH has signed onto the NHPCO letter to support the important work of the Hospice industry.
HOSPICE: CMS Narrows Hospice QAPI, Waives COVID-19 Testing Rule, Hospice News, May 1, 2020 – The U.S. Centers for Medicare & Medicaid Services (CMS) is allowing hospices to narrow the scope of their required Quality Assurance and Performance Improvement (QAPI) programs during the pandemic to focus on infection control and adverse events. The agency will also allow any health care professional who is authorized by state law to order a COVID-19 test.

HOME HEALTH: Home Health HIPPS Recoding Error Affecting Claims that Span January 1, 2020, Palmetto GBA – A HIPPS recoding error occurred that affected home health claims that span January 1, 2020 (60-day episode billing, pre-PDGM), if the number of therapy services on these claims changed the HIPPS code. The appropriate recoding of the first and fourth positions of the HIPPS code did occur, but changes to the second and third positions did not. Claims may have been either over or under paid, depending on whether therapy services increased or decreased during the episode. The issue was corrected in the April 2020 Quarterly System Release. Palmetto GBA will complete a mass adjust on the affected claims, using the criteria referenced in this article, by June 26, 2020. Please review this Claims Payment Issues Log (CPIL) and share it with your staff.

HOME HEALTH: Medical Coverage Database (MCD) Article Updates: Home Health, Palmetto GBA  - The Billing and Coding: Home Health Occupational Therapy A53057 and the Billing and Coding: Home Health Physical Therapy A53058 HHH MCD articles were revised.

HOME HEALTH and HOSPICE: Dual Eligible Beneficiaries Under Medicare and Medicaid — Revised, CMS MLN Matters, April 30, 2020 – A revised Dual Eligible Beneficiaries Under Medicare and Medicaid Medicare Learning Network Booklet is available. Learn about:

  • Medicare Savings Programs, including benefits and qualifications
  • Billing requirements
HOME HEALTH and HOSPICE: MM11765, CMS MLN Matters, April 30, 2020 – Addition of the QW modifier to Healthcare Common Procedure Coding System (HCPCS) code U0002 and 87635, this article has been revised.  Please ensure your billing staff are aware.

HOME HEALTH and HOSPICE: Audit and Reimbursement Testing Email for Future Correspondence, Palmetto GBA 

HOME HEALTH and HOSPICE: PECOS Document Upload and Retrieval Issue, Palmetto GBA  

Education & Events

News Clips & Links

HOSPICE: Hospices Ramp Up Staff Screening Procedures for COVID-19, Hospice News, May 1, 2020
HOSPICE: Hospices Focus on Staff to Cut Turnover During Pandemic, Hospice News, May 4, 2020
HOME HEALTH and HOSPICE: CDC Billing Resource: ICD-10-CM Official Coding and Reporting Guidelines April 1, 2020 - Sept 30, 2020, NHPCO NewsBriefs, April 30, 2020
HOME HEALTH and HOSPICE: EPA Resource: COVID-19 Disinfectant List., NHPCO NewsBriefs, April 30, 2020
HOSPICE: Hospices to Leverage Data Analytics in Value-Based Payment Models, Hospice News, April 27, 2020

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