Bulletin: May 26th, 2020

May 26th, 2020


COVID-19 Resource Center

HOME HEALTH and HOSPICE: HHS Announces 45-Day Compliance Deadline Extension for Providers, NAHC List Serve, May 22, 2020--The U.S. Department of Health and Human Services (HHS) announced on May 22, 2020 there will be a 45 day deadline extension for providers who are receiving payments from the Provider Relief Fund to accept the Terms and Conditions for Provider Relief Fund payments. This announcement means providers have now been granted 90 days from the date they received a payment to accept HHS Terms and Conditions or return the funds.  All providers who have received Provider Relief Fund payments must agree to the program Terms and Conditions if they wish to keep the funds.
HOME HEALTH and HOSPICE: FDA Update on Antibody Tests, NHPCO COVID Polciy Update, May 21, 2020-- FDA on Thursday (May 21) listed 27 COVID-19 antibody tests that no longer are on the market under FDA’s March 16 policy that allowed tests to be marketed and distributed without FDA authorization as long as the manufacturers notified the agency. The list includes tests that were voluntarily withdrawn by the manufacturers, as well as those for which there are no pending Emergency Use Authorization requests or issued EUAs. The tests on the removal list will not be marketed or distributed, FDA says. The agency expects the list will continue to be updated.
HOME HEALTH and HOSPICE: From Headaches to ‘COVID Toes,’ Coronavirus Symptoms Are a Bizarre Mix, NHPCO COVID-19 Update, May 20, 2020--The new coronavirus that has infected millions of people around the globe can wreak havoc far beyond the lungs. Some of the symptoms of the disease it causes, COVID-19, are predictable enough: cough, fever, chills, headache. But the pathogen’s effects by no means stop there. Visit the website for Scientific American to learn more.
HOME HEALTH: RESOLVED: Additional Documentation Requests (ADRs) Issued in Error for Pre-Claim Review Home Health AgenciesPalmetto GBA List Serve, May 20, 2020--A brief system issue caused fewer than 500 claims to go into Additional Documentation Requests (ADRs) status (SB6001) on or about May 15, 2020. All of the claims that did into ADR status were released on or about May 19, 2020, and are now processing. Home health agencies that had claims go into ADR status or downloaded/received an ADR(s) should not respond and disregard the ADR. No provider action is needed.
HOSPICE: Medicare 2% Sequestration Suspension and the Hospice Aggregate Cap, NHPCO NewsBriefs, May 21, 2020-- As previously reported, Section 3709 of the Coronavirus Aid, Relief, and Economic Security (CARES) Act suspended the 2% payment adjustment currently applied to all Medicare Fee-For-Service (FFS) claims due to sequestration.
Hospices that do not have a CAP liability will realize a two percent (2%) increase in Medicare payments for services rendered on or after May 1, 2020. Likewise, CAP hospices will realize a two percent (2%) increase as well.
HOSPICE and PALLIATIVE CARE: OCHCH Recives Grant to Provide Education to Improve Veteran Care—Recently OCHCH submitted a Request for Proposal (RFP) to NHPCO/We Honor Vets, for a grant to provide Trauma Informed Care education to Hospice and Palliative Care staff.  OCHCH was one of 13 associations across the nation who were awarded a grant to do this important work.
OCHCH will partner with Hospice and Palliative Care providers, VA Medical Centers and local VA support groups to work together to improve Veteran Care. Trauma Informed Care for Vets education will be offered in June 2020 to Hospice and Palliative Care staff. More details about this education will be coming soon.

>>>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: 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.

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

COVID Updates: The New Normal

By Alexandra Weingarth Policy and Advocacy Director

As the COVID-19 crisis continues to trickle into the summer days, the state of Ohio has been making steps to reopen the economy and to reopen Ohio’s businesses. There has been a lot of changes in and around the world as we begin to adapt to the “new normal.” There is no telling when this pandemic will be over, or if there is going to be a resurgence, but one thing we know for sure is that we will prevail! Even though COVID-19 has brought numerous challenges and hurdles, you as providers have continued to show how passionate and determined you are to overcome the adversary challenges. As we continue to adapt to the new normal, OCHCH will continue to advocate for your interests at the state and federal level with the help of our partners. While you have been working for the vulnerable Ohioans to remain safe in their homes, we have been working for you on issues surrounding COVID-19 and others that would have an impact on our industry.
I wanted to share 3 quick updates with you to give you a bit of insight of what is new in our space.

  1. The state of Ohio has received 1.7 million Federal grant dollars to assist older Ohioans: This fund is an Older Americans Act fund for the Aging and Disability Resource Networks in Ohio. Each AAA will receive funding to: continue to be connected to the aging population by rapidly assessing the needs of older adults, available services, the workforce available to deliver those services, enhanced accessibility, and to combat social isolation.
  2. U.S Senator Susan Collins made a comment about introducing a potential framework for telehealth reimbursement: There has been a lot of advocacy at the federal level to encourage a framework to be created to reimburse for telehealth services provided by home health agencies. The Senate Special Committee on Aging had a committee hearing on Thursday, May 21st and heard from multiple witnesses testifying from the home health setting. During the committee, Chairwoman Collins (R-ME) expressed that she planned to introduce a bill soon to create a framework for telehealth services provided by home health agencies. We look forward to continuing to advocate for telehealth reimbursement and will update you along the way.
  3. OCHCH submitted written testimony for Sub. HB606: Civil Immunity- COVID-19 Transmission (Grendell, D.): This bill would grant civil immunity for essential workers during the COVID-19 crisis. OCHCH submitted written testimony to advocate that health care workers should protected. We stated in our testimony: “Providers’ number one priority is to keep Ohio’s most vulnerable patients safe and cared for in their home.” “The passage of this bill would help alleviate the burden of having to worry about facing unnecessary and costly civil lawsuits for these front line providers and allow them to focus on patient care.”

There are many more issues I can provide updates on surrounding the HCBS industry and COVID-19. Therefore, if you have any questions regarding what OCHCH is advocating for at the state or federal level- please reach out to alex@ochch.org or 614-885-0434 ext 204.


By Alexandra Weingarth Policy and Advocacy Director

HelpDesk Question of the Week

HOME HEALTH: NP, PA Certifying and Ordering Home Health
Question:  I know that CMS under Covid said that NPs and PAs could certify and sign orders for patients.  But, I also understood that Ohio restricted NP and PAs from this.  When did Ohio allow NPs and PAs to certify home care and write orders for Medicare patients.   What date did Ohio allow NPs and PAs to sign our orders?   I also read the email thread that Ohio is trying to put forth language to allow NP and PAs sign for Medicaid. 
Answer:  It is not the state of Ohio restricting NPs and PAs from ordering home health services.  It is the Ohio Dept. of Medicaid (ODM – the payer source) that has not approved the use of NPs, CNSs, and PAs to order Medicaid Home Health services.
OCHCH is waiting for ODM to address the Plans of Care and Certifying/Recertifying Patient Eligibility by NPs, CNSs, and PAs by enacting an emergency rule package that is being prepared.
OCHCH will share the emergency rule as soon as we receive it!
Until then home health agencies can only accept orders from the NPs, CNSs, and PAs that are caring for Medicare beneficiaries.  If your agency contracts with other insurance plans you need to check to determine if these plans approve receiving  Home Health orders from NPs, CNSs, and PAs.
Under this Public Health Emergency (PHE), NPPs may certify Medicare patients and order home health services, effective March 1, 2020. 


Regulatory & Policy Digest


HOME HEALTH and HOSPICE: IMPORTANT: Please Read this FDA-Required Updated REMS Safety Information, NAHC Report, May 19, 2020--
Risk of:
• Cytokine Release Syndrome (CRS), which may be life-threatening or fatal
• Neurological Toxicities, which may be severe, life-threatening or fatal
• Preparation and Administration Errors
The Food and Drug Administration (FDA) has required this safety notice as part of the BLINCYTO® REMS (Risk Evaluation and Mitigation Strategy) to be distributed to the to highlight new safety information about cytokine release syndrome and neurological toxicities. Amgen requests that you distribute the information to your members, informing them about the serious risks of BLINCYTO.
HOME HEALTH and HOSPICE: OSHA Revises Coronavirus Reporting Enforcement Policy, NAHC COVID-19 Communication, May 21, 2020--OSHA is revising its previous enforcement policy for recording cases of coronavirus. Under OSHA’s recordkeeping requirements, coronavirus is a recordable illness, and employers are responsible for recording cases of the coronavirus, if the case:

HOME HEALTH and HOSPICE: CMS Updates Targeted Probe & Educate Information, NAHC Report, May 21, 2020--The Centers for Medicare & Medicaid Services (CMS) published updated targeted probe and educate (TPE) information contained in Chapter 3 of the CMS Program Integrity Manual (Publication 100-08) through Transmittal 10132/Change Request (CR) 11695. The updates incorporate information about TPE practices providers have experienced, but were not clearly outlined in the Manual.
HOSPICE: NAHC Urges Permanent Medicare Flexibilities for Use of Technology in Hospice, NAHC Report, May 18, 2020--The National Association for Home Care & Hospice (NAHC) is urging the Centers for Medicare & Medicaid Services (CMS) to establish permanent flexibilities allowing hospices to utilize telecommunications to deliver multi-disciplinary, patient-centered care, and to ensure that such services can be recorded and monitored for their impact on quality of care.

HOSPICE: Hospice Quality Reporting Program: Quarterly Update for January – March, CMS MLN Connects, May 21, 2020--The Hospice Quality Reporting Program (HQRP) Quarterly Update (PDF) for the first quarter of 2020 is available. This update includes highlights, events, planned engagement opportunities, and questions and answers from the Hospice Quality Help Desk. Visit the HQRP Requirements and Best Practices webpage for more information.

HOME HEALTH: Senator: Bill to Reimburse Home Health for Telehealth Services Is Coming, NAHC Report, May 22, 2020-- On Thursday, May 21, 2020, a Senate Special Committee on Aging heard from multiple witnesses testifying to the need for more telemedicine, particularly in the home health setting, prompting committee chair Senator Susan Collins (R-ME) to say “I plan to introduce a bill soon to create a framework to reimburse for telehealth services provided by home health agencies.

The news, while important, did not come as a complete surprise; NAHC President William A. Dombi who told a Home Health Care News webinar earlier this week that such legislation could be pending. “I think we’re getting closer to making it happen,” said Dombi.


Education & Events

News Clips & Links

HOSPICE: Hospices Reevaluate Staff PTO Policies During Pandemic, Hospice News, May 20, 2020
HOSPICE: CEO Cathy Conway: The Business of Hospice Is Changing, Hospice News, May 20, 2020
HOSPICE: Hospices Mobilize Dedicated COVID Teams, Hospice News, May 25, 2020
HOSPICE: VITAS to Launch COVID-19 Grief Helpline, Hospice News, May 25, 2020

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