Bulletin: May 5th, 2020

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, 2020 – At 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.

• Home Health Agencies (PDF) UPDATED (4/30/20)

• State Medicaid & Basic Health Programs (4/30/20) – Addresses NPPs Ordering HH Care.

• COVID-19 Emergency Declaration Blanket Waivers & Flexibilities for Health Care Providers (PDF) UPDATED (4/30/20)

• Hospices (PDF) UPDATED (4/30/20)

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, 2020 – CMS 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.
 

PDGM/RCD WEEKLY CALL UPDATES – ON HOLD
 
AT THIS TIME OCHCH IS NOT SCHEDULING ANY WEEKLY PDGM/RCD CALLS.
 
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!

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.

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

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