volume 21, no. 31 september 2, 2016 this is the final ... · volume 21, no. 31 september 2, 2016...
TRANSCRIPT
Legislative Issues Public Policy News
A Weekly Publication Of HCAHCAHCAHCAHCAHome Care Association of New York State
Helping New YorkersFeel RightAt Home
ASAPVolume 21, No. 31 September 2, 2016
Inside Inside Inside Inside Inside ASAPASAPASAPASAPASAPSee F2F p. 4
See ASAP p. 2
This is the Final Edition of ASAP – Ever!But don’t worry: We have a new newsletter, with a new name, and a new publication schedulesoon coming to you on Mondays!
As previously announced, HCA is changing our newsletter publication schedule, name and design. Therevamped newsletter will first come to you on September 12, a Monday, which is our new publication day.(We won’t be publishing a newsletter during the Labor Day holiday week of September 5 to 9, but, asalways, will inform you of breaking news with e-mail alerts).
We decided to move our newsletter to Mondays because there are so many late-breaking news items thatoccur on Fridays, and we wanted to give you a chance to start each week with a full digest of all the
HCA Meets with DOH on Medicaid
Face-to-Face Requirement
This week, HCA brought together a coalition ofHCA and the state’s hospital and physicianassociations to meet with Andrew Segal, the newDirector of the Division of Long Term Care at thestate Department of Health (DOH), urgingmitigation of the state’s action related to a new
September “Emergently” Opens
Emergency Preparedness MonthDOH plans release of preparedness survey forHurricane Hermine: details expected soon today!
September has opened national emergency preparednessmonth with true urgency, as the U.S. Eastern seaboard –from Florida to New York – prepares for the potentialimpact of Hurricane Hermine.
While the full course and the power of Herminecannot exactly be predicted, the state Departmentof Health (DOH), in preparation yesterday,
See PREPAREDNESS p. 5This is the Final Edition of ASAP – Ever!................................................1HCA Meets with DOH on Medicaid F2F.............................................1September “Emergently” Opens Emergency Preparedness Month........1Registration Open for HCA Compliance Symposium: Oct. 6.............3Seagate, HCA Partner on HCA Member Group-Purchasing Savings......6DOH Establishes Exemptions from 90-Day Billing Requirement…....7Member Hiring Announcements….....................................................8OMIG Compliance Guidance Posted..............................................9HCA Forums Coming for HCC & Upstate LHCSA Members….........9Media Outreach on BTVH-NY….........................................................11Naylor Invites Advertising Options in HCA Member Directory......…12HCA & Partners Plan Sepsis PR, 9/30 Webinar on Screening Tool….13Sponsors, Exhibitors at HCA Women’s Leadership Summit............14NYSHealth Launches 2017 Special Projects Fund RFP…..................14Is Your Agency Interested in Reducing Workers’ Comp. Costs?.......15Further Court Action Issued on Jimmo Case.....................................15IMPACT Act Forum and Provider Call Scheduled...............................16September eMedNY Trainings.........................................................17NGS Updates....................................................................................18Publications............................................................................................................18
HCA’s offices will be closed on Monday, September 5,for Labor Day. We will reopen on September 6.
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ASAP is a weekly publication of the Home Care Association of NewYork State (HCA). Unless otherwise noted, all articles appearing inASAP are the property of the Home Care Association of New YorkState. Reuse of any content within this newsletter requires permissionfrom HCA.
Joanne Cunningham, [email protected]
Roger L. Noyes, Director of Communications, [email protected]
Al Cardillo, Executive Vice President, Policy & Programs, [email protected]
Patrick Conole, Vice President, Finance & Management, [email protected]
Andrew Koski, Vice President, Program Policy and Services, [email protected]
Alexandra Fitz Blais, Director of Public Policy, [email protected]
Laura Constable, Senior Director, Membership & Operations, [email protected]
Celisia Street, Director of Education, [email protected]
Mercedes Teague, Finance Manager, [email protected]
Jenny Kerbein, Director of Governance and Special Projects, [email protected]
Billi Wilson, Manager, Meeting and Events, [email protected]
Teresa Brown, Administrative Assistant, [email protected]
President:
Editor:
388 Broadway, 4th Floor, Albany, NY 12207Tele: 518-426-8764; Fax: 518-426-8788; Website www.hcanys.org
ASAP – a publication of the Home Care Association of New York State Volume 21, No. 31 September 2, 2016
ASAP from p. 1
important home care policy, regulatory, advocacy andeducation developments from the previous week. The newpublication will have a different look but the samecommitment to rigorous analysis, advocacy and insightfulnews.
Our newsletter will also have a new name: The SituationReport.
We chose this name for several reasons. If you follow cablenews shows regularly, you know that the “Situation Room”is where the President and top security or military officialsgather to make urgent decisions. Also, the term “situationreport” is used in emergency preparedness and militarycontexts as a medium for keeping stakeholders attuned toan urgent incident or development under activemanagement.
We know that the weekly “situation” of home care policy,regulatory and advocacy updates typically come to you with a level of urgency; and your need for thisinformation is often immediate. The stories in our weekly news report to you all concern the financing,compliance, clinical standards, new innovations, novel program designs, and, yes, the emergency preparedness(see related story on page 1) of your organization.
This week’s final newsletter title ASAP (a.k.a., “As Soon As Possible”) has long served to convey the immediacyof home care’s information need, engagement and grassroots action. Our new name, The Situation Report, is a
ASAP – a publication of the Home Care Association of New York State
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Volume 21, No. 31 September 2, 2016
nod to this HCA communications tradition and an extension of our overall purpose in reporting to youon a weekly basis, as we revitalize HCA’s communications offerings.
By now, you also have seen some other new communications features, including our twice-per-week HCANews Clips (including one distribution today), which provide links to home care-related stories fromblogs, digital media and news websites. We hope these articles interest you and inform you on a differentbut equally valuable level.
If you have any recommendations for how we can improve our outreach to you, don’t hesitate to contactHCA’s Communications Director Roger Noyes at (518) 810-0665 or [email protected]. We hope youenjoy our new look, name and schedule.
Registration Open for Must-Attend HCA Compliance Symposium: Oct. 6 Registration is now open for HCA’s annual CorporateCompliance Symposium, on October 6 in Albany, a must-attend event that includes presentations from national andstate compliance experts helping you to sharpen yourknowledge and strategies for identifying risks, addressingthem, and developing an ironclad compliance program. Few other organizational priorities require the substantiallevel of knowledge and action-plan development that comeswith the job of compliance manager, a role that runsthroughout the work activities of your entire organization. HCA’s Corporate Compliance program is a highlyanticipated annual event which brings together the top stateand federal regulators (like Medicaid Inspector GeneralDennis Rosen and staff from the federal Office of theInspector General), legal experts and organizationalcompliance consultants. These experts will keep your teamup to date on: new requirements, changes in laws andregulations, tools, resources and best-practices for fulfilling your compliance responsibilities. Your compliance officers and senior management need routine training in all of these areas to avoid bothfinancial risk and potential harm to your organization’s reputation and patients. This program givesaccess to top state and federal government auditors and experts so that your team has the understandingto ensure your compliance program is functioning at the highest level. If you plan on staying over the night before the conference, please note that the deadline for HCA’s
room-block at the conference site, the Renaissance Albany Hotel, is September 19. All details and a full agenda are included in the brochure at the link below:
http://hca-nys.org/wp-content/uploads/2016/09/HCA-Corporate-Compliance-Symposium-Brochure-2016.pdf.
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ASAP – a publication of the Home Care Association of New York State Volume 21, No. 31 September 2, 2016
F2F from p. 1
Medicaid face-to-face (F2F) requirement for homehealth services.
Our partners represented at the meeting included theHealthcare Association of New York State, IroquoisHealthcare Alliance, and the Medical Society of theState of New York.
As reported in prior editions of ASAP, the U.S.Centers for Medicare and Medicaid Services (CMS)issued a final rule in early February of this yearregarding a new physician F2F documentationrequirement for Medicaid home health services.
The final rule went into effect on July 1, 2016;however, CMS acknowledges that states andproviders may need more time. As a result, CMS is
delaying compliance for up to one year in states like
New York, and possibly two years for those stateswhose Legislature meets every two years.
The federal government does not require a F2F formanaged care enrollees, but CMS is deferring tostates to determine the application of the F2Frequirement to managed care. CMS also is notprescribing a specific documentation format, but isallowing states to determine what constitutesappropriate documentation. In addition, personalcare services are not subject to the Medicaid F2Frequirement, but home health aide services are.
Prior to this meeting, HCA has been in close contactwith DOH to find out their implementation plansand to advocate exemption of Medicaid F2F whereverpossible, such as for managed care. HCA broughttogether the major stakeholders to meet directly withthe responsible DOH staff to share our largerconcerns about face-to-face and to urge exemptionswherever possible on DOH’s pending guidance.
At this week’s meeting, HCA advocated that the stateshould not apply this requirement to patients inmanaged care, as CMS allows for this exemption.
HCA also requested that the state considerexpanding this exemption to include services provided
under the Delivery System Reform IncentivePayment (DSRIP) program and value basedpayments (VBP) and other system changes,including accountable care organizations(ACOs), as a face-to-face requirement runscontrary to the state’s reform efforts whichrely on a robust home care system for timelydischarges, care transitions and carecoordination. In addition, reimbursementunder VBP and ACOs and other reformefforts differ from Medicaid fee-for-servicepayments, which is what the face-to-facerequirement is intended to apply to.
HCA also pointed out the multiple problemsour home care providers, hospitals, anddoctors have encountered with MedicareF2F. Mr. Segal acknowledged and well-understood these issues from the Medicarecontext.
Mr. Segal agreed to bring our concerns andrecommendations to DOH leaders.
HCA has worked strenuously for repeal ofthe already active F2F rule for Medicare;barring repeal, we seek changes that willsimplify the confusing and time-consumingdocumentation and process issues whichhave led to payment denials based onconfusing requirements for payment. We willcontinue to advance such efforts and alsoadvance a campaign to ensure that MedicaidF2F is implemented in a feasible and lessburdensome way.
HCA thanks DOH for listening to ourconcerns and our partner associations whojoined in our advocacy for limiting theimpact of a face-to-face requirement.
HCA will keep members informed of anydevelopments on this issue.
For more information, contact the HCA Policystaff.
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issued guidance for health care providers inreadying for the possibilities. The New YorkCity Advance Warning System (AWS) alsoprovided its alert and advisory.
The DOH guidance can be accessed on theHealth Commerce System (HCS) at: https://commerce.health.state.ny.us/hpn/ctrldocs/alrtview/postings/Notification_20862.pdf.The NYC AWS can be accessed at http://hca-nys.org/wp-content/uploads/2016/09/September-1-NYC-AWS-Hermine.pdf.Organizations that serve people withdisabilities or access and functional needs canregister for AWS Alerts at: https://advancewarningsystemnyc.org/.
Be sure your HCS emergency contactinformation is accurate and updated
Providers and MLTC plans are reminded that itis critical for you to ensure your contactprincipals and information are accurate andupdated in your organization’s HCS account,especially your emergency contacts, as the HCSis a main avenue for emergency managementleaders to reach the provider community with“situation reports” and potential reportingrequirements as developments unfold.
September “Aware Prepare” issued
DOH has issued its September Aware Preparedocument. This publication is full of importantinformation, activities and announcementsrelevant to emergency preparedness for thismonth ahead. Providers and MLTCs can accessthis document at http://hca-nys.org/wp-content/uploads/2016/09/2016_September_AP.pdf.
Exercises, training, more information on theway for Emergency Preparedness Month
HCA will be providing you with furtherinformation on a full slate of emergencypreparedness guidance, activities and exercises
planned in conjunction with DOH and other emergencypreparedness partners throughout EmergencyPreparedness Month.
A sample of these include:
Use of the Preparedness Month theme as aspringboard for intensive HCA efforts to garnerwide and vocal support for the Governor’ssignature of HCA’s “Essential Personnel”legislation for home care and hospice – a billthat was unanimously passed by the StateLegislature in June. Governor Cuomo has twicevetoed (on the basis of technicalmisinterpretations by some localities) thiscritically important legislation that is designedto ensure home care and hospice patients haveaccess to care in emergencies. HCA willespecially use this September theme period toalso target and ensure clarification of anymisreads or concerns over the implementation ofthis legislation.
Convening of a special workgroup of DOH,HCA, the New York State Association ofHealth Care Providers (HCP) and home careagencies to compile a provider toolkit to assisthome care patients and families in emergencypreparedness.
Psychological First Aid (PFA) training sessionsfor providers; HCA has been serving on theproject committee for the statewide PFAinitiative being led by the University at AlbanySchool of Public Health.
Preparations and provider recruitment thismonth for a major Western and Central NewYork emergency drill and exercise known as“WRECKIT” which will involve hospitals, theemergency management system and home care,and will “unfold” in a simulated severe weather“emergency” over a week at the end of October/November. (HCA has been working with DOHofficials on the planning and preparations forannouncement and kickoff this month.)
Plans and announcements for local emergencypreparedness networking sessions jointly
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conducted by HCA and HCPfor home care agencies,hospices, county offices ofemergency management andlocal public health offices; theseencompass the next phase ofsessions HCA and HCPconducted in 17 counties in theWestern New York region inApril. Phase 2 will involve 17counties in the broader CapitalRegion, from the SchoharieValley to the Canadian Border.The plan is to methodicallyconvene these sessions acrossthe entire state.
Health EmergencyPreparedness Coalitionmeetings being conducted acrossthe state, and Regional TrainingCenter education offerings forproviders and emergencymanagers.
HCA is a collaborating partner toDOH and health care associationsacross the continuum in supporting theoperation of New York’s emergencypreparedness system and coordinatingand serving as informational conduitand advocate for the home andcommunity based care community. OurPrimer document on emergencypreparedness, which helps inform keyparticipants in the emergencypreparedness and response processabout home care preparedness, can beaccessed at http://hca-nys.org/wp-content/uploads/2016/09/EP-Primer.pdf. We encourage you to printit (the publication is formatted for bi-fold printing) and distribute it to yourlocal managers and key health systempartners.
Please contact HCA with questions,comments and ideas.
Seagate Alliance Partners with HCA for
Group-Purchasing Discounts to Members
Rochester-based Seagate Alliance is partnering with HCAto provide HCA members with group-purchasingdiscounts and one-stop-shopping for supplies. Arepresentative from Seagate will address members at ourupcoming Senior and Financial Manager’s Retreat, onSeptember 8 to 9, and executive level members at HCAagencies can expect to receive a communication fromSeagate in the near future about this unique group-purchasing arrangement.
Seagate is a membership organization that includesfacilities across the continuum of health care. SeagateAlliance is an owner of Premier, Inc., one of the largesthealth care purchasing alliances in the country. Seagatemembers have joined together to collaborate and developcontracts and service agreements that have significantlyreduced their membership supply chain and labor costs.
Seagate works with various suppliers that include medicalsupply manufacturers and distributors, office supplycompanies, cell phone, IT vendors, and much more. Theywill analyze existing agreements and develop a customizedmember service plan to fit your specialized agencyrequirements.
HCA-member HCR Home Care has been working withSeagate Alliance and has experienced the benefits of themembership.
“Since we started working with Seagate Alliance in 2013,we have experienced a noticeable reduction in our per-patient medical supply expenses,” said Elizabeth Zicari,HCR President and HCA Board Member. “We continue tosee significant savings on a per-item basis compared towhat we were paying prior to engaging their services.They’ve been a great partner and we look forward tocontinuing our relationship as we strive to provide best-in-class care for our patients.”
Seagate will be reaching out to introduce their organizationin the coming weeks. Please consider having a conversationwith them to see how they may be able to help yourorganization’s bottom line, or meet their representative atHCA’s upcoming Senior and Financial Manager’s Retreat.
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DOH Establishes HCA-Advocated Exemptions from 90-Day Billing RequirementChange makes billing requirements consistent with recently-extended physician-order deadline
As reported in an e-mail alert earlier this week, the August Medicaid Update includes an article referencing along-anticipated change in the home care billing requirements under Medicaid fee-for-service, making themconsistent with recent extensions to the physician-order deadlines for home care. (See p. 7 here: http://www.health.ny.gov/health_care/medicaid/program/update/2016/aug16_mu.pdf.) Both changes (physician-orders and billing) were long sought by HCA which worked hard for their consideration. The first of these changes, permitting agencies more time (up to a year) to obtain signed orders, was announcedin a May 4 Dear Administrator Letter (at http://hca-nys.org/wp-content/uploads/2016/05/DAL_Physician-Orders-for-Home-Care_5-5-16.pdf ). Previously, agencies had to obtain the signed orders within 30 daysafter admission to the agency, or prior to billing, whichever was sooner. (We note that this timeframe changeapplies to written signatures based on verbal orders, but does not affect the requirements to obtain orders orthe frequencies by which they must be reviewed and/or revised.) At the time of this physician-order change, in May, DOH indicated that it would also change the 90-day limitfor submitting home care claims when delays are attributable to the timing of physician signatures. This 90-day time period conflicted with the now-extended deadline for physician orders, given that the physician orders(obtainable within one year) are required, first, in order to bill (within 90 days). “In order to accommodate the provisions of the revised regulation, the 90-day timely filing requirement found
in NYCRR Title 10, Section 540.6 has been extended to exempt appropriately submitted home care claimsfrom certain timely filing edit denials,” the Medicaid Update article states. “Home care providers must submit
their claims within 30 days of the date of the signed physician order. No Delay Reason Code should be
included with these claims.”
This change makes it clear that home care providers do not have to submit home care claims within 90 daysof the service date, with the additional time intended to align with the revised deadline to obtain physicianorders (within one year). However, DOH’s article stresses that once home care providers receive the signed physician order (forexample, it could be 6 or 7 months from the last date of service), they will have 30 days from the date of the
physician order to submit their claim to Medicaid, as specified in the excerpt above. The Medicaid Update article also establishes the following details:
In cases where a claim is returned to a provider due to data insufficiency or claiming errors (rejected ordenied), it must be corrected and resubmitted within 60 days of the date of notification to the provider.Claims not correctly resubmitted within 60 days, or those continuing to not be payable after the secondresubmission, are neither valid nor enforceable.
All claims must be finally submitted to the fiscal agent and be payable within two years from the datethe care, services or supplies were furnished in order to be valid and enforceable. (The two-yeartimeframe would apply in cases where there is a dispute over the claim or a delayed reason code ischallenged by DOH.)
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HIRING
Director of Patient Services – Full Time
Living Resources Certified Home Health Agency in Albany is growing and we are seeking a dynamic leader to fill thispivotal position.
This position is responsible for overall strategic, clinical, operational and financial leadership to the CHHA andensures high quality, cost effective care. This individual will work in collaboration with the Living ResourcesCorporation’s CEO and Associate Executive Director to ensure the integrity of the agency in accordance with the goalsand objectives of the agency as set forth by the Board of Directors.
Qualifications: Current RN license, required Bachelor’s degree, Master’s degree preferred; minimum of three years ofmanagement experience in home health care or related field.
For immediate consideration, please forward résumé/cover letter and salary requirements in confidence to LisaRazanousky at [email protected].
Additional opportunities available: Clinical Manager, RNs, Physical Therapists, Occupational Therapists, HomeHealth Aides and PCAs.
Essex County Dept. of Public Health’s Certified Home Health Agency (CHHA)
HIRING: DIRECTOR OF PATIENT SERVICES
Essex County Nursing Services, Elizabethtown, New York, located in the heart of the Adirondacks is seeking anexperienced individual who has the will and determination to successfully lead the agency in today’s home healthcare environment.
This position involves planning, organizing, directing, coordinating and evaluating patient care services provided bythe certified home health agency. The Director of Patient Services is responsible for the professional and financialoperations of the agency; provides and ensures that quality improvement is the main focus of the agency.
MINIMUM QUALIFICATIONS: A Masters or Baccalaureate Degree in Nursing from an approved program, or from a non-approved program supplemented by content which can be equated to an approved program, and either: A) Two years ofexperience in a management level position in a certified home health agency; or B) A combination of education andexperience which is deemed equivalent to the experience requirement as specified in (a) by the State Office of HealthSystems Management.
BENEFITS: Excellent county/government benefits including New York State Retirement System. Great team ofprofessionals to work with.
Candidates must possess a limited permit to practice or licensure and current registration to practice as a RegisteredProfessional Nurse in New York State at the time of appointment.
LAST DATE TO FILE FOR PROVISIONAL APPOINTMENT IS SEPTEMBER 14, 2016.
Qualified candidates will be subject to a civil service examination to be announced at a later date. Applications willbe accepted until the announced closing date for the examination.
Please go to www.co.essex.ny.us/job.asp to complete an application and to view a complete job description.
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Compliance Guidance Posted by OMIG
The state Office of the Medicaid Inspector General (OMIG) has posted on its website OMIGCompliance Guidance 2016-01. It requires that the Certifying Official on certifications of Medicaidproviders’ compliance programs must be the person to whom the Compliance Officer reports on theactivities of the compliance program.
This eliminates the previous direction by OMIG that only recommended that the Certifying Official besomeone to whom the Compliance Officer reports. The guidance also states that the Certifying Officialand the Compliance Officer not be the same person for a provider.
Additionally, the Certifying Official should be one of the following:
1. The required provider’s chief executive (e.g., Chief Executive Officer, most senior administrator,owner, etc.);
2. A senior administrator of the required provider formally designated by the chief executive towhom the Compliance Officer reports (e.g., Chief Operating Officer, Vice President or otherofficer level staff, etc.);
3. A member of the required provider’s governing body to whom the Compliance Officerperiodically reports (e.g., chair of the board’s Compliance Committee, board chair, etc.).
Directions on the certification form to reflect this new direction will be made when the certification formis updated starting on December 1, 2016.
OMIG Compliance Guidance 2016-01 is available at: http://on.ny.gov/2c3OTUS. Questions about thisguidance or any or any OMIG compliance matter can be directed to OMIG’s Bureau of Compliance at(518) 408-0401 or [email protected]. Upcoming HCA Member Forums for HCC and Upstate LHCSA Providers
on Sept. 19 & 20 HCA has two member forums coming up for Home Care Council (HCC) of HCA members andour upstate LHCSA members. These forums are a benefit of your membership in HCA and they address issues of direct impact orimportance to your agency type. (If you are not an HCA member and would like to join HCA so you cantake part in these and other benefits, please contact HCA’s Membership Director Laura Constableat [email protected].) A light breakfast will be provided at both forums. The HCC Member Forum is on September 19 from 10 a.m. to 12:30 p.m. at the Hunter CollegeBrookdale Campus in New York City. It is geared for home-attendant agencies in New York City whowere previously members of the Home Care Council.
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The Upstate LHCSA Forum is on September 20 from 10 a.m. to 12:30 p.m. at the Mohawk ValleyHealth System Community Room in Utica, NY. These Forums are led by HCA’s Policy and leadership team. For the HCC Forum, we’ll be delving intosuch issues as:
HRA update on contracts and other important topics;
Current issues with billing and receivables;
Quality Incentive Vital Access Provider Pool (QIVAPP) final awards;
Fair Labor Standards Act (FLSA) funding and DOH survey;
Minimum wage increase and funding for home care providers;
Other policy changes; and
Education programs.
The Upstate LHCSA Forum will address:
Companionship exemption changes;
FLSA funding and state survey;
CDPAP;
State and federal legislative developments;
Minimum wage increase and state funding;
DOH regulatory changes (physician orders, LTHHCP status and others);
DSRIP and value based payment; and
Issues in your region
Participation in HCA Member Forums gives you an opportunity to interact with HCA staff andmembers, and exchange valuable information with your colleagues. As always, members are welcome
to bring any issues of concern to the HCA team at these forums so we can troubleshoot or advocateon your behalf. You can register for each respective forum by downloading the registration forms at the links belowand sending them to HCA.
HCC Forum: http://hca-nys.org/wp-content/uploads/2016/08/HCC-Forum-9-19-16-Registration-Form.pdf
Upstate LHCSA Forum: http://hca-nys.org/wp-content/uploads/2016/08/HCA-Upstate-LHCSA-Forum-September-20-Registration-Form.pdf
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Media Outreach on BTVH-NY: New Op-Ed by HCA Board Member Zicari,
Crain’s Interview with HCA, Selfhelp HCA and members have begun working the media angle on our Bring The Vote Home-NewYork campaign, and we hope you can join us.
Over the past weekend, HCA BoardMember Elizabeth Zicari had an op-edpublished in the Rochester Democrat andChronicle newspaper about the work herorganization is doing to participate in BringThe Vote Home-NY. Ms. Zicari is President ofHCR Home Care.
“During this year’s presidential election season,we hear a lot about voter turnout, polls, andvoter registration issues, but one importantconstituency demands attention: the 400,000 elderly, chronically ill, and persons with disabilities in NewYork state who receive home care services,” Ms. Zicari writes. “Many of these individuals are homebound,meaning they have difficulty getting to the polls on Election Day. Others have life-limiting illnesses ordisabilities that hinder their access to election sites because of transportation issues or the incredibly taxingeffort it takes to leave home – access issues that many of us take for granted.”
“But caregivers around New York are stepping in to help, including HCR Home Care,” she adds. “Ouragency and colleagues are engaging in a new nationwide campaign called Bring The Vote Home. Thiscampaign is delivering voter registration and ballot materials to thousands of home care patients as part ofan outreach initiative designed to reach this unique and especially vulnerable population.”
You can read her op-ed online at http://www.democratandchronicle.com/story/opinion/guest-column/2016/08/27/campaigning-help-make-voting-easier-patients/89462544/.
On Tuesday, HCA also sent out a press release to select media contacts about Bring The Vote Home-NY.The press release is posted to the press release section of HCA’s website (at http://hca-nys.org/category/press-releases) and it draws attention to the work that home care agencies are doing to deliver thousands ofvoter materials to patients.
The press release was picked up by Crain’s Health Pulse today, who interviewed HCA President Joanne
Cunningham and one of our active campaign participants in New York City: Selfhelp Community
Services. As Selfhelp told Crain’s, its “agency is asking its 1,800 home care clients in New York City andNassau County about their registration status and informing them how they can sign up to receive arecurring absentee ballot for every election.”
Sandy Myers, Director of Government and external relations at Selfhelp, explained the value of thecampaign: “It’s a way to empower people who otherwise don’t have their voices heard in the voting booth toparticipate in the process,” she said.
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HCA extends thanks to Selfhelp and HCR for helping to spread the word. We encourage all members toread our press release and share it with your local media with a note about your organization’s work on BringThe Vote Home-NY.
Are You In?
If you are not yet participating in this important campaign, we hope that this media opportunity gives you agood reason to take part. Time is running out, and we need as many agencies as possible to begin the processof orienting their staff so they can supply patients with voting materials well before the fall deadlines toregister to vote and obtain an absentee ballot.
As you can see, Bring The Vote Home-NY offers an opportunity for you to show the good work you are doingin the community: Delivering vital home care services, yes, but also helping patients in other ways. Yourparticipation in Bring The Vote Home-NY gives you a new angle to talk about your agency and its overall rolein community work.
If you need assistance with any press outreach on Bring The Vote Home-NY, or further information about the campaign,please contact HCA’s Communications Director Roger Noyes at [email protected] or (518) 810-0665.
More information, including a video and background are available on our Bring The Vote Home-NY websiteat www.bringthevotehomeny.org.
Naylor Advertising Option in HCA Membership Directory Offers you Exposure
to Discharge Planners and Care ManagersOptions are in addition to free member listing
By now, HCA members may have received a notice about advertising options for our Membership Directoryand Reference Guide. This guide is produced each year as a publishing arrangement between HCA and NaylorAssociate Solutions.
Once published, the guide will be sent to discharge planners, local districts and other case managers as aspecial member marketing benefit, listing all HCA member home care agencies, free of charge, so that referralsources know where to turn to arrange for home care services with your agency. Your agency will be listed bygeographic region in alphabetical order, with contact information and a listing of the services you provide,based on the information HCA has on file for you, so that key case managers and referral sources can reachyou. The guide will be published and circulated in late November.
In addition to your free agency listing, HCA and Naylor are offering some options for home care agencies topromote their brand even further among referral sources with full-color advertisements in the guide, targetedto your region of the state. We encourage members to review the options for additional exposure by reviewingthe advertisement selection form.
If you have not received this form yet, you can download it from HCA’s website at http://hca-nys.org/wp-content/uploads/2016/08/HCNR0017PDischargePlannerGuide.pdf. The deadline to reserve an ad isSeptember 29, 2016.
For questions about the guide, please contact Naylor’s Ashley Benton at [email protected] or HCA’sMembership Director Laura Constable at (518) 810-0660 or [email protected].
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HCA and Partners Engage in PR Campaign on Sepsis, Plan
Sept. 30 Webinar on Sepsis Screening Tool
HCA this week joined qualityimprovement experts from IPRO in thefirst of a series of PR efforts aimed atraising public awareness of the sepsiscrisis and the role that home care canplay in tackling it.
We will also be soon announcingregistration for a series of webinarshighlighting a sepsis screening tool –developed by the HCA Qualitycommittee in conjunction with nationalmedical experts – that home careclinicians can use to assess sepsis risk inpatients at home and then interveneaccordingly.
On the PR front, HCA Executive VicePresident Al Cardillo, IPRO SeniorDirector of Health Care QualityImprovement Sara Butterfield, andIPRO Quality Improvement SpecialistEve Bankert recorded an interview onWednesday with radio news host Diane Donato for her program “Upstate Issues.” The program is broadcaston several iHeart radio outlets in the Capital Region, including WGY 810 AM and 103.1 FM.
Though the interview was scheduled a few weeks ago, it followed a major media campaign last week by theU.S. Centers for Disease Control and Prevention (CDC) highlighting the enormous risk of sepsis and thefact that as much as 80 percent of sepsis cases occur in community settings, further substantiating the needfor a robust home care response to the crises. (HCA members may have seen some news stories on this issuein our HCA News Clips this past week.)
During the interview, HCA and IPRO discussed the sepsis risk factors, signs and symptoms, mortality ratesand other incidence data, as well as HCA’s efforts with IPRO to pilot an HCA screening tool that home careproviders can use to identify and intervene in combatting this public health crisis, which is the number-onedriver of Medicare hospital readmissions in New York State.
HCA expects the segment will air later in September, and we have several other PR efforts underway tohighlight sepsis action and response during National Sepsis Awareness Month in September.
September 30 webinar on sepsis screening tool
HCA is also soon announcing registration for a September 30 webinar for home care providers that willprovide an overview of sepsis and the HCA home care screening tool recently piloted by IPRO as part of its
From left: HCA Executive V ice President Al Cardillo; IPRO'sDirector of Health Care Quality Improvement Sara Butterfield;and IPRO Quality Improvement Specialist Eve Bankert discusssepsis prevention and intervention with radio news host DianeDonato. (Photo courtesy of Carolyn Snedeker, IPRO QualityImprovement Specialist).
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federal sepsis intervention project. (HCA and the National Sepsis Alliance are partners to IPRO on thefederal pilot.) The webinar will include CDC and other officials supporting the launch of this first-in-the-nation sepsis screening tool for home care developed by HCA.
Two additional webinars are in the works, dealing with agency adoption and integration of the tool intoelectronic health records (EHRs), and a train-the-trainer session.
Please stay tuned for additional information on our PR efforts and registration links for the upcomingtraining sessions, with details announced in an upcoming alert to the membership.
Check Out Our Sponsors and Exhibitors at HCA Women in Healthcare
Leadership Summit: Register Today!
HCA’s Women in Healthcare Leadership Summit, on September 28-29 in Saratoga Springs, is HCA’s first-ever program geared for all of the exceptional women leaders in healthcare, and we have a world-class lineup ofspeakers offering skills in communications, negotiations, networking and other tools designed to supportwomen in their healthcare leadership careers.
This week, HCA posted a list of sponsors and exhibitors supporting our conference, including several vendorswho will be on-site as part of our Women’s Health Mini-Expo at the summit. This fun showcase includes anarray of fashion, lifestyle, and health & wellness opportunities (make-up, chair massages, product demos andmore).
Plus, FREE for all attendees, we are offering an Executive Headshot Station for you to get a professionalphoto to use on your C.V. or networking platforms!
Sponsor and exhibitor information, registration options and more are all posted on our website at http://hca-nys.org/general-news/hcas-first-ever-women-in-healthcare-leadership-summit-sept-28-29-in-saratoga.
Be on the lookout next week for a special message from HCA President Joanne Cunningham on the summitand why you should plan on attending.
NYSHealth Launches 2017 Special Projects Fund Request for Proposals
The New York State Health Foundation (NYSHealth) 2017 Special Projects Fund Request forProposals (RFP) is now available (see http://tinyurl.com/jbbrsxb).
Applicants must submit an online inquiry form to determine whether a proposed project fits the fundingcriteria. There are two funding cycles for the Special Projects Fund. Deadlines for the online inquiry formare September 27, 2016 and March 15, 2017. Selected organizations will be invited to submit full proposals,with deadlines of November 18, 2016 and May 17, 2017.
NYSHealth Special Projects Fund awards are one-time, nonrenewable funding opportunities consistent withthe Foundation’s mission to improve the health of all New Yorkers but outside of its main priority areas.
Eligible projects are coordinated interventions that take place over a specified period of time to achievequantifiable results. Under the Special Projects Fund, the Foundation gives preference to projects that: help
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low-income and elderly consumers understandand navigate the health system; improve accessto health care in service areas with acuteshortages; improve quality in measurable ways;support and strengthen safety-net providers toreach more people; and address statewide healthsystem issues that could improve the efficiencyor effectiveness of the system.
Further Court Action
Issued on Jimmo Case
On August 17, the U.S. District Court for theDistrict of Vermont issued an Opinion andOrder related to a prior court case, Jimmo v.Burwell, with implications for the Medicarehome health benefit.
The Opinion and Order is at http://www.medicareadvocacy.org/wp-content/uploads/2016/08/Jimmo-2.pdf.
The court decided that U.S. Department ofHealth and Human Services must provideadditional education about the issues decided inthe Jimmo case, but does not have to makefurther revisions to the Medicare Benefit PolicyManual than it had previously done in responseto the case.
The Jimmo court case challenged Medicare’s useof an “improvement standard” in determiningmedical necessity for skilled services provided athome, in nursing homes and in outpatientsettings, on the grounds that this standardviolated Medicare law and deprived Medicarebeneficiaries of needed care.
Under the settlement, the U.S. Centers forMedicare and Medicaid Services (CMS) agreedto revise its Medicare manuals to clarify thathome health and skilled nursing facility “coverageof nursing care does not turn on the presence orabsence of an individual’s potential forimprovement from the nursing care, but ratheron the beneficiary’s need for skilled care.”Furthermore, skilled care may be necessary to
Is Your Agency Interested in
Reducing Workers’ Compensation
Costs?
Presumably the answer is a resoundingyes! Please reserve your seat today at the nextsession in our Home Care Survival BootcampEducation Series: Addressing Factors thatIncrease Workers’ Compensation Costs andDeveloping Ways that Home Care ProvidersCan Reduce Their Expenses.
This session will be held on September 28
from 9:30 a.m. to noon at 130 East 59th St.,7th Floor (near Lexington Ave.), New York,NY 10022.
The financial burden of Workers’Compensation has been increasing for homecare providers due to numerous factors.Agencies face the potential for additionalincreases due to the recently enacted $15minimum wage and a shrinking Workers’Compensation insurance market. By developing a cohesive Workers’Compensation risk-management strategy,home care agencies can play an active role inreducing their costs. Learn from an insuranceindustry expert with the Reis Group aboutpricing issues and the need to understand howinsurance companies and their agents decidethese issues. When it comes to Workers’ Compensation, inparticular, the goal is to help employersunderstand what the insurance underwritersare doing, why they’re doing it, and how they’redoing it, so that your agency can leverage thatinformation to positively impact your bottomline.
To register, please download the brochure athttp://hca-nys.org/wp-content/uploads/2016/06/Sept-28-Survival-Bootcamp-Work-Comp-Costs-and-Expense-Reduction.pdf.
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improve a patient’s current condition, to maintain the patient’s current condition, or to prevent or slow furtherdeterioration of the patient’s condition.
Also, CMS agreed to engage in certain educational activities to implement the Medicare manual changes and toeducate stakeholders regarding the “maintenance coverage” standard.
The plaintiffs’ asserted that CMS had not adequately revised the Medicare manuals to reflect the maintenancecoverage standard and that CMS’s educational campaign was “deficient,” prompting a return to court to seekfurther action.
In particular, the plaintiffs took issue with Medicare manual section 40.1.2.1 that includes a reference to skilledobservation services being covered for three weeks (“three-week rule”), and another section that seems topreclude observation and assessment to address a long standing pattern of a patient’s condition, particularlywhen the treatment plan does not require changes to meet the patient’s needs or maintain his or her condition.
The court did not agree that CMS violated the Settlement Agreement by failing to revise these Medicare manualprovisions, but did find that some of the information in CMS’s educational campaign was “inaccurate,nonresponsive, and failed to reflect the maintenance coverage standard.” As a result, the court required CMS topropose corrective action on its educational campaign within 45 days of the order.
HCA will keep members advised of any actions taken by CMS to comply with this court decision related tofurther education.
IMPACT Act Forum and Provider Call Scheduled
The U.S. Centers for Medicare and Medicaid Services (CMS) will hold a Special Open Door Forum on “TheIMPACT Act and Improving Care Coordination” on September 15 from 2 to 3 p.m., and a National ProviderCall on October 13, 2016, from 1:30 to 3 p.m.
Open Door Forum Details
The September 15 Forum will provide information and solicit feedback pertaining to the Improving MedicarePost-Acute Care Transformation Act of 2014 (IMPACT Act). As previously reported, the IMPACT Actmandates the standardization of patient assessment data across post-acute care settings including skillednursing facilities, home health agencies, inpatient rehabilitation facilities, and long term care hospitals in orderto improve quality of care and quality of life.
This Forum will offer discussion on the goals of the IMPACT Act, the expected outcomes of the Act, andpotential roles post-acute care providers can play in improving coordinated care.
Question, comments, and ideas can be submitted to: [email protected].
Click here for the presentation: http://tinyurl.com/hgc7cbw.
The participant dial-in number is 1-800-837-1935; the Conference ID no. is 74951666.
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A transcript and audio recording will be posted to the Special Open Door Forum website at http://www.cms.gov/OpenDoorForums/05_ODF_SpecialODF.asp (under the “downloads” section) as well ason the IMPACT Act Downloads and Videos webpage: http://tinyurl.com/hn6mqmn.
National Provider Call
CMS’s National Provider Call for home health agencies and other post-acute care providers will discussthe IMPACT Act and how data elements fit within measure development, how information fromassessment instruments is used to calculate quality measures, and examples of the process using thePressure Ulcer measure.
To register or for more information, visit https://blh.ier.intercall.com/details/b745cb4472bb40018189a1da9077eeee.
September eMedNY Trainings
eMedNY has announced its September training programs. Some of the topics include:
ePACES for Dental, DME, Institutional, Professional (Real-Time), Physicians, Private DutyNursing, and Transportation
ePACES COB Billing for Professional and Clinics
New Provider/ New Biller
Medicaid Eligibility Verification Systems (MEVS)
eMedNY training seminars are being held at the following locations:
Binghamton
Canandaigua
Hauppauge
Plattsburgh
New York City
Poughkeepsie
Rensselaer
eMedNY also offers webinars; information for all programs is athttps://www.emedny.org/training/index.aspx.
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NGS Updates
New York’s Medicare Administrative Contractor (MAC), National Government Services (NGS), hasposted the following news to its website:
Update to IVR System – NGS’s Interactive Voice Response (IVR) system now provides theNational Provider Identifier (NPI) of the home health or hospice if there is an overlapping homehealth episode or hospice election for the date of service in question. Providers no longer need tospeak with a live customer care representative to obtain this information. This information isavailable within the Eligibility feature by just saying “Eligibility” or pressing 1 and authenticatingone’s provider information and the beneficiary information.
Reminder When Billing Third Party Liability Demand Claims – Home health agencies arereminded that all requests for anticipated payment (RAPs) and claims, including those billedunder Third Party Liability (TPL) guidelines, must be submitted to Medicare within one calendaryear of the episode end date. Any RAP billed past the timely filing limit will reject as untimely inthe claims processing system. Untimely RAP billing may cause an issue with the TPL demandclaim processing; therefore, both the RAP and the claim for the TPL demand episode must be inthe system as a clean claim submission within one calendar year of the episode end date.
Additional CERT Information Now Available – The Comprehensive Error Rate Testing(CERT) Documentation office recently published documentation reference lists based on providerand billing types. The provider and billing types are listed alphabetically. Providers can view andprint the documentation listing(s). The documentation listings will be updated when changes areapproved. If printing, providers should refer to the CERT Provider Website to confirm thecurrent listing. The documents are available in both English and Spanish. The lists also includemedical record documentation that may be needed to support services billed to Medicare.Providers submitting documentation via CD should send the password [email protected]; use the CID number in the subject line of your e-mail. The availablelists can be found on the CERT Provider website at: https://www.certprovider.com/ProviderDocumentationRequestListing.aspx.
For further information, contact Patrick Conole at (518) 810-0661 or [email protected].
Publications
“Caring for America’s Seniors: The Value of Home Care,” by the Home Care Association ofAmerica and the Global Coalition on Aginghttps://www.homewatchcaregivers.com/docs/default-source/default-document-library/value-of-home-care-report-4-17-2016—hcaoa.pdf?sfvrsn=2
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“Medicaid Eligibility Verification System (MEVS) and Dispensing Validation System (DVS)Provider Manual (August 2016),” by eMedNYhttps://www.emedny.org/ProviderManuals/5010/MEVS/MEVS_DVS_Provider_Manual_(5010).pdf
“Realizing the potential of telehealth: Federal and state policy is evolving to support telehealth invalue-based care models,” by the Deloitte Center for Health Solutions and the Deloitte Center forRegulatory Strategyhttp://www2.deloitte.com/us/en/pages/life-sciences-and-health-care/articles/telehealth-policy-brief.html?id=us:2em:3na:chs3327:awa:chs:081716
For more information, contact Andrew Koski at (518) 810-0662 or [email protected].