Bulletin: May 12th, 2020

HOME HEALTH and HOSPICE: Health Care Supply Chain, Provider Self-Care, and Emergency Preparedness Resources, CMS MLN Connects, May 7, 2020 – The most recent Express from the Office of the Assistant Secretary for Preparedness and Response (ASPR) Technical Resources, Assistance Center, and Information Exchange (TRACIE) highlights recently developed resources, including:

• Stress Management Exercise for Health Care Workers Responding to COVID-19: Manage stress before, during, or after your shift
• Crisis Standards of Care during COVID-19: Speakers share their experiences and practical considerations for state health departments and hospital systems related to the ethical application of crisis standards of care
• COVID-19 Clinical Rounds Peer-to-Peer Virtual Communities of Practice: Interactive virtual learning sessions aim to create a peer-to-peer learning network where clinicians from the U.S. and abroad who have more experience treating patients with COVID-19 share their challenges and successes
• COVID-19 Alternate Care Site Resources: Collection addresses capacity and capability gaps and includes a toolkit, video, and fact sheet
• COVID-19 Health Care Workforce Virtual Toolkit: Links to tools and resource collections related to health care workforce issues, from licensure and scope of practice expansions, to training, protection, and resiliency resources for health care workers

• ASPR TRACIE Fact Sheet
• ASPR TRACIE website
• ASPR TRACIE Novel Coronavirus Resources webpage

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!

NEW: Option to Stay in PCR, Palmetto GBA – For Home Health providers participating in the Review Choice Demonstration (RCD), you will now have the option to keep Pre-Claim Review (PCR) as your review choice for future cycles. This will avoid having to reselect PCR for each selection cycle. Providers can withdraw from this option and still change to another review choice in a future cycle.

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.

Ohio Providers Transition to Review Choice Demonstration (RCD) Cycle Two, Palmetto GBA – Beginning 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.

HOME HEALTH: Home Health Plans of Care: NPs, CNSs and PAs Allowed to Certify, Palmetto GBA – Section 3708 of the Coronavirus Aid, Relief, and Economic Security (CARES) Act (Pub. L. No. 116-136) amended sections 1814(a) and 1835(a) of the Social Security Act to allow Nurse Practitioners (NPs), certified Clinical Nurse Specialists (CNSs), and Physician Assistants (PAs) to certify beneficiaries for eligibility under the Medicare home health benefit and oversee their plan of care. This is a permanent change that will continue after the Public Health Emergency. Effective for claims with dates of service on or after March 1, 2020, these non-physician practitioners (NPPs) may bill the codes listed in this article. Please share with the NPPs.

HOME HEALTH and HOSPICE: Addition of the QW modifier to Healthcare Common Procedure Coding System (HCPCS) code U0002 and 87635, CMS MLN Connects, May 7, 2020 – A new MLN Matters Article MM11765 on Addition of the QW modifier to Healthcare Common Procedure Coding System (HCPCS) code U0002 and 87635 (PDF) is available.CLIA regulations require a facility to be appropriately certified for each test performed. To ensure that Medicare & Medicaid only pay for laboratory tests performed in certified facilities, each claim for a HCPCS code that is considered a CLIA laboratory test is currently edited at the CLIA certificate level.  
 

• Update the hospice wage index, payment rates, and cap amount for fiscal year (FY) 2021
• Proposes changes to the hospice wage index by adopting the most recent Office of Management and Budget statistical area delineations,with a 5% cap on wage index decreases
• Summarizes the changes to the hospice election statement finalized in the FY 2020 Hospice Wage Index and Rate Update final rule and effective for October 1, 2020; and provides hospices with a model election statement and sample addendum 
• The proposed FY 2021 hospice payment update percentage is 2.6 percent