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ASAP

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

Legislative Issues  Public Policy

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News

Volume 21, No. 11 March 18, 2016

Assembly, Senate Budgets Adopt Key HCA-developed Language; Wage and Other Core Issues Demand Major Attention, Advocacy The state Assembly and Senate introduced their own versions of legislation outlining provisions for a new state budget. Conference committees have swiftly assembled to iron out the differences between each house’s bills and resolutions, with mere days to go before a final budget is expected to hit the presses for passage by the April 1 deadline. As we informed members in an alert yesterday, HCA will be holding a statewide, members-only conference call early next week on the status of the state budget and our urgent advocacy appeals at this critical juncture of negotiations. The call is on Monday, March 21 at 4 p.m. To register, please enter your contact information in the online form at https://www.surveymonkey.com/r/BudgetUpdate and HCA will send you the dial-in information in advance of the call. HCA this week also sent you a preliminary memo on the budget provisions which will form a basis for Monday’s discussion. You can download the memo at http://hca-nys.org/wp-content/uploads/2016/03/ PreliminaryMemoSenateAssemblyBudgets.pdf.

HCA Continues Full Court Press on FLSA Funding

Over the past several weeks, HCA has pushed hard on a proactive two-part platform for home care in this year’s state budget. This platform, developed through our in-house team of bill-drafting experts and Board Member input, calls for: 1) reimbursement fixes; and 2)

Today, HCA met with state Medicaid Director Jason Helgerson and other key Department of Health (DOH) staff to discuss our concerns regarding the entire process taken by the state to distribute monies to help home care providers with their new costs due to recent changes in the Fair Labor Standards Act (FLSA).

See BUDGET p. 3

Meeting Today with State Medicaid Director Leads to Possibilities, Next Steps

Inside ASAP

See FLSA p. 6

Wage and Other Core Issues Demand Major Attention, Advocacy....1 HCA Continues Full Court Press on FLSA Funding..............................1 Author and Adviser to Canada’s PM To Speak at HCA Conference....2 It’s Time for the HCA PAC Caucus.......................................................5 LHCSA Survival Bootcamp in April......................................................7 Watch: HCA Awards Nominations Due Monday.................................7 MedPAC’s Report Again Calls for Home Care, Hospice Cuts............8 Skin & Wound Care Management Live Training Courses.....................8 Member Hiring Announcement...........................................................9 DOH Releases Guidance on UAS.......................................................10 January Global Cap Report: Spending $46M Over Projections.......11 CMS Announces Interactive Mapping Medicare Disparities Tool...12 Upcoming NGS Education Programs...............................................13 Trainings Scheduled on FIDA-IDD.....................................................13

Helping New Yorkers Feel Right At Home

Volume 21, No. 11 March 18, 2016

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

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Acclaimed Author and Adviser to Canada’s Prime Minister to Speak about “Superforecasting” at HCA Annual Conference Gardner, an awardwinning journalist before joining as adviser to Trudeau, has lectured widely for governments and businesses such as Google and Siemens ... and now he’s coming to HCA.

The new Prime Minister of our neighbor to the North, Justin Trudeau, made headlines for his first official visit to the United States earlier this month. One of his trusted advisers, author Dan Gardner, has also grabbed accolades, including from the likes of Harvard’s Steven Pinker, who called Gardner’s work “required reading for journalists, politicians, academics and anyone who listens to them.”

HCA just last week announced our preliminary brochure for the 2016 Annual Conference; registration options are posted to our conference website at www.hcaannualconference.com. We’ve published the brochure to the back of this week’s ASAP as well.

In keeping with the “Vote Home Care” theme of our Annual Conference on May 4 to 6 in Saratoga, Gardner, a forecasting expert, has joined our exceptional speaker roster, drawing upon insights from his latest book Superforecasting: The Art and Science of Prediction.

We’ll be announcing other speakers soon, but we encourage you to register ahead of time and make your hotel reservation by the April 3 deadline for the discount rate. Online registration is available on the conference website or at https://www.eventville.com/ Catalog/EventRegistration1.asp?EventId=1011878.

His talk applies to business, finance and daily life, as well as politics, examining the process by which we forecast the future and facilitate decisionmaking, whether it’s management or strategic planning at your organization.

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 Alexandra Blais, Director of Public Policy, ablais@hcanys.org Laura Constable, Senior Director, Membership & Operations, lconstable@hcanys.org Celisia Street, Director of Education, cstreet@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

Volume 21, No. 11 March 18, 2016

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

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What follows is a deeper summary of items included in the one-house budget bills at this time, though we stress that these provisions are subject to vigorous and dynamic negotiations.

BUDGET from p. 1 program supports/infrastructure investment for home care. The Legislature has included pieces of HCAauthored language in the budget – including our payment rate adequacy proposal and HCArequested infrastructure pools for communitybased providers – but a lot more work needs to be done to reconcile these parts, which are handled differently between each house’s budget and subject to negotiations with the Governor.

HCA Rate Adequacy Language The Assembly has included major portions of HCA’s legislative language to require vital rate adequacy for critical costs necessary under state payments to home care and managed care, a major thrust of HCA’s priority “Fix no. 1” previously outlined for the membership. The purpose of this language is to provide an avenue for coverage of home care costs, including existing or prospective labor costs, such as the Governor’s minimum wage hike proposal (which the Assembly would separately and partially fund through an additional appropriation; see below), as well as other costs shouldered by the home and community sector.

Urgently, and separate from these proposals, the Governor’s priority of a minimum wage hike has cascaded over much of this process, punctuated by a recent rally with as many as 5,000 people pushing for the wage hike (funded or not), and with the Legislature currently presenting a mixed picture on its stances. Given this very urgent place for home care providers, HCA is presenting a simple message on the wage issue, through our advocacy with the Legislature, the media, and in our appeals for member advocacy. The message is this: The Legislature must fully fund this wage proposal for affected providers, or outright reject it.

The HCA language also requires a positive premium adjustment for MLTCs for regions (rural and other) where the current premium and methodology are inadequate to cover costs due to unique regional cost factors. Minimum Wage Increase to $15/hour

We have several campaigns on the budget posted to our Legislative Action Center with variations on this message, all applicable to the current state of negotiations. Our most recent campaign, shared with members yesterday, lays out the urgent needs for home care support and relief in a few short paragraphs. We urge all members to send this message to their legislators with a quick push of the button at http://p2a.co/tcC4nBq.

The Senate bill rejects the Governor’s proposal; however, it is believed that discussions between the Senate and Governor are continuing. The Assembly bill would adopt a $15/hour minimum wage, and upon phase-in, index the $15 minimum wage to an annual inflation factor. The Assembly bill also proposes to remove Medicaid expenses related to a minimum wage increase from impacting the Medicaid Global Cap.

On the wage issue, specifically, HCA has been working with a coalition of health care associations on strategies and a possible joint press statement that would send a unified message to the media, the public, the Legislature and Governor on our core point that full funding is needed, or the wage hike must be rejected. Discussions are ongoing and remain fluid at ASAP press time.

In recognition of efforts by HCA, our health care coalition allies, and several other sectors, the Assembly includes $200 million in Medicaid funding for home care and other 3

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health and social service providers to pay for any minimum wage increases. However, this $200 million appropriation is significantly less than the projected cost of a minimum wage increase in the first year across all of these sectors, and remains subject to negotiations, especially at a time when the home care sector alone faces a $1.1 billion impact in the first two years of implementation. $200 Million Pool to Assist with Health Care Transformation In alignment with HCA’s priority advocacy “Fix no. 2” for home care infrastructure support, the Assembly budget bill contains an additional $200 million pool to assist providers with “health care transformation.” Home care, primary care and other community based providers are part of this pool, and HCA is working to push for more dedicated community health/home care funding. The Senate bill contains a much smaller and geographically limited pool, but it, too, represents a critical step upon which HCA and colleagues will seek to build. MLTC Cuts/Actions Both the Senate and Assembly bills reject or modify certain MLTC cuts proposed by the Governor (opposed by HCA and MLTCs), including rejection of the transportation carve-out. Additionally, the Senate rejects the Governor’s proposed MLTC eligibility change to “nursing home eligibility”; the Assembly modifies the Governor’s proposal. Next Steps These provisions are highlighted in our preliminary memo, including others such as the status of the paid family leave proposal, the Governor’s proposed “spousal responsibility” provision, the Global Cap and other items. Again, that memo is at http://hca-nys.org/wp-content/uploads/2016/03/PreliminaryMemoSenateAssemblyBudgets.pdf. Separately, HCA also continues to advocate strenuously for revision of the state Department of Health’s recent Fair Labor Standards Act funding plan. (Our concerns were communicated in the past several editions of ASAP). HCA today met with state officials to pursue several revisions. (See related p. 1 story.) HCA urges all members to enlist your staff, your management teams and your boards to call the Legislature, using the messages reflected in our Legislative Action Center campaign. The text for this campaign is below. You can call your Senator and Assembly Member at the main switchboard numbers (Senate at 518-455-2800 and Assembly at 518-455-4100) and use our message as a guide. •

An unfunded minimum wage hike puts home care programs at grave risk – financially and in their ability to provide care to needy patients. The Legislature must either reject the wage increase outright, or fund it fully. It’s that simple.

•

The Home Care Association of New York State has also provided budget language for Medicaid reimbursement rate adequacy and infrastructure support for home care and managed care.

•

The Assembly has adopted this language, and I appreciate its support. Any final budget must include this investment support – specifically, with dedicated home care infrastructure pools – along with the Assembly’s home care-managed care rate adequacy language.

•

In summary: 1) reject or fully fund any minimum wage hike; 2) adopt dedicated home care infrastructure support; and 3) support the Assembly’s budget language and Senate resolution for home care-managed care rate adequacy. These actions are urgent. 4

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

Volume 21, No. 11 March 18, 2016 

It’s Time for the

HCA PAC

CAUCUS!

HCA PAC’S RECEPTION MAY 5, 2016 SARATOGA SPRINGS, NY

Everyone’s a Party Boss at HCA’s PAC Party! Join HCA’s Rank and File for this fun night of political trivia! We’re busting open the Pork Barrel for some food & drink, prizes and more!

The HCA PAC Advisory Committee urges you to contribute to the HCA PAC to make sure your voice is heard at the HCA PAC Caucus Party and at the State Capitol!

$100 minimum contribution is required. Pre-registration is suggested. 5

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FLSA continued from p. 1 The discussion centered on distribution of the state funding: its workability, excessive administrative burden, treatment of home care providers and MLTC plans, attestation forms, and areas of inconsistency with prior administration communications. We strenuously advocated that home care providers should be allowed to apply the FLSA funding to all FLSA-related costs, not just overtime hours as some plans have been requiring, and the attestations need to be revised to reflect such. We specifically argued that: the funding should be applied to all hours of aide services; any documentation required of home care providers should not create undue burdens on time and resources for providers and plans; there needs to be more transparency in DOH’s distribution of funds to plans; the funding should be continued past March 31; and more. Mr. Helgerson expressed a willingness to consider alternative ways to distribute the funds, as well as changes that HCA urged are necessary to the attestation forms, if all groups (home care, managed care, and unions) develop an agreeable proposal. Joining HCA to present this case were: Board Members Susan Larman, Chief Executive Officer, VNA HomeHealth and Russell Lusak, Senior Vice President, Selfhelp Family Home Care, Inc.; and our Government Affairs Team at Hinman Straub. In addition to today’s meeting, HCA has been communicating similar concerns to DOH officials since the monies were first announced. HCA has also provided intensive one-on-assistance to members who have questions about the distribution and attestation processes and continues to receive many calls daily. As we redouble our efforts on this issue, HCA reminds members to keep us informed on the distribution process and further concerns you have. You can contact Andrew Koski at akoski@hcanys.org, Alex Blais at ablais@hcanys.org or Patrick Conole at pconole@hcanys.org.

HOTEL INFORMATION

Marriott Marquis 901 Massachusetts Avenue NW Washington, DC 20001 Phone: (202) 824-9200 Hotel Group Rate $229

Stay tuned for additional details to come.

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

Volume 21, No. 11 March 18, 2016 

LHCSA Survival Bootcamp in April As New York State and other payors move from paying based on units of service towards paying based on outcomes and measures, LHCSAs must transition their operations and practices to keep pace with new payment models. Whether it is DSRIP, value based reimbursement, bundled payments or other financing mechanisms, LHCSAs can no longer continue to successfully operate as they have under the fee-for-service payment structure. LHCSAs must measure and demonstrate their value at improving outcomes, preventing emergency room visits and hospital stays, and avoiding rehospitalizations to compete in an already crowded market that is growing rapidly. Strong and well informed clinical leadership are critical to adapt under this seismic change. On April 12, 2016, HCA is holding a three-hour training presented by Trish Tulloch of RBC Limited that will equip LHCSA clinical directors, supervisors, and educators with the necessary tools to accomplish this essential transition. This is an event you cannot afford to miss! Register at: http://hca-nys.org/wp-content/uploads/2016/02/ HCADownstateLHCSAForumMarch292016Registration.pdf.

Watch: HCA Awards Nominations Due Monday, Choose Candidates Today! HCA has extended the deadline to make nominations for our Annual Awards (to March 21). To help our committee pick the right winners, we need several more nominations, and you’ll want to take advantage of this opportunity to recognize a member of your staff or a colleague. These awards accrue important benefits to your agency: enhancing team spirit, gaining recognition for your organization at HCA’s Annual Conference (where the awards are presented), as well as possible media coverage for wider public awareness of the great work your staff and colleagues do ... and much, much more. Watch our video (by clicking the image above), pick a candidate, and complete the online form at https://www.surveymonkey.com/r/2016HCAAwards. If you have any questions, please contact Jenny Kerbein at jkerbein@hcanys.org or (518) 810-0659. Make your nominations today!

Volume 21, No. 11 March 18, 2016

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

MedPAC’s March Report Again Calls to Eliminate Home Health Payment Update for 2017, Rebase Rates in 2018 The Medicare Payment Advisory Commission (MedPAC) has released its March 2016 Report to the Congress: Medicare Payment Policy, which, again, contain strongly objectionable positions that HCA will contest. The Report is at http:// medpac.gov/documents/reports/march-2016-report-to-thecongress-medicare-payment-policy.pdf?sfvrsn=2. The report includes MedPAC’s analyses of payment adequacy in Medicare fee-for-service (FFS) and provides a review of Medicare Advantage and the prescription drug benefit. Congress often looks to MedPAC’s analysis and recommendations in formulating its legislative proposals. HCA has long argued that MedPAC’s analyses rely on faulty data about the financial condition of home care agencies while recommending regressive proposals such as home health beneficiary copayments, payment cuts and rebasing of home health rates. The Medicare home health recommendations include the following: •

•

Eliminate the payment update for 2017 and implement a two-year rebasing of the payment system beginning in 2018. MedPAC argues that the payment update should be again eliminated because of high aggregate Medicare margins for freestanding agencies. MedPAC states that in 2014, aggregate margins for these agencies averaged 10.8 percent. As HCA has noted to MedPAC and the New York Congressional Delegation numerous times, New York’s margins are significantly lower, due to the large number of facilitybased agencies operating in New York, and MedPAC does not include all of the data. HCA’s analysis of 2014 margin data shows that New York’s home care agencies have an unweighted average margin of negative-16.4 percent, with negative margins for the last 13 years straight. Revise the prospective payment system to eliminate the use of therapy visits as a factor in payment determinations, concurrent with rebasing (in 2018). MedPAC cites the need to take this step, 8

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Skin & Wound Care Management Live Training Courses HCA Members receive a discounted rate ($300 off standard rate) for four and five day trainings offered at various locations throughout New York State by The Wound Care Education Institute. Both courses are designed for LPN/LVNs, RNs, NPs, PAs and OTs and offer the opportunity to take a certification exam. Use the discount code “HCANYS”. The Four-Day Skin & Wound Management Course will be held April 14 to 16, 2016 in Elmhurst, NY. The Five-Day Skin & Wound Management Course will be held on the following dates: •

April 25-29, 2016 in Buffalo, NY

•

July 11-15, 2016 in Uniondale, NY

•

October 24-28, 2016 in Elmhurst, NY

Also available free to HCA members through the Wound Care Education Institute is an array of on-demand webinars using the code HCANYS. Learn more at http://hca-nys.org/eventseducation/upcoming-events.

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

arguing that utilization trends indicated that the inclusion of therapy in the Medicare PPS creates an improper financial incentive for agencies. HCA strenuously argues against this perception, maintaining that therapy use is appropriate and must be included as part of the payment methodology. Hospice recommendations include: •

Eliminate the update to the hospice payment rates for fiscal year 2017.

•

Integrate hospice care into the Medicare Advantage managed care benefit package.

HCA opposes regressive cuts to hospice services and will be further analyzing MedPAC’s data in conjunction with our Hospice Forum for follow-up advocacy. HCA will continue to review the MedPAC report and provide insights and comments about the implications for New York’s home health and hospice providers to the New York Congressional Delegation in order to assure that New York’s data and impact are well understood by the Delegation. In addition, these issues will be part of HCA’s federal advocacy program on July 11 to 13, 2016 that is held in conjunction with federal advocacy efforts by thirteen other states. Please see the flyer on p. 6 for details.

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HIRING Job Position: Director of Performance Improvement and Staff Development (Winthrop University Hospital Home Health Agency) Winthrop seeks a Director of Performance Improvement and Staff Development for the CHHA, which services Nassau, Suffolk and Queens. The PI Director is responsible for the quality assessment/ assurance program, compliance with DOH regulations and The Joint Commission standards, as well as overseeing the educational programs of the agency. Minimum qualifications include: BSN, NYS RN license, two years professional nursing experience, two years supervisory experience in a CHHA or related home health program; working knowledge of Performance Improvement/ Quality Assurance, The Joint Commission standards and DOH regulations. Master’s degree preferred. Send résumés to Anne Calvo via e-mail to acalvo@winthrop.org Job Position: Director of Patient Services (Montefiore Home Health Agency) The Director is responsible for directing, planning, coordinating and evaluating patient care services, providing supervision of professional staff, and recruiting/hiring an adequate number of professional staff to ensure quality. The Director will evaluate the performance of Patient Service Managers and support staff supervisors at stated intervals. The Director will participate in administration of the annual budget and personnel policies. The ideal candidate will manage all clinical functions. Required Qualifications: Current NYS RN License and Registration; Master’s in Nursing or Health Related Field; five years of senior and direct management experience within a CHHA. Additional Qualifications: Knowledge of clinical documentation protocols, home health regulations and standards; skill in training, working with building high performance teams; ability to develop and lead strategic plans; strong written and verbal communication skills. Please send résumé & cover letter to chenley@montefiore.org with “Director of Patient Services” and your name in the subject line. Résumés without cover letters and applicants who do not meet requirements won’t be accepted. No phone calls, please. MMC is an equal opportunity employer and will not discriminate against any employee or applicant for employment because of race, color, religion, gender, sexual orientation, or national origin.

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DOH Releases Guidance on UAS If the nurse assessor must collect information from a collateral who is not available at the time of the assessment in order to complete the assessment, it is expected that the nurse gather the necessary information and sign and finalize the assessment no later than two days from the date that the assessment was conducted. At that time, the nurse should conduct and sign/finalize the Assessment Outcomes.

This week, the state Department of Health (DOH) posted guidance to reiterate the assessment requirements for MLTC plans previously provided in MLTC policy documents, the UAS-NY Training Environment and DOH-issued memos. This is important for plans and any home care providers that conduct assessments for them. The guidance should be posted soon at http:// www.health.ny.gov/health_care/medicaid/redesign/ mrt90/mltc_policies.htm.

Review/Consult Process Many plans have instituted a Review/Consult process as part of the assessment process. Some plans have incorrectly instructed staff to leave assessments unfinalized until after the supervisor has reviewed the assessment. Supervisors who have the review/consult responsibility cannot sign an assessment using the “Review/Consult” node until the assessment is finalized. According to DOH, leaving assessments unfinalized impedes the review/consult process and lends itself to any number of unintended consequences including viable assessments being deleted.

Assessment Requirements As per MLTC Policy 13.09 (http:// www.health.ny.gov/health_care/medicaid/redesign/ mrt90/mltc_policies.htm), a nurse assessor is required to complete all required questions in the Uniform Assessment System (UAS-NY) Community Assessment. It is not permissible to administer only the items that determine the Nursing Facility Level of Care. If a Functional and/or Mental Health Supplement are triggered, they must be completed in order for the assessor to sign/finalize the assessment. Upon finalizing the assessment, the Assessment Outcomes must be conducted, signed and finalized.

Unsigning/Unfinalizing Assessments In rare instances, a plan may identify a need to unsign and unfinalize an assessment. A nurse supervisor (UAS-45) has that functional capability provisioned to that role. It is important to note, unfinalizing an assessment also unfinalizes the Assessment Outcomes.

Assessments must be conducted in person, face-toface. Telephonic and video assessments (i.e. Skype, FaceTime) are not permitted. Signing Assessments

Assessments that were finalized and then unfinalized should be refinalized in a timely manner.

Nurses conducting a UAS-NY assessment should sign and finalize the assessment at the time the assessment is conducted. This allows the nurse to then conduct the Assessment Outcomes with input from the patient. The nurse assessor should then sign and finalize the Assessment Outcomes. When signing an assessment, the complete legal name, license number, and official title of the assessor is required and must be accurately recorded in the appropriate fields.

Unassigned Assessments On October 3, 2014, DOH issued a memo regarding signing assessments. As per that memo, unsigned/unfinalized assessments are not recognized as valid. Moreover, these assessments

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cannot be used in conjunction with care planning, authorization of services or billing. The guidance gives several examples of the circumstances that result in unfinalized assessments. Questions concerning the assessment policy guidelines should be directed to the Bureau of Managed Long Term Care at mltcworkgroup@health.ny.gov, while questions on the UAS can be directed to the UAS-NY Project Team at (518) 408-1021 or uasny@health.ny.gov.

January Global Cap Report: Spending $46M Over Projections The state Department of Health (DOH) has issued its monthly Medicaid Global Cap report. This latest report, for January, covers the period of April 1, 2015 to January 1, 2016. It finds that overall spending for this period was $46 million above Medicaid Global Cap projections, across all sectors, a difference of $15.267 billion in actual spending versus $15.221 billion in estimated spending for the ten-month period. Specifically, DOH mentions the following two significant pressures on the Global Cap which have now been incorporated: •

Significant enrollment growth in the MLTC program. Year-to-date growth (through September) was 11,000 individuals, primarily in New York City (68 percent). The original estimates only assumed an annual growth of 10,000 and have been revised to reflect projected growth of 16,375 recipients; and

•

A recent court ruling on the Fair Labor Standards Act (FLSA) requiring overtime to be paid at timeand-one-half of wage, with travel time as compensable hours, and changes to live-in rules for home care. (See related p. 1 story.)

While FLSA costs are, indeed, adding pressure, the current state budget process may be adding even newer pressures that demand the state to reexamine its forecasts and carve-out certain cost categories for which home care providers should not be liable. Members will recall that the law governing the global cap allows for broad state powers to adjust payments in sectors – or across-the-board – to keep expenditures within the confines of the cap. HCA is urging funding to match the Governor’s proposed wage mandate and these costs must not be included in the cap as an expense otherwise subject to sanctions. (The Assembly one-house budget bill contains a provision that would ensure any monies to pay for a minimum wage increase don’t count towards the cap.) According to the report, the category that includes home care (“Other Long Term Care”) was $3 million over projected spending. The Department shows actual spending of $566 million versus projected spending of $563 million, a slight difference from the December 2015 report, which showed “Other Long term Care” services as being even with estimated spending. Medicaid Managed Care (MMC) was $30 million over projections, a difference of $10.858 billion (actual spending) versus $10.828 billion (estimated spending), which is still significantly better than the September 2015 report when MMC spending was $81 million over estimates. Continued on next page

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Continued from previous page Medicaid total enrollment reached 6,207,150 enrollees at the end of January 2016. This reflects an increase of 31,083 enrollees, or 0.5 percent, since March 2015. The full report is at http://www.health.ny.gov/health_care/medicaid/regulations/global_cap/monthly/ sfy_2015-2016/docs/january_2016_report.pdf. The Medicaid Global Cap for the current fiscal year (April 1, 2015 to March 31, 2016) is $17.7 billion for all sectors. Both the Senate and Assembly one-house budget bills, still under negotiation, reject the Governor’s proposed additional year (i.e. through 2017-18) of the Medicaid Global Cap extension. HCA is surveying these global cap reports carefully in an information gathering effort, combined with other data analysis, to ensure accurate reflections of home care finances, with an eye toward any indication of rate or payment decisions stemming from the state’s analysis of home care’s performance. For further information, contact Patrick Conole at (518) 810-0661 or pconole@hcanys.org.

CMS Announces Interactive Mapping Medicare Disparities Tool The U.S. Centers for Medicare and Medicaid Services (MS) Office of Minority Health (CMS OMH) has released a new interactive map to increase understanding of geographic disparities in chronic disease among Medicare beneficiaries. The Mapping Medicare Disparities (MMD) Tool identifies disparities in health outcomes, utilization, and spending by race and ethnicity and geographic location. The tool was developed in collaboration with KPMG and the National Opinion Research Center (NORC) at the University of Chicago as part of the CMS Equity Plan for improving quality in Medicare. CMS reports that racial and ethnic minorities experience disproportionately high rates of chronic diseases, and are more likely to experience difficulty accessing high quality of care than other individuals. The tool has a dynamic interface with data on the prevalence of 18 chronic conditions, end-stage renal disease, or a disability. It also includes data on Medicare spending, hospital and emergency department (ED) utilization, preventable hospitalizations, readmissions, and mortality rates. Users can sort by state, other demographics and dual-eligibility for Medicare and Medicaid. A benchmarking feature allows for analysis within counties, across racial and ethnic groups, and within racial and ethnic groups across counties. The tool is at: https://www.cms.gov/About-CMS/Agency-Information/OMH/OMH-MappingMedicare-Disparities.html. Some frequently asked questions (FAQs) on the tool are at: https://www.cms.gov/About-CMS/AgencyInformation/OMH/Downloads/MMDT-FAQs.pdf. For further information, contact Patrick Conole at (518) 810-0661 or pconole@hcanys.org. 12

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Upcoming NGS Education Programs National Government Services (NGS), New York’s Medicare Administrative Contractor (MAC), has recently posted the following educational webinars. •

Ordering and Certifying Medicare Home Health Services: March 31, from 3 to 4 p.m. Registration is at: https://attendee.gotowebinar.com/rt/48586692185987844

•

Ordering and Certifying Medicare Home Health Services: April 4, from noon to 1 p.m. Registration is at: https://attendee.gotowebinar.com/rt/48586692185987844

•

Home Health Documentation and the Additional Development Request (ADR): April 5, from noon to 12:30 p.m. Registration is at: https://attendee.gotowebinar.com/register/ 8352611976132375810

•

Top Medical Review Denials for Hospice Claims: April 7, from 1:30 to 2:30 p.m. Registration is at: https://attendee.gotowebinar.com/register/6387672548298099972

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

Trainings Scheduled on FIDA-IDD The Office for People with Developmental Disabilities (OPWDD) will be conducting trainings on the new Fully Integrated Duals Advantage (FIDA) plan for individuals with intellectual and developmental disabilities (FIDA-IDD). Remaining training dates are March 22, 23 and 24. More information is at http://www3.opwdd.ny.gov/wp/wp_catalogz2449.jsp. Voluntary enrollment for FIDA-IDD begins April 1, 2016. Partners Health Plan has been contracted to offer this program in New York City, Long Island, Rockland and Westchester Counties, which are the only areas in which it will be available at this time. This training will explain the benefits of the FIDA-IDD program and talk about the upcoming mailings that eligible people will begin receiving during the month of March. Eligible individuals include those who are at least 21 years old, receive both Medicare and Medicaid coverage, and are eligible for OPWDD services. Multiple resources on FIDA-IDD are at http://www.opwdd.ny.gov/opwdd_services_supports/ people_first_waiver/care_management/FIDA_IDD.

Value-Based Payments TRIPLE-AIM AWARDS

Make your choice!Quality Board of Directors

Calling all Home Care Delegates! Join HCA for this Star-Spangled Event that you won’t want to miss!

ANNUAL MEMBERSHIP CONFERENCE MAY 4 – 6, 2016 SARATOGA SPRINGS, NY

ANNUAL MEMBERSHIP CONFERENCE MAY 4 – 6, 2016 – SARATOGA SPRINGS, NY

Hotel Information The Saratoga Hilton, Saratoga Springs, NY is the site of the HCA

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.

Annual Conference. Rooms at the Saratoga Hilton are

per night. This discounted rate is available until April 3. After this date, higher rates will prevail. Parking is $5 per night. To make a reservation, call 888-866-3596 or register online at:

Why not use the HCA Annual Conference as an educational retreat for your team? Let us know if we can help make that happen!

Thanks TO OUR

S & PE O HX NI S BI ET R OR SS

$165

https://resweb.passkey.com/go/HomeCareNY2016. The hotel’s check-in time is 4 p.m. and check out is 11 a.m. Luggage storage is available should your room not be ready prior to check-in time.

HCA graciously thanks those Sponsors and Exhibitors who have already committed to support you and this signature educational event.