March 6, 2015 ASAP

ASAP

A Weekly Publication Of HCA Home Care Association of New York State

Legislative Issues  Public Policy



News

Volume 20, No. 9 March 6, 2015

Registration Open for HCA Annual Conference, Leadership Institute Streamlined schedule, lower costs, special leadership institute are among the new offerings for members this year!

Registration is now open for HCA’s Annual Membership Conference on May 6 and 7 at the Saratoga Hilton in Saratoga Springs, our premier annual event.

This year’s conference – themed “Catch The Wave! Are You Ready for the Turnaround?” – has several new features that we are excited to tell you about!

See CONFERENCE p. 3

Senate/Assembly Staking Positions as Budget Process Moves Quickly

See DRIVES p. 2

The process for adoption of a new 2015-16 state budget is moving quickly toward delineation of Senate/Assembly positions on the Executive’s proposals, as well as proposals and priorities of their own.

HCA continues push for budget priorities in Senate/Assembly Bills Throughout this week’s rapidly moving, complex process, HCA continued to reach out to key legislative offices in meetings, calls and document-exchange in support of HCA budget priorities for home care and managed care. Our budget proposals seek funding for home Inside ASAP and community based care within the Executive’s Register Now for HCA Annual Conference….....................................1 more than $2 billion in proposed health care Senate/Assembly Staking Budget Positions….................................1 investment funding, along with our language for Member Hiring Announcement...........................................................4 March 18 CFO Forum Just Days Away: Register Today…....................5 CMS Extends Technology Survey Deadline…......................................5 HCA Data Webpage Has New Home Care Data Reports…..............6 “Quality Tool” Participants Discuss Beta Results, Next Steps…........7 CMS, OMIG to Begin Random Payment Audits…...........................7 HCA Develops, Submits Veterans’ Home Care Pilot….......................8 Case Management ‘Care at Home’ Rates Increase…...........................8 Some Providers Must Use Special CBSA Codes for PPS......................9 Managed Care Update….....................................................................9 DSRIP and Value Based Payment Updates….....................................10 Registration Now Open for June OASIS Blueprint Program….........10 NY Health Exchange ePACES Identifier Established…....................11 CMS to Host 2nd Forum on F2F Documentation Template…...........12 HCS Paperless User Account Information.........................................12 Reminder: Flu Vaccine Report Due May 1….....................................13 DOH Letter Reiterates Health Screening, Training Requirements....14 NGS Reminds Hospices about Cap Self-reporting…......................14 DOH Issues 2015 Regulatory Agenda…...........................................16 CMS Creates Health Care Payment Learning & Action Network......17 ‘Money Follows The Person’ Update…............................................18 Open Call for HCA’s 2015 Award Nominations…..............................18 Publications................................................................................…................19

See BUDGET p. 2

Helping New Yorkers Feel Right At Home

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Volume 20, No. 9 March 6, 2015 

BUDGET from p. 1 infrastructure, transition and innovation support for the home care-managed care system. (Please refer to the February 27 edition of ASAP for a description of these items.)

One-house bills/resolutions to be revealed, adopted next week State legislative staff worked throughout the week, and will be working over the weekend, to prepare their onehouse budget bills and/or resolutions for Senate and Assembly adoption sometime next week. Once adopted, the two houses will begin the process of reconciling their positions through joint-legislative conference committees for each budget area (e.g., health, transportation, education, etc.).

HCA member outreach critical during narrow window It is critical that HCA members contact their individual legislators urging support for home care-managed care priorities in the budget. (Please refer to the talking points on p. 3 of the February 13 ASAP at http://www.hcanys.org/documents/ASAP021315.pdf.) Regardless of whether you have already done so, it is very important to call or e-mail your legislators during this narrow window, as proposals which appear in the one-house bills and/or resolutions of the Senate and Assembly (preferably both houses) stand the best chance of making it to the next round of the negotiations. Even then, the proposals must be agreed-to and adopted by the Legislature and Executive to be included in the final, enacted budget.

HCA will continue to keep the membership closely apprised of our progress and the status of budget formation.

For further information, please contact a member of the HCA Policy staff.

ASAP is a weekly publication of the Home Care Association of New York State (HCA). Unless otherwise noted, all articles appearing in ASAP are the property of the Home Care Association of New York State. Reuse of any content within this newsletter requires permission from HCA.

President: Editor:

Joanne Cunningham, jcunningham@hcanys.org Roger L. Noyes, Director of Communications, rnoyes@hcanys.org Al Cardillo, Executive Vice President, Policy & Programs, acardillo@hcanys.org Patrick Conole, Vice President, Finance & Management, pconole@hcanys.org Andrew Koski, Vice President, Program Policy and Services, akoski@hcanys.org Laura Constable, Senior Director, Membership & Operations, lconstable@hcanys.org Lynda Schoonbeek, Director of Education, lschoonbeek@hcanys.org Mercedes Teague, Finance Manager, mteague@hcanys.org Jenny Kerbein, Director of Governance and Special Projects, jkerbein@hcanys.org Billi Hoen, Manager, Meeting and Events, bhoen@hcanys.org Teresa Brown, Administrative Assistant, tbrown@hcanys.org 388 Broadway, 4th Floor, Albany, NY 12207 Tele: 518-426-8764; Fax: 518-426-8788; Website www.hcanys.org

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ASAP – a publication of the Home Care Association of New York State

Volume 20, No. 9 March 6, 2015 

CONFERENCE from p. 1 Smaller fee, less time out of the office This year’s conference is now a two-day event, reducing the cost to you and limiting the amount of time you must spend away from the office … while also continuing to offer the top-caliber speakers you’ve always experienced at this signature event.

Special leadership training segment In addition, we are pleased to offer a new half-day Leadership Institute on May 8, also at the Saratoga Hilton, following the regular conference program.

The Courage to Lead: Critical Skills for Healthcare Leaders is presented exclusively for HCA by the American College of Healthcare Executives. Designed for health care leaders at all levels, the program will provide proven tools and techniques to identify and develop your leadership philosophy and skills, no matter what your level of formal authority is.

You can choose to attend both programs – the HCA Annual Conference and the Leadership Institute – or only one.

Continuing education credits sought While skill-development is the main goal of our conference, it is also nice for you to get some formal credit for your attendance. This is why the HCA Annual Conference has been submitted, but not yet approved, for Continuing Education clock hours from the National Association of Boards of Examiners of Long Term Care Administrators (NAB/NCERS).

Who Should Attend Chief Executive Officers, Executive Directors, Administrators, Finance Managers, Clinical Leaders or any other department leader who plays a key role in the success of your operation.

Why not use the HCA Annual Conference as an educational retreat for your team?

Let us know if we can help make that happen!

Some other highlights This year’s conference agenda was developed with an eye toward meeting important emerging education needs in home care while responding to your continuing feedback from prior events. As always, we offer sessions that fit the needs of all staff levels.

NAB Continuing Education Clock Hours

For instance, internationally known speakers T.R. Reid and Tom Clynes will offer new ideas and perspectives that inspire you. Mr. Reid is author of the national bestseller “The Healing of America: A Global Quest for Better, Cheaper and Fairer Health Care.” He will reveal how some U.S. communities have found ways to improve the quality of care and contain costs by orchestrating their local health care providers, including home care, to work together rather than waiting for Washington to tell them what to do.

The HCA Annual Conference has been submitted, but not yet approved, for Continuing Education clock hours from the National Association of Boards of Examiners of Long Term Care Administrators (NAB/NCERS).

Mr. Clynes, a National Geographic journalist and photographer, covers the adventurous side of science, the environment and public health. He will bring you along ‘on assignment’ to some of the most intriguing places on Earth through stunning

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photos and provocative stories. In this journey, Mr. Clynes will share how we all have the capacity for finding vision and generating extraordinary results.

In addition to these leading keynote presenters, attendees will have the opportunity to hear from experts on timely topics such as population health care-coordination, caregiver recruiting and retention, physician collaboration and face-to-face mandate documentation, communication and more.

The Annual Conference will also provide networking opportunities and showcase over thirty vendors in attendance. We will also recognize our 2015 award recipients – a highlight of the conference. If you haven’t yet submitted a nomination for our annual awards, please see the announcement on this page and send us your nomination using a quick and easy online form. It takes just a few minutes to submit your nomination.

Deadline Extended to March 13.

See the back of this week’s ASAP.

HIRING

A brochure that further describes the programs and presenters is available at www.hcaannualconference.com.

VNA Home Care: Quality Assurance/ Performance Improvement Manager The Quality Assurance/Performance Improvement Manager is responsible for the direct implementation of the Corporate Quality Improvement Plan including the identification of care outcomes and the development of appropriate intervention action plans throughout the Certified Home Health Agency (CHHA), Licensed Home Care Services Agency (LHCSA), Managed Long Term Care (MLTC) plan, and Social Adult Day Center (SADC).

You can register using the form included with the brochure, or you can register online, safely and securely, at www.eventville.com/hcanys using your credit card.

Special discount Our brochure also describes a special discount for first-time attendees of the Annual Conference with the opportunity to also attend the Leadership Institute at the lowest price available. Please review the brochure for this special offer, and register today!

Qualifications: Current license as a Registered Nurse, Physical Therapist, or Occupational Therapist in New York State; Bachelor’s degree from an approved school, acceptable to the state Department of Health, Master’s Degree preferred; Two years of experience as a clinician in home and community based services.

For further information, contact Lynda Schoonbeek at (518) 810-0656 or Lschoonbeek@hcanys.org.

To learn more about the position and to apply, please visit http://477home.org/2015/02/qualityassuranceperformance-improvement-managersyracuse-ny/.

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ASAP – a publication of the Home Care Association of New York State

March 18 CFO Forum Just Days Away: Register Today HCA’s March 18 CFO Forum is less than two weeks away. Please be sure to register now for this must-attend program, which is an important benefit of your HCA membership.

If you are a home care or Managed Long Term Care (MLTC) financial manager, CFO, or executive-level staff, you will not want to miss this unique, once-a-year opportunity to hear directly from HCA policy experts, state Department of Health (DOH) finance and reimbursement officials, and industry consultants on the issues that matter most directly to your role overseeing the budget and fiscal management functions of your agency.

Kicking off the Forum, HCA staff will highlight the many finance-related advocacy areas where we are working on your behalf, including: federal and state budget updates; our work to influence the many rate packages and payment-model implementation efforts occurring internally at DOH; and the complex Medicare payment issues under federal rebasing and the home health Prospective Payment System (PPS).

DOH reimbursement officials will provide yet further details on all of the state-level issues that interest you, including updates on: provisions in the 201516 Executive State Budget; the upcoming rebasing of the Certified Home Health Agency Episodic Payment System (EPS); the Medicaid Global Cap; premium rate adjustments to MLTC and Mainstream Medicaid Managed Care plans; Wage Parity adjustments to plans and home care providers; Quality Incentive/ Vital Access Provider monies; the Long Term Home Health Care Program and Personal Care fee-for-service Medicaid rates; the 2014 Medicaid cost reports and other Medicaid reimbursement issues.

Robert Simione will provide participants with the latest aggregate benchmarking data for Medicare and Medicaid to help you make sense of how the various federal and state fiscal policy levers are affecting your bottom-line and operational practices related to your peers. Participants will also hear from two former executives at MVP Health Plan, based in the Capital District, who will share tips on ways that home care providers and managed care organizations can forge successful relationships, drawing from their many years of experience in the plan world.

Please do not miss out on this robust program which delves into several important areas relevant to your agency’s fiscal health. Further details are below and a registration form is published in the back pages of this week’s ASAP. CFO Forum Wednesday, March 18, 2015 9 a.m. to 2:30 p.m.

Hilton Albany, 40 Lodge Street (Corner of State and Lodge Street) Albany, NY 5

Volume 20, No. 9 March 6, 2015 

CMS Extends Technology Survey Deadline The U.S. Centers for Medicare and Medicaid Services (CMS) has extended the deadline – until April 3 – for home care and other postacute providers to complete a voluntary survey that will “help CMS understand the role technology is playing in the delivery of health care services.” The survey is at https:// www.surveymonkey.com/s/ 3T9MV3J. According to CMS, the goal of the survey is to learn more about the adoption rate of health information technology (HIT) and engagement in electronic health information exchange (HIE) in long term and post-acute settings and the extent to which HIT and HIE are used in these settings.

The information will help CMS understand where such technology may be playing a role in the delivery of health care services in such settings.

It will also identify both the benefits and the gaps hindering provider participation in programs that promote care coordination.

This survey is fully voluntary, and there is no penalty for not responding. Individual survey responses will not be made public.

The estimated time to complete the survey is 20 minutes.

ASAP – a publication of the Home Care Association of New York State

Volume 20, No. 9 March 6, 2015 

HCA Data Webpage Offers New Home Care Data Reports Over the past few weeks, HCA staff posted a number of significant updates to our ‘HCA Data’ website (http://www.hca-nys.org/data.cfm) including the following highlights: •

National Government Services (NGS) home health utilization data from July to December 2014;

•

2013 New York statewide aggregate Medicare Margins and other prospective payment system (PPS) data as well as aggregate Medicare margins and PPS data for hospital-based Certified Home Health Agencies (CHHAs), free-standing CHHAs and CHHAs in rural and urban areas;

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The latest CHHA, Long Term Home Health Care Program (LTHHCP), Licensed Home Care Services Agency (LHCSA) and Hospice Directories from the state Department of Health (DOH);

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A link to the current New York City Human Resource Administration (HRA) Vendor/Personal Care Rates; and

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Current Medicare Advantage enrollment statistics.

‘HCA Data’ is a members-only page that provides data reports to assist home care and hospice providers and managed care plans in their benchmarking efforts, understanding of system-wide trends, and access to reimbursement and premium rates. It is password protected. If you do not know your password for HCA’s website, please feel free to send an e-mail to info@hcanys.org and a password will be provided to you.

Other data updates in the works HCA has recently submitted a Freedom of Information Law (FOIL) request for the 2013 Medicaid Cost Reports for all non-hospital based CHHAs and all LTHHCPs in the state. Upon receipt of this data, HCA will prepare a spreadsheet summarizing key Cost Report data including: revenue by all payors; expenses; total operating margins; unit costs by discipline; number of full time equivalents (FTEs) and more. HCA hopes to make this data available to members in May. In late April or early May, HCA will also be submitting another FOIL request for the fourth quarter 2014 Medicaid Managed Care Operating Reports (MMCORs) from each Managed Long Term Care (MLTC) plan and Program of All-Inclusive Care for the Elderly (PACE) plan in the state. MLTCs and PACE programs have until March 31, 2015 to submit the MMCOR data to DOH, and it usually takes the Department four to five weeks to assemble this data before making it available for FOIL request.

Upon receipt of the 2014 MMCOR data, HCA will prepare a spreadsheet summarizing key MMCOR data, including such items as: plan enrollments; per-member-per-month premium revenue and premium income; unit costs; and other information, which should be available to members in mid to late June.

HCA Data currently has the fourth quarter 2013 MMCOR and 2012 CHHA and LTHHCP Medicaid Cost Report data for members.

For further information, contact Patrick Conole at (518) 810-0661 or pconole@hcanys.org.

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ASAP – a publication of the Home Care Association of New York State

Volume 20, No. 9 March 6, 2015 

“Quality Tool” Participants Discuss Recent Beta Test Results, Next Steps The results of the HCA Quality Risk and Compliance Tool beta test were presented and discussed this week with beta test participants via an HCA webinar.

The beta test resulted in excellent feedback and suggestions on formatting and on some of the tool’s metrics.

Most importantly, the beta test validated the overall functionality and utility of the tool, which continues to be enthusiastically received.

The HCA Quality Risk and Compliance Tool has been developed under the HCA Quality Committee and, in particular, the leadership of Committee and Board member Laurie Neander, President and CEO of Bassett Healthcare At Home. The Quality Committee has worked steadily on this tool, first giving rise to the concept and then shepherding its progress, over the past year and a half.

Simultaneous with the tool’s development and now beta test, HCA is pursuing additional steps to support the tool’s integration within the home care sector in the state. HCA is exploring automation, reports and further beneficial feedback/consultation for agencies based on the tool. HCA has also submitted language for the state budget that would provide financial support for agency integration, staff training and quality innovation related to the tool.

Based on the beta test, HCA and the Committee will be incorporating the format and content recommendations and will review in Committee the next iteration, working toward finalization and eventual member-wide implementation. Many HCA members have contacted HCA with enthusiasm to adopt the tool as soon as it can be made ready; HCA and the Committee will be working as expeditiously as possible to ready this resource for the membership.

HCA is proud to be taking this leadership role in seeking to advance quality through home care, which is not only essential for excellence in care but also vital to the value that consumers, payors and policymakers are more than ever seeking and desiring of the health care system.

Many thanks to Ms. Neander, the Quality Committee members and the beta test volunteers for their effort and leadership.

For further information, please contact Al Cardillo at acardillo@hcanys.org.

CMS, OMIG to Begin Random Payment Error Rate Measurement (PERM) Audit The U.S. Centers for Medicare and Medicaid Services (CMS) is collaborating with the state Office of the Medicaid Inspector General (OMIG) to measure improper payments under the Payment Error Rate Measurement (PERM) program. This is the third time New York has participated in PERM. (It last did so in fiscal year 2011.)

CMS, its contractor, and OMIG have the authority to collect this information under the Social Security Act. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) statutes and regulations require the provision of such information upon request, and the information can be provided without patient consent.

Beginning this month, agencies may receive a request from A+ Government Solutions, Inc., the CMS contractor, for medical review of randomly selected claims. If your agency’s claims are selected, the contractor will request 7

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that you submit, in writing, documentation to substantiate claims paid in federal fiscal year 2014 (October 1, 2013 to September 30, 2014).

The specified medical documents should be sent directly to the CMS contractor with a copy to OMIG at the following address: Office of the Medicaid Inspector General, 800 North Pearl Street Room No. 328, Albany, NY 12204, Attention: PERM Project Staff.

Failure to comply with the record requests will result in a determination of erroneous payment, and OMIG will pursue recovery of these amounts.

For specific questions on PERM, contact the PERM project staff at (518) 486-7153 or (518) 402-7041.

For further information, contact Patrick Conole at (518) 810-0661 or pconole@hcanys.org.

HCA Develops, Submits Veterans’ Home Care Pilot With the budget as a possible vehicle, HCA this week developed and shared with the Legislature a proposal for an enhanced home care-pilot for veterans.

The proposal is an attempt (within the narrow budget window) at quick and opportune follow-up to the discussions and recommendations at a recent, joint roundtable sponsored by HCA and the New York State Health Foundation on Veterans’ Home Care.

The proposal would pilot-test the benefit, quality, cost-effectiveness and increased access to services of a coordinated, interdisciplinary plan of home and community based services for veterans. The program would be structured as a collaboration between home care agencies, physicians and other partners, for addressing the health, psychosocial and other interdisciplinary health needs of veterans through home and community based services. The program would be established through eligible home care agencies with experience in veterans care, including Certified Home Health Agencies, Licensed Home Care Services Agencies and Long Term Home Health Care Programs.

Experience and data collected through the pilot would be reviewed and considered by the state in rendering recommendations for next steps and/or other areas of policy or program improvement for veterans’ health. The proposal would further authorize the state to seek federal matching funds, as well as to seek federal authority for integrating through the pilot program the benefits available to veterans through the U.S. Department of Veterans Affairs, Medicare, Medicaid and/or any other federal benefit program.

Preliminary reactions were positive, and included discussion of still-further ideas for approaching and/or promoting this goal. Stay tuned for further reports.

For further information, please contact Al Cardillo at acardillo@hcanys.org.

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Case Management ‘Care at Home’ Rates Increase The state Department of Health Office of Health Insurance Programs has announced a statewide fee increase for case management services provided in the Care at Home (CAH) I/II waiver program, effective for dates of service on and after April 1, 2014. The new fee is $0.85/unit ($90.93 per hour). This change is limited to CAH I/II case management services.

CAH case management agencies should continue to use the same rate code to claim for services provided on or after April 1, 2014, corresponding to the waiver in which the client is enrolled. These CAH rate codes are CAH I 2301 and CAH II 2302.

For services prior to April 1, 2014, the reimbursement will be at the previous rate of $21.88 per quarter hour.

Note: the date of service determines the fee, not the date the provider submits a claim for reimbursement. It is anticipated that the payment adjustment will be effective by cycle 1960.

If you have questions, please contact Lydia Kosinski at the Bureau of Home and Community Based Waivers of the Division of Long Term Care at (518) 474-5271.

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Some Providers Must Use Special CBSA Codes for Transitional PPS Wage Index In the 2015 home health prospective payment system (PPS) final rule, the U.S. Centers for Medicare and Medicaid Services (CMS) is using a transitional wage index system that includes two Core-Based Statistical Areas (CBSAs).

As a result, home health agencies (HHAs) may serve beneficiaries in areas where there is more than one unique CBSA. In these cases, HHAs should use special CBSA codes in the range 50xxx on their claims.

CMS and its contractors have reported that some HHAs are not using these special CBSA codes, causing the claim to be paid incorrectly with 2014 wage index values. Soon, 2015 claims with invalid CBSA codes will be returned to the provider. HHAs should adjust any claims previously paid incorrectly.

For additional information on this issue, see: http://www.cms.gov/Outreach-and-Education/MedicareLearning-Network-MLN/MLNMattersArticles/downloads/MM8969.pdf.

For further information, contact Patrick Conole at (518) 810-0661 or pconole@hcanys.org.

Managed Care Update The U.S. Centers for Medicare and Medicaid Services (CMS) has approved the Managed Long Term Care (MLTC) transition into Cattaraugus County.

Starting next week, or soon thereafter, individuals who need community-based long term care services for more than 120 days will be required to enroll into an MLTC plan, and existing recipients of such care are required to enroll into plans over a period of time.

Letters have been sent to existing recipients to advise them of this change.

The following remaining upstate counties will move to mandatory MLTC enrollment upon CMS approval: Allegany, Chautauqua, Chemung, Schuyler, Seneca, Yates, Clinton, Essex, Franklin, Hamilton, Jefferson, Lewis, and St. Lawrence. Some of the MLTCs have requested state approval to expand their services into these counties.

These are the remaining final counties for statewide implementation of mandatory MLTC enrollment for this population.

FIDA As mentioned in last week’s ASAP, the state has postponed the roll-out of the Fully Integrated Duals Advantage (FIDA) program in Westchester and Suffolk counties (Region Two), originally scheduled for April 1. Instead, the state plans to concentrate on increasing FIDA enrollment in New York City and Nassau (Region One).

There are currently 765 individuals who have opted into FIDA and 27,932 individuals who have opted out of FIDA. Starting April 1 and continuing for a few months, individuals in Region One who have not enrolled or

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ASAP – a publication of the Home Care Association of New York State opted out will be “passively enrolled” into a FIDA plan. Once enrolled, they will still have the option to disenroll from the FIDA plan and enroll in a partially capitated Managed Long Term Care plan.

DOH has posted numerous notices related to FIDA at http:// www.health.ny.gov/health_care/medicaid/redesign/mrt_101.htm.

These include: Voluntary Enrollment Denial Notice, Safe Discharge Confirmation Form, Managed Care Transfer Request Confirmation Notice, and Voluntary Disenrollment Confirmation and Denial Notices.

For more information, contact Andrew Koski at (518) 810-0662 or akoski@hcanys.org.

DSRIP and Value Based Payment Updates The state Department of Health (DOH) has announced that the U.S. Centers for Medicare and Medicaid Services (CMS) has finalized its review of the Vital Access Provider (VAP) Exceptions to participate in DSRIP with a safety net designation.

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Registration Now Open for June OASIS Blueprint Program The popular Blueprint for OASIS Accuracy is coming to Albany on June 23 and 24, with an option to take an OASIS certification exam on June 25, the day following the workshop.

Registration is now open, and we encourage you to reserve your spot as soon as possible to ensure access to this important course for your field data collectors and their supervisors.

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Three Licensed Home Care Services Agencies (LHCSAs).

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Harm Reduction Providers.

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Home and Community Based Services (HCBS) 1915(i) Providers.

The Certificate for OASIS Specialist-Clinical (COS-C) Exam, offered on June 25 at the same location as the workshop, is a voluntary certificate examination for those interested in demonstrating and establishing their expertise and commitment to OASIS data accuracy. The scope of the COS-C exam is similar to the Blueprint workshop agenda, covering federal guidelines related to OASIS time points, regulations, patient populations, and OASIS-C1 item-specific scoring.

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State Designated Health Homes. Health Homes are only approved for safety net designation based on the state’s criteria of providers that billed $10,000 or more of health home and care management services to Medicaid annually.

To learn more about this program, please see the flyer at the back of this week’s ASAP or register online at http:// tinyurl.com/qj7lvmo.

These approvals are in addition to the nine approved lead entities announced in January 2015.

The approved entities include:

The CMS approval letter is at http://www.health.ny.gov/ health_care/medicaid/redesign/dsrip_safety_net_definition.htm.

Any provider that was not approved by CMS for safety net designation may still participate in DSRIP under its respective Performing Provider System (PPS) as a non-qualified provider. This includes non10

Blueprint for OASIS Accuracy June 23 and 24 (workshop) June 25 (optional COS-C exam) Holiday Inn Albany 205 Wolf Road Albany, NY 12205

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qualified health homes within a network that has approved safety net providers. Non-qualified providers, as a group, cannot receive more than 5 percent of the project’s total value.

Questions related to the VAP Exception or DSRIP safety net process should be sent to BVAPR@health.ny.gov. All other questions can be directed to DSRIP@health.ny.gov.

Resources DOH also has made available the following publications: • • •

NY Health Exchange ePACES Identifier Established An ePACES identifier has been activated to assist providers in identifying New York State of Health (NYSoH) Medicaid recipients. The identifier is displayed as H78 in the Office field.

DOH has updated its DSRIP timeline. The revised listing is at http://www.health.ny.gov/health_care/medicaid/redesign/ dsrip/docs/dsrip_timeline.pdf.

NYSoH is the official New York State health plan marketplace where individuals can select health coverage.

Providers servicing NYSoH Medicaid consumers in need of recipient restriction changes, exception coding to allow Medicaid payment for case management services, exclusion coding, or who experience certain “lifechanging” events, can now identify NYSoH recipients and utilize the state Department of Health’s established points of contacts.

Some important dates include:

NYSoH Level of Care Transitions

• •

DSRIP High-Level Timeline Implementing the DSRIP Finance Function Medicaid Redesign Team Innovation eXchange (MIX) Update Implementation Plan, Quarterly Reports, and Achievement Values DSRIP Workforce Workshop

Timeline

• • • • •

Attribution for performance results released – March 16 PPS member roster released to PPS leads – mid to late March Baseline data released to PPS leads – late March Implementation plan due from PPSs – April 1 DSRIP year one begins – April 1

Value Based Payments DOH has released version 3 of the Draft Value Based Payment (VBP) Roadmap for public comment. HCA is part of a Value Based Payment Workgroup of stakeholders and has already provided comments on a previous VBP roadmap version. (See last week’s ASAP for an in-depth look at value based payments.)

The roadmap can be accessed at https://www.health.ny.gov/ health_care/medicaid/redesign/dsrip/vbp_reform.htm.

Public comments are due on March 30 to dsrip@health.ny.gov.

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To assist individuals in immediate need of certain services that are not available on NYSoH, providers can: e-mail hxfacility@health.ny.gov; call (518) 473-6397; or fax (518) 474-9062.

Those services unavailable under NYSoH include managed long term care, waiver services, fee-for-service personal care, fee-for-service short term (up to 29 days) rehabilitation, long term (permanent placement) nursing home, ICF, congregate care facility, Special Needs Plans and Medicaid Advantage.

Questions may be referred to the Bureau of Medicaid Enrollment and Exchange Integration, Office of Health Insurance Programs at (518) 473-6397.

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CMS to Host 2nd Forum on Documentation Template for F2F The U.S. Centers for Medicare and Medicaid Services (CMS) will host a second Open Door Forum on Wednesday, March 11, 2015, from 1 to 2 p.m., to assist physicians/practitioners in documenting patient eligibility for the Medicare home health benefit.

CMS is considering a voluntary home health paper clinical template for physician documentation of home health eligibility, along with consideration of an electronic template which has been in the development process over the past year.

According to CMS, the purpose of these templates is to help reduce the documentation burden on physicians and practitioners who order home health services.

In fiscal year 2014, the Comprehensive Error Rate Testing (CERT) program found that more than half of home health claims were paid improperly, and inadequate face-to-face (F2F) documentation was a big driver of these CERT errors. Of the 1,308 CERT-reviewed claims found to include errors, 90 percent (1,172) did not have documentation meeting the F2F requirement.

The participant dial-in number for this call is 1-866-501-5502. The conference ID number is 78964233.

Additional calls on the templates will be held on April 8 and May 6, all at 1 p.m. CMS’s presentation will be posted at: https://www.cms.gov/Research-Statistics-Data-and-Systems/Monitoring-Programs/Medicare-FFSCompliance-Programs/Medical-Review/Home_Health_Medical_Review_Update.html. Feedback and questions on the templates can be sent to HomeHealthTemplate@cms.hhs.gov. A transcript and audio recording will be posted at: http://www.cms.gov/OpenDoorForums/05_ODF_SpecialODF.asp.

HCA and other national partners continue to express major concerns with the federal government’s efforts to reshape the Medicare F2F requirements, which have long been problematic.

While the idea of a clinical template to assist the physician in this effort is conceptually helpful, HCA believes the extensive five-page form, introduced by CMS last month, only increases the burden on physicians and, thus, increases the risk of noncompliance.

Meanwhile, the underlying requirements of F2F – which the form seeks to support – are themselves problematic, especially recent changes that put the responsibility on the physician record for home care service compliance, with financial risk to the home care provider. These issues remain a focus of HCA’s advocacy as we seek a streamlined process for physician documentation of home care eligibility and, specifically, F2F. For further information, contact Patrick Conole at (518) 810-0661 or pconole@hcanys.org.

HCS Paperless User Account Information The state Department of Health (DOH) has posted revised information about its paperless process to establish Health Commerce System (HCS) User Accounts.

In order to obtain an HCS account, individuals can now submit an online form and demonstrate that they have a valid photo identification. The information includes instructions for users and HCS Coordinators and is posted at https://commerce.health.state.ny.us/public/hcs_login.html (under Newsroom Highlights).

12

ASAP – a publication of the Home Care Association of New York State

Volume 20, No. 9 March 6, 2015 

Reminder: Flu Vaccine Report Due May 1 This week, the state Department of Health (DOH) sent an informational message to remind home care and other health care providers about the Healthcare Personnel Influenza Vaccination Report that must be submitted on the Health Electronic Response Data System (HERDS) by May 1.

As mentioned in previous editions of ASAP, this year’s report covers personnel employed by or affiliated with your agency from October 1, 2014 through March 31, 2015. Agencies are required to submit a single, longitudinal report that is open from November 19, 2014 through May 1, 2015.

Detailed guidance on how to access, complete, and submit the report on HERDS, including instructions and a Frequently Asked Questions (FAQ) document, are available at www.health.ny.gov/FluMaskReg. Under the ‘flu mask’ requirement – in effect since December 11, 2014 for this current influenza season – home care and other health providers are mandated to ensure that their aides and other designated personnel who are not vaccinated against influenza wear a surgical or procedure mask while in areas where patients are present. Any personnel vaccinated after July 1, 2014 count as being vaccinated for this influenza season.

Questions about the report should be directed to the DOH Bureau of Immunization at either (518) 4734437 or immunize@health.ny.gov.

Technical questions about HERDS should be directed to the Health Emergency Preparedness Program at (518) 408-5163 or hseppny@health.ny.gov. Questions about the flu mask regulation should be directed to flumaskreg@health.ny.gov.

Weekly influenza surveillance report DOH’s February 28 Influenza Surveillance Report found: •

The influenza activity level was categorized as geographically widespread with laboratory-confirmed influenza reported in 54 counties plus New York City.

•

There were 1,458 laboratory-confirmed influenza reports, a 30 percent decrease over the prior week.

•

The number of patients admitted to the hospital with laboratory-confirmed influenza or hospitalized patients newly diagnosed with laboratory-confirmed influenza was 313, a 40 percent decrease over the prior week.

•

There were no influenza associated pediatric deaths reported this week. Five have been reported this season.

13

ASAP – a publication of the Home Care Association of New York State

Volume 20, No. 9 March 6, 2015 

DOH Letter Reiterates Provider Health Screening & Training Requirements The state Department of Health (DOH) posted a Dear Administrator Letter (DAL) this week on the Health Commerce System (HCS) reminding home health agencies (HHAs) and Hospices of the required personnel requirements related to health assessments and training for agency personnel.

These requirements are found in (10) NYCRR Section 766.11 for Licensed Home Care Services Agencies (LHCSAs); (10) NYCRR Section 763.13 for Certified Home Health Agencies (CHHAs) and Long Term Home Health Care Programs (LTHHCPs); and (10) NYCRR Section 793.5 for Hospices.

The DAL states that all personnel who provide patient care must be licensed or certified and have documented pre-employment and annual health assessment screenings. This includes documentation of immunization against rubella, immunization against measles (for personnel born on or after January 1, 1957), pre-employment and annual tuberculosis screenings, and annual vaccination against influenza (or the required use of a surgical mask during the influenza season, in lieu of the required vaccination). In addition, home health aides are required to complete and document a minimum of 12 hours of in-service education on an annual basis.

The DAL encourages HHAs and Hospices to review the applicable regulations regarding the qualification requirements related to employee health screenings and training, and ensure that all staff meet these qualification requirements. DOH also recommends that providers review personnel records to ensure that documentation of all required screenings, trainings, certification and licensure is on file.

DOH states that its survey activities will continue to review personnel records to verify compliance with these requirements and HHAs and Hospices will be cited for deficient findings. Continuous noncompliance with these requirements may result in enforcement action.

The DAL is posted to the HCS, at https://commerce.health.state.ny.us/hpn/, and can be found on the “New Items” section underneath the Newsroom Highlights.

For specific questions on the DAL, please contact the Division of Home and Community Based Services at homecare@health.ny.gov.

For further information, contact Patrick Conole at (518) 810-0661 or pconole@hcanys.org.

NGS Reminds Hospices about Procedures for Hospice Cap Self-reporting National Government Services (NGS), New York’s Medicare Administrative Contractor (MAC), recently posted information on Hospice cap self-reporting.

The 2015 Hospice Payment Rate Update final rule, issued by the U.S. Centers for Medicare and Medicaid Services (CMS) on August 22, requires Hospice providers to self-report the 2014 and subsequent hospice cap determinations no earlier than January 31 and no later than March 31 of each year. Any hospice that does not report its self-determined cap by March 31 will be subject to payment suspension.

Once Hospice providers have self-reported, NGS will send a confirmation letter within 45 days of receipt.

When applicable, the confirmation letter will also serve as a demand letter for providers with an amount 14

ASAP – a publication of the Home Care Association of New York State

Volume 20, No. 9 March 6, 2015 

due to Medicare. NGS will also perform a cursory review of the submitted self-determination for obvious errors within 60 days of receipt.

Completing and submitting the pro-forma Before completing the CMS-issued pro-forma, please review the “Instructions for completing the Pro-Forma for Provider Self-Determination of Aggregate Cap Limitation” tab. Providers should download and use the CMS-issued pro-forma calculation form. The pro-forma and instructions can be found at: http://www.ngsmedicare.com/ngs/portal/ngsmedicare/newngs/home-lob/pages/forms.

The Provider Statistical and Reimbursement (PS&R) data used in filing the self-reported cap cannot be earlier than January 31, 2015. The statutory cap amount to be used for the 2014 self-reported hospice cap calculation is $26,725.79.

Hospices should submit the pro-forma calculation along with supporting documentation and a copy of the submitted check (if applicable) to NGS no later than March 31.

Hospices in New York should submit these in any of the following ways: by e-mail at selfreportedhospicecap@anthem.com; through NGSConnex; by fax to (414) 459-5081, Attn: Mario Berkec; or by mail to National Government Services, Inc., Reimbursement Department, 6775 W. Washington Street, Milwaukee, WI 53214.

Repaying an overpayment If the Self-Report Calculation indicates an amount due to Medicare, please make a check payable to NGS and submit it in a separate envelope to: National Government Services, 00450 WI Part A Non-MSP, P.O. Box 809199, Chicago, IL 60680-9199.

Other NGS Updates •

CMS Incorporates Revalidation Policies into Integrity Manual – CMS’s Change Request 9011 explains the incorporation of various existing Medicare enrollment revalidation policies into Chapter 15 of the “Program Integrity Manual” (PIM). Additional information is at: http://www.cms.gov/Outreach-andEducation/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM9011.pdf.

•

New Fax Number for Credit Balance Submissions – As of July 1, 2014, the number used for Jurisdiction 6 Credit Balance submissions was changed to (315) 442-4287. Credit Balance reports sent to the previous number may not be accepted.

•

EDI Maintenance Will Be Performed on March 7 to 8 – From March 7 at 10 p.m. through March 8 at 11:59 p.m., the NGS EDI Gateway will be unavailable due to maintenance. During the outage, Trading Partners will be unable to connect and exchange transactions with EDI. Providers with questions can contact the EDI Help Desk at (877) 273-4334.

For further information, contact Patrick Conole at (518) 810-0661 or pconole@hcanys.org.

15

ASAP – a publication of the Home Care Association of New York State

Volume 20, No. 9 March 6, 2015 

DOH Issues 2015 Regulatory Agenda This week’s State Register includes the state Department of Health’s (DOH) list of regulatory actions being considered for submission as a Notice of Proposed Rulemaking through June 2015.

They are listed at http://docs.dos.ny.gov/info/register/2015/march4/pdf/regulatory.pdf and include the following categories and regulatory proposals.

•

Personal Care Services Program: Amend the regulations to reflect the statutory change regarding the limitation of housekeeping services to 8 hours weekly, and to clarify eligibility requirements for continuous and live-in personal care services.

•

Consumer Directed Personal Assistance Program (CDPAP): Amend the regulations to reflect the statutory change regarding the limitation of housekeeping services to 8 hours weekly, and to clarify eligibility requirements for continuous and live-in consumer directed personal assistance.

•

Personal Emergency Response Services (PERS): Amend the regulations to allow for annual authorizations and to delete the requirement that authorization of PERS be contingent upon a reduction/ elimination of personal care aide/home health aide hours.

•

Adult Day Health Care in Residential Health Communities: Amend the regulations describing reimbursement for adult day health care (ADHC) programs based in residential health care facilities (RHCFs) to include a subsection specific to reimbursement for AIDS ADHC programs.

•

Assisted Living Programs (ALPs) Billing for Assessments: Add regulations to provide for reimbursement of the cost of preadmission assessments conducted directly by ALPs.

•

Physician Home Visits for Hospitals and Clinics: Amend the regulations to establish Medicaid rates and billing policies to allow hospitals and clinics to be reimbursed for physician home visits for chronically ill patients.

•

Adult Day Health Care (Services for Registrants with AIDS): Amend the regulations to create a more flexible model appropriate to the clinical state of the HIV/AIDS epidemic and for inclusion into the Medicaid Managed Care benefit package.

•

Adult Homes, Enriched Housing Programs, Residences for Adults, Assisted Living Programs and Assisted Living Residences: Amend the regulations to reflect recent legislative changes and the changing environments of these types of facilities. Amendments will provide clarification and consistency to residents, operators and the public with regards to adult care facilities, including role of nurse practitioners and physician assistants, as well as modifications to the assisted living program, including changes to the admission, assessment and medication management processes.

For more information, contact Andrew Koski at (518) 810-0662 or akoski@hcanys.org.

16

ASAP – a publication of the Home Care Association of New York State

Volume 20, No. 9 March 6, 2015 

CMS Establishes Health Care Payment Learning and Action Network The U.S. Centers for Medicare and Medicaid Services (CMS) has established the Health Care Payment Learning and Action Network which, according to CMS, is intended to provide a forum for public-private partnerships to help the health care payment system meet or exceed recently established Medicare goals for value-based payments and alternative payment models.

The Network will serve as a forum where payors, providers, employers, purchasers, state partners, consumer groups, individual consumers, and others can discuss how to transition towards alternative payment models that emphasize value. The Network will be supported by an independent contractor acting as a convener and facilitator.

The Health Care Payment Learning and Action Network will perform the following functions: •

Serve as a convening body to facilitate joint implementation of new models of payment and care delivery.

•

Identify areas of agreement around movement toward alternative payment models and define how best to report on these new payment models.

•

Collaborate to generate evidence, share approaches, and remove barriers.

•

Develop common approaches to core issues such as beneficiary attribution, financial models, benchmarking, quality and performance measurement, risk adjustment, and other topics raised for discussion.

•

Create implementation guides for payors, purchasers, providers, and consumers.

The network contractor will identify discussion topics, bring together technical experts and create workgroups that will catalogue best practices and implementation successes for alternative payment models and other payment reform.

The Network contractor will also provide logistical support to workgroups and help disseminate best practices to all Network participants.

Individuals and organizations interested in participating are invited to register at http://innovation.cms.gov/ initiatives/Health-Care-Payment-Learning-and-Action-Network/. This site also includes background information on the Network.

As described in previous editions of ASAP, the U.S. Department of Health and Human Services (HHS) has set a goal of tying 30 percent of Medicare fee-for-service payments to quality or value through alternative payment models by 2016 and 50 percent by 2018. HHS has also more broadly set a goal – through alternative and other payment models – of tying 85 percent of all Medicare fee-for-service to quality or value by 2016 and 90 percent by 2018.

17

ASAP – a publication of the Home Care Association of New York State

‘Money Follows The Person’ Update This week, the Money Follows the Person (MFP) Stakeholder Advisory Committee held a meeting to update participants on the MFP program.

MFP provides enhanced Federal Medical Assistance Percentage (FMAP) reimbursement for select services for 365 days to persons who: have resided in a nursing home for at least six months; were in receipt of Medicaid for at least one month prior to transitioning from the nursing home; and are transitioning into a qualified residence.

In January 2007, the U.S. Centers for Medicare and Medicaid Services (CMS) approved New York’s application to participate in the MFP Federal Rebalancing Demonstration Program.

The goals of the program are to: •

•

Eliminate barriers or mechanisms – whether in the state law, the state Medicaid plan, the state budget, or otherwise – that prevent or restrict the flexible use of Medicaid funds to enable Medicaid-eligible individuals to receive support for long term care services in the settings of their choice.

Volume 20, No. 9 March 6, 2015 

Open Call for HCA’s 2015 Award Nominations Deadline extended to March 13 HCA invites you to nominate colleagues, staff, peers or mentors for the Ruth F. Wilson, Caring or Advocacy Awards. Candidates for each of these award categories should be those who have made significant contributions to the home care industry by demonstrating notable professional accomplishments.

This year, HCA has assembled an Awards Selection Committee comprised of past Ruth F. Wilson Award winners. The committee will identify, select and help us honor exemplary individuals in home care who have made significant contributions to the industry or the patients they serve, through their outstanding leadership, advocacy or clinical care. The Awards Selection Committee will meet this March to review the nominations and make its winning selections.

Winners will be honored during a special ceremony at HCA’s Annual Conference in early May. Also new this year – we’ve made the nominations process much easier by providing an online nomination form.

Simply click on the link below, complete the form electronically, and you’re done! No need to copy, scan, attach documents or fax any longer! This process is streamlined and a nomination can be completed and submitted within 5 minutes!

We hope you will take these few minutes to really consider the good work being done by your staff, your colleagues and peers, and nominate them for consideration. Tell us their success stories so we can recognize the outstanding work they do each and every day for home care. Past award winners have garnered media attention, too, which helps your agency broadcast the great work it is doing for your community.

To submit a nomination, please go to the online form here: https://www.surveymonkey.com/r/2015HCAAwards.

If you have any questions, contact HCA’s Jenny Kerbein at jkerbein@hcanys.org.

Increase the ability of the state Medicaid 18

ASAP – a publication of the Home Care Association of New York State

Volume 20, No. 9 March 6, 2015 

program to assure continued provision of home and community-based long term care services to eligible individuals who choose to transition from an institutional to a community setting.

•

Ensure that procedures are in place to provide quality assurance for eligible individuals receiving Medicaid home and community-based long term care services and to provide for continuous quality improvement.

At the stakeholder meeting, the Office for People with Developmental Disabilities (OPWDD) provided an update on its involvement in MFP. This included: •

OPWDD’s participation in MFP is occurring within a larger de-institutionalization initiative (system transformation). Under this initiative, OPWDD is helping many people leave Developmental Centers and Intermediate Care Facilities.

•

In 2014, OPWDD helped a total of 598 individuals move into community settings, including 133 people who were transitioned to MFP “qualifying settings.”

•

The goal for 2015 is to assist 357 people to transition to MFP qualifying settings.

•

So far this year, OPWDD has assisted 43 individuals to transition to community settings and 13 to enroll in MFP.

The meeting also covered additional MFP activities, including housing counselor training; peer outreach, referral and training; identification of potential participants in institutional settings and facilitating successful transitions; community preparedness education; database development; and MFP sustainability.

For more information, contact Andrew Koski at (518) 810-0662 or akoski@hcanys.org.

Publications •

“2015 National Impact Assessment of the Centers for Medicare & Medicaid Services Quality Measures Report,” by the U.S. Centers for Medicare and Medicaid Services http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/ QualityMeasures/Downloads/2015-National-Impact-Assessment-Report.pdf

•

“Housing and Health Care: A Toolkit for Building Partnerships,” by LeadingAge Center for Housing Plus Services http://www.leadingage.org/HousingHealth/ ?mkt_tok=3RkMMJWWfF9wsRonvarNZKXonjHpfsX56+gsXKG2lMI/ 0ER3fOvrPUfGjI4JS8d0aPyQAgobGp5I5FEKSbTYTK5mt6MOXw

•

“Home Health Chartbook: Prepared for the Alliance for Home Health Quality and Innovation,” by Avalere http://avalere-health-production.s3.amazonaws.com/uploads/pdfs/ 1422047320_FINAL_2014_AHHQI_Chartbook.pdf

For more information, contact Andrew Koski at (518) 810-0662 or akoski@hcanys.org.

19

CFO Forum

March 18, 2015

9:00am – 3:30pm Albany Hilton Albany, New York 12207

CFO Forum

March 18, 2015 9:00am – 3:30pm Albany Hilton Albany, New York 12207

HCA’s CFO Forum is a must‐attend program for home care financial managers, CFOs and other executive staff to hear from HCA finance and reimbursement experts, state Department of Health (DOH) officials, and industry consultants on home care fiscal issues.

Kicking off the Forum, HCA staff will highlight the many finance‐related advocacy areas where we are working on your behalf – from the federal and state budget fronts to our work on the many rate packages and payment model implementation efforts occurring internally at the DOH and state Executive levels. DOH reimbursement officials will provide yet further details on all of these issues from the state’s perspective.

Robert Simione will provide participants with the latest aggregate benchmarking data for Medicare and Medicaid to help you make sense of how the various federal and state fiscal policy levers are affecting your bottom‐line and operational practices related to your peers. Participants will also hear from two former executives at MVP Health Plan, based in the Capital District, who will share tips on successful relationships with managed care organizations, drawing from their many years of experience in the plan world.

Please do not miss out on this robust program which delves into several important areas relevant to your agency’s fiscal health.

AGENDA 9:00am – 9:30am

HCA Registration & Continental Breakfast 9:30am – 10:15am

HCA Update HCA staff will provide a state legislative update, which will focus on the 2015‐16 proposed Executive State Budget and its impact on home care, along with an update on our advocacy efforts in Albany and Washington. HCA staff will highlight our annual financial condition report as well as discuss the latest on Vital Access Provider (VAP) funding, DSRIP, Wage Parity mandates, and the 2015 Medicare Prospective Payment System (PPS).

10:15am – 11:15am

Department of Health Update Tim Casey, Bureau of Long Term Care Reimbursement Daniel Carmody, Bureau of Managed Care Reimbursement Mr. Casey and Mr. Carmody will provide updates on the following: provisions in the 2015‐16 Executive State Budget that impact home care, personal care and Medicaid managed care; the upcoming rebasing of the CHHA Episodic Payment System (EPS); the Medicaid Global Cap; premium rate adjustments to Managed Long Term Care (MLTC) and Mainstream Medicaid Managed Care plans; Wage Parity adjustments to plans and home care providers; Value Based Purchasing; the LTHHCP and Personal Care fee‐for‐service Medicaid rates; the 2014 Medicaid cost reports and other Medicaid reimbursement issues.

Continued on next page

CFO Forum

March 18, 2015 9:00am – 3:30pm Albany Hilton Albany, New York 12207

AGENDA - Continued 11:15pm – 12:15pm

Simione Consultants – Medicare PPS and CHHA Medicaid EPS Benchmarking Data Robert Simione, CPA, Vice President, Simione Financial Monitor During this session, Mr. Simione will share the latest aggregate benchmarking data for the Medicare Home Health Prospective Payment System (PPS), Medicaid EPS and managed care using comparisons from clients of Simione’s Financial Monitor here in New York versus national averages. This data is especially useful in the context of federal rebasing under the Medicare home health PPS and the state Department of Health’s current rebasing efforts for CHHA EPS. Some benchmarking highlights will include: the volume of outliers, LUPAs, PEPs and full episodes; Medicare net and gross margin data; as well as average case‐mix weights and visits per discipline.

12:15pm – 1:15pm – Lunch 1:15pm – 2:45pm

Tips for Successful Relations with Managed Care Organizations Frank J. Fanshawe, Attorney At Law, Wilson Elser Moskowitz Edelman & Dicker, LLP Mark Fish, Managing Director, FTI Consulting Health care is experiencing dramatic change as the nation’s delivery system transitions to a value‐based system. Value‐based contracting will be critical to the ability of health care providers to establish themselves as essential in their markets with managed care organizations. During this session, Frank Fanshawe, Esq. and Mark Fish will discuss how managed care organizations approach contracting with current and prospective network providers, particularly in an evolving market where the focus is on value based contracting.

2:45pm – Adjournment

Payment of $40 per person

Registration __________________________________________________________________ Name

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__________________________________________________________________ Title

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__________________________________________________________________ Agency

Card Billing Address:_______________________________

Expiration Date:_____________ Sec. Code:_____________

__________________________________________________________________ Address

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Signature:________________________________________

_______________________ _________________________________________ Phone/Ext. Email (Required)

Or, make checks payable to: HCA and mail to 388 Broadway, 4th Floor, Albany, NY 12207

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Cancellation Policy: Cancellations received by March 11th will receive a full refund, less 25% of total due as an administrative fee. Cancellations received on March 12th or later will forfeit their registration fee, as well as those who register and do not attend. Substitutions are permitted.

FAX TO: (518) 426‐8788

Blueprint for OASIS Accuracy Two day OASIS-C1 workshop on Data Collection Rules and Guidance , followed by an optional Certificate for OASIS Specialist-Clinical (COS-C) exam.

Effective up-to-the-minute education targeted for field data collectors, their supervisors and those preparing for the COS-C exam.

June 23 and 24 Workshop 8:00am to 4:00pm

June 25

Experience the comprehensive and nationally acclaimed two-day Blueprint for OASIS Accuracy workshop and learn to confidently teach, audit and collect OASIS-C1 items accurately. Through guided, expert instruction, and participation in problem-solving discussions and application scenarios, achieve mastery of the OASIS items, conventions, and the latest data collection rules.

Rather than provide opinions, assumptions, or unfounded interpretations, the “Blueprint” presenters will model reliance on CMS guidance documents and provide and demonstrate strategies for how to find defendable answers to your OASIS questions.

COS-C Exam 9:00am to 11:30am Individuals may register for the workshop, the exam or both.

Facilitators: Kim Corral

Bobi Rose

Workshop/Exam Location Holiday Inn Albany 205 Wolf Road Albany, NY 12205

Hotel Accommodations Holiday Inn Albany 205 Wolf Road Albany, NY 12205 HCA has reserved a limited block of rooms at the rate of $111 per night.

Please call (800) 465-4329 before June 1st and ask for the HCA Education and Research Block.

Kim Corral, BSN, MaEd, HCS-D, BCHH-C, COS-C Kim has been practicing in home health since 1984. She is an Associate Consultant with OASIS Answers, Inc. Bobi Rose, RN, BSN, CWCN, CCCN Bobi is a registered nurse practicing since 1994, with the majority of her nursing experience in home health. She is a Senior Consultant with OASIS Answers, Inc.

COS-C Exam The Certificate for OASIS Specialist – Clinical (COS-C) Exam is a voluntary Certificate examination for those interested in demonstrating and establishing their expertise and commitment to OASIS data accuracy. Administered the day following the Blueprint for OASIS Accuracy training, the scope of the COS-C exam is similar to the Blueprint workshop agenda, covering CMS guidelines related to OASIS time points, regulations, patient populations, and OASIS-C1 item specific scoring. Please note the exam fee is in addition to the two-day Blueprint workshop fee. Register for the exam online at www.oasisanswers.com or complete the attached form and send to OASIS Answers, Inc. Candidates who successfully pass the examination are awarded the COS-C designation.

www.hca-nys.org

Blueprint for OASIS Accuracy – 2-Day Workshop – June 23 and 24, 2015 REGISTRANT INFORMATION Registration deadline is June 12 Name: ___________________________________________________________________

Register Online for the workshop only at www.eventville.com/hcanys

Title:______________________________________________________________ Agency:____________________________________________________________ Address:___________________________________________________________ City/State/Zip:______________________________________________________ Phone:_________________________ Ext._________ Fax: __________________ Email: _____________________________________________________________ (Required)

WORKSHOP ONLY REGISTRATION FEE Member Fee: Early Bird - Until June 2

 $499

After June 2:

 $549

Non-Member Fee

 $685

Workshop fee includes instructors for two days, two lunches and handout materials. Exam fee is additional.

Walk-in registrations will not be accommodated.

Cancellation Policy: Refunds will be issued for those that cancel the workshop by June 12, less a 25% administrative fee.

Cancelling after this date or for no shows will forfeit the registration fee.

Substitutions are permitted for the workshop. Cancellations must be received in writing via e-mail at info@hcanys.org

To register for the COS-C Exam use the attached form or go to: www.oasisanswers.com Registrations for the exam must be received two weeks prior to the exam date.

PAYMENT Please check method of payment: (Checks must be received by workshop date). ____MasterCard ____VISA ____ American Express

_____ Check*

*Make checks payable to: HCA Education and Research and mail to: 388 Broadway, 4th Floor, Albany, NY 12207 ______________________________________________________________________ Card Number Security Code Expiration Date ______________________________________________________________________ Name on Card

______________________________________________________________________ Card Billing Address (Street/Suite/Room Number) ______________________________________________________________________ City, State, Zip ______________________________________________________________________ Authorized Signature

Fax to (518) 426-8788

Exam Registration Fee $250 – For those participating in the workshop Renewal Exam Fee $200 – For those participating in the workshop Taking the Exam Only – add $50

Discovering the

Treasures of

HOME CARE

2015 Award Nominations

2015 Award Nomination Form HCA is encouraging members to submit nominations for the 2015 HCA Awards. In addition to the Ruth F. Wilson Award, our highest honor, HCA will also present awards in other categories during our Annual Meeting and Awards Breakfast on May 7, 2015.

Deadline for submission

In submitting nominations, members should give consideration to an individual, group of people or an organization that has made an impact on the home care industry, and the patients and clients we serve. This year we are soliciting nominations in the following categories:

Ruth F. Wilson Award HCA’s highest honor, the Ruth F. Wilson Award, is bestowed upon an individual who has demonstrated exceptional dedication and made a significant contribution to home care over a period of time. With this award, HCA recognizes someone whose work has had a dramatic effect on home care, reaching beyond a single agency. The recipient will have strengthened the practice of our profession, raised the standards of quality and care for patients, or advanced the level of understanding and mutual cooperation among the home care community, legislators, federal and state agencies, health care providers and the public. This prestigious award recognizes an individual who has made our services stronger and more visible and who has never wavered from his or her support of home care.

Caring Award This award recognizes a professional and/or a paraprofessional staff person of a member agency or a family member who has exhibited the compassion, skills and service that sets their contribution apart, or whose actions on a particular day, or over a period of time, exemplify outstanding compassion.

Advocacy Award This award recognizes a provider agency or person (including both elected and appointed officials) who took risks or “stuck their neck out� to improve the home care industry, clients and workers through their advocacy efforts.

Please complete the attached nomination form and submit it by March 6th to Jenny Kerbein at jkerbein@hcanys.org or Fax it to (518) 426-8788.

2015 Award Nomination Form Nominee - Contact Information

Nominator - Contact Information

___________________________________________________ Name of Nominee

___________________________________________________ Name of Nominator

___________________________________________________ Title of Organization

___________________________________________________ Title of Organization

___________________________________________________ Address

___________________________________________________ Address

___________________________________________________ City, State, Zip

___________________________________________________ City, State, Zip

___________________________________________________ Telephone Email

___________________________________________________ Telephone Email

Please complete the information below detailing specific contributions the nominee has made to home care and the reason for your nomination. Please include as much detail as possible and indicate specific challenges faced or particular achievements reached. What has made this candidate’s contribution unique? Please use additional sheets if necessary and also include a bio or resume if applicable.

□ Ruth F. Wilson Award

□ Advocacy Award

□ Caring Award

Please describe contributions the nominee has made to Home Care: (please use additional sheet if needed) __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ Please describe specific challenges faced or particular achievements reached: (Please use additional sheet if needed)

________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ Along with your submission, please consider sending us a digital photograph of your nominated person or group. If selected as a winner, the photograph will be included in the Awards Program.

Fax by March 13, 2015 to: 518-426-8788

388 Broadway Fourth Floor Albany, New York 12207

Submit by March 6th

To: