May 1, 2015 Edition of ASAP

ASAP

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

Legislative Issues  Public Policy



News

Volume 20, No. 17 May 1, 2015

Home Care Insurance Coverage, ‘Advanced Aide’ Proposals among New Bills Codes Committee to consider ‘essential personnel’ and other bills Among this week’s state legislative introductions were two new home care bills, including an HCA-developed measure that would modernize the home care insurance law, and another bill that would establish “advanced home health aides” in a follow up to the final state budget, which considered but did not include authorization for advanced home health aides.

See BILLS p. 5

DOH Sets Interim EPS Rebasing Reductions for CHHAs The state Department of Health (DOH) this week issued a Dear Administrator Letter (DAL) setting in motion a rebasing of Certified Home Health Agency (CHHA) Episodic Payment System (EPS) rates on an interim basis as the Department works towards a final rebasing plan.

HCA has posted the DAL on our website at http://hca-nys.org/wp-content/uploads/2015/04/ DALLetterCHHAEPSInterimAdjustment.pdf.

Inside ASAP

With this DAL, the Department is acting on its administrative authority and statutory directive to rebase CHHA EPS, and on the Division

New Bills on Home Care Insurance Coverage, ‘Advanced Aides’...........1 DOH Sets Interim EPS Rebasing Reductions for CHHAs.......................1 Get More Details on EPS Rebasing Next Week!................................3 Member Hiring Announcements...................................................7, 11 Save the Date for HCA’s Technology Symposium.................................8 CMS Issues FY 2016 Proposed Hospice Rule.......................................8 DOH Posts New QIVAPP FAQs..........................................................11 Medicare Home Health Patient Survey Information Posted.............13 HCA Quality Committee Progressing in Major Areas......................14 DOH Issues Final 2015 LTHHCP Rates...............................................15 NEW to HCA Data Webpage: 2013 CHHA & LTHHCP Cost Data....15 Influenza Mask Mandate Still in Effect...............................................16 NYSE-CON Update............................................................................16 Funding Announced on Health Information Technology...................17 Resources Posted on Medicaid Validation.......................................18 Incident Reporting Changes for NHTD and TBI Providers................18 NAHC and UPenn Seek Your Response on Telehealth Survey............19 CMS Clarifies Documentation Maintenance Requirements.............19 NGS Updates.....................................................................................20 Publications......................................................................................................................21

See REBASING p. 2

Helping New Yorkers Feel Right At Home

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

Volume 20, No. 17 May 1, 2015 

REBASING from p. 1 of Budget’s adoption of Medicaid reductions in the new budget reflecting the rebased system.

The interim rates discussed in the DAL will be established retrospectively, effective April 1, 2015, and are currently being expedited through the Department of Health and Budget’s approval process, hitting the eMedNY system by about May 15, 2015, at which point another DAL will be circulated.

The upcoming rates will include an interim reduction of 12 percent to the current 2009 base year EPS, taking an initial step toward full implementation of EPS rebasing, in accordance with Section 3614.13(b) of the Public Health Law and Part 86-1.44 of the Commissioner’s Administrative Rules and Regulations.

The final step in rebasing is expected to be completed by October 1, 2015; but, according to the DAL, the state has opted to issue these interim rates as a backfill to meet the April 1 statutory effective date and to avoid larger retroactive recoupments that would occur if it were to delay action until the final rebasing adjustment is completed on or about October 1.

Legislative background By statute (enacted under the original 2011 Medicaid Redesign Team package), the CHHA episodic payment rates are to be rebased effective April 1, 2015 – three years after the initial CHHA EPS was implemented, on May 1, 2012, with a base year of 2009.

The DAL references Section 3614.13(b), which establishes that: “Subsequent base year episodic payments may be based on Medicaid paid claims for services provided by all CHHAs in a base year subsequent to 2009,

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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as determined by the Commissioner of Health, provided, however, that such base year adjustment shall be made not less frequently than every three years.”

Are You Concerned about the 12% CHHA EPS Rebasing Cuts?

Get More Details Next Week!

Rebasing process On Monday, HCA alerted you about the new rate cuts announced by the Department of Health as it begins the process of Medicaid Episodic Payment System (EPS) rebasing for CHHAs.

The Department has determined that the latest complete base year claims data available for rebasing is calendar year (CY) 2013, coupled with the corresponding 2013 OASIS assessment data.

Ultimately, the rebasing process will require adjustments to both provider Medicaid grouper and billing software, the wage index factor and the outlier threshold calculation as well as changes to the eMedNY Medicaid payment system, which cannot be retroactively applied.

Next week, HCA’s policy team will be briefing our Board of Directors about the specifics of these new cuts, the overall rate methodology, and the rebasing process going forward.

We want you to have a front-row seat to learn more about this major, new development, as well as other relevant policy, legislative, reimbursement and regulatory updates.

The Department’s preliminary analysis reveals that the overall process will yield an estimated reduction of no less than $30 million in statewide CHHA expenditures. Based on the latest data, DOH has determined that a statewide interim reduction of 12 percent to the current 2009 base rates achieves this estimated annual statewide savings of approximately $30 million. This adjustment will affect the 108 casemix adjusted payment rates for services to patients 18 years of age and older under the current CHHA EPS.

HCA’s Board meetings are a forum for HCA Policy staff to check in with our main governing body about all of the issues on our daily work-plan and to gain perspectives as well as the authority to act on your behalf.

Wouldn’t you like to be a part of this discussion?

DOH notes that these CHHA EPS rate revisions will not include any adjustment to the rates for pediatric patients. Those services will continue to be reimbursed on an historical fee-for-service (FFS) perunit basis, in accordance with Part 86-1.13.

On May 7, at HCA’s Annual Conference in Saratoga Springs, we will invite all attending HCA members to hear the briefings and deliberations of our Board as it considers vital issues for your organization, including our action plan for CHHA rebasing.

Next steps HCA has met with DOH twice this week on CHHA EPS rebasing – first to meet on the DAL and secondly for a “drill down” into the Department’s data analysis of the entire CHHA EPS rebasing initiative.

Guest Speaker: HANYS President Dennis Whalen Every year, we also invite a special guest speaker to present at the Board meeting. This year’s guest is Dennis Whalen, President of the Healthcare Association of New York State

During both meetings, HCA expressed serious concerns regarding effects of DOH’s rebasing proposal on the home care community, particularly given the already-precarious financial situation of many CHHAs as they adjust to mandatory managed care, wage parity, the Delivery System Reform

See CONCERNED p. 4 3

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CONCERNED continued from p. 3

Incentive Payment (DSRIP) program, the impending change to Value Based Payment reforms, new requirements for utilizing verification organizations and other payment changes that are already creating pressure.

(HANYS), who will engage with the Board in discussions on hospital-home care collaboration and other avenues for partnership that will assist the growth of your organization.

HCA also strongly emphasized the need for CHHAs and their software vendors to be given a reasonable timeframe to make the appropriate adjustments to the current Medicaid grouper weights and billing software.

If you haven’t yet done so, please act now to get your front-row seat at this special meeting while taking part in the other great offerings at next week’s Annual Conference, including a special session on Value Based Payments, led by Dr. Marc Berg, who is working with New York State on its Value Based Payment (VBP) design.

HCA will be providing a further EPS update to the HCA Board and membership at next week’s Annual Conference. (See related p. 3 sidebar story.) All members should attend this important event. Please see the registration form at the back of this week’s ASAP.

You may have noticed that several other groups and sponsors are holding education programs on Value Based Payments ... and for good reason.

Like CHHA EPS, like mandatory Managed Long Term Care (MLTC) enrollment, like Fully Integrated Duals Advantage (FIDA), like the Delivery System Reform Incentive Payment (DSRIP) program, VBP is going to be a major part of the state’s payment and service delivery changes under Medicaid. We’re on top of this, with Dr. Marc Berg’s presentation, and he is just one of the many education sessions and workshops that will provide you with perspectives, information and ideas at HCA’s Annual Conference.

Register today using the brochure at the back of this week’s ASAP

There are two easy ways to register for next week’s Conference and it is not too late to do so: 1. Download the brochure at the back of this week’s ASAP and send it immediately to HCA. 2. Use a credit card to register online at https://www.eventville.com/Catalog/ EventRegistration1.asp?EventId=1011491.

Our conference is just one week away! Don’t delay. Register today and visit www.hcaannualconference.com for more information.

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BILLS continued from p. 1 Meanwhile, several other bills saw action this week, including the HCA-developed “essential personnel” legislation (A.5125-B/ S.3482-B), which will be considered by the Assembly Codes Committee on May 4.

Consistent with current hospital and medical care practice, the bill modernizes the specifications for the covered individual which would include someone who requires services for:

This bill – which would allow home care and hospice staff to access patients during emergency curfews or restrictions – has been extensively summarized in several past editions of ASAP. Sponsored by Senator Lanza and Assemblyman Cusick, both of Staten Island, the bill also provides for home care and hospice involvement in the local emergency planning process.

The Assembly Codes Committee is an important next step in the process, from which the bill would likely next reach the Ways and Means Committee on a track toward consideration by the full Assembly. Several other bills are on the Codes Committee, as summarized later in this article.

•

Transition from a hospital, nursing facility or other institutional setting to home;

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Rehabilitation, recovery or medical management at home following hospitalization or institutional care; or

•

Medical management of a condition predisposing the covered individual to hospitalization or confinement in a nursing facility or to the need for other out-of-home services otherwise covered under the contract or policy if home care is not provided.

It also updates the reference to a home care agency’s authorized list of services to reflect other services the agency actually provides, such as social work, respiratory therapy and nutritional counseling.

Home Care Insurance Coverage (S.5076) As announced in an E-alert to the membership this week, the chairman of the state Senate Insurance Committee, Senator James Seward, has introduced an HCA-developed bill to modernize and align the State Insurance Law specifications for home care coverage.

Additionally, the bill replaces outdated mechanisms for utilization and cost controls (e.g., replaces the existing law’s 40 visit minimum) with contemporary and more dynamic controls used in insurance and managed care, such as management or utilization review of home care benefits, or use of preauthorization and appropriateness criteria as to the level and intensity of treatment applicable to home care.

HCA proposed this legislation conceptually as a major prong of our state advocacy agenda to support home care agencies in an evolving health care landscape. In the weeks since our State Advocacy Day, in January, we have worked closely with Senator Seward’s office to garner support for the measure and to develop the legislative language, now introduced as S.5076 and referred to the Senate Insurance Committee.

HCA will continue to work with Senator Seward and with the Insurance Committee Chairman of the Assembly, Kevin Cahill, to urge bicameral sponsorship and passage of this important measure.

Advanced Home Health Aide Bill (A.7188)

This bill provides long overdue updates to the State Insurance Law coverage specifications for home care services which were adopted in the early 1970s and have not since changed.

Assembly Member Deborah Glick has introduced a bill providing for an exemption to the Nurse Practice Act to establish “advanced home health aides” who

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would be authorized to perform additional tasks under the supervision of a nurse.

existing home health aide training programs to prepare for advanced home health aides.

A range of “advanced home health aide” proposals have been under consideration during the past several legislative sessions – most recently serving as the focus of a state workgroup involving stakeholders from across the service spectrum, including HCA.

Other legislative action Several other bills of interest to home care providers saw action this week, including the following bills that HCA is monitoring and/or responding to: •

The Caregiver, Advise, Record and Enable (CARE) Act has been referred to the Assembly Codes Committee. It previously passed the Senate. It would require a hospital to allow patients to designate a caregiver for discharge planning who the hospital must notify prior to discharge and consult with regarding after-care planning and coverage.

HCA last reported on this bill in the April 24 ASAP.

•

An act to increase the minimum wage (A.7257) has been reported to the Assembly Labor Committee. The bill, extensively reported in past editions of ASAP, would change the statutory minimum wage to $12.50 in New York City and Nassau, Suffolk, and Westchester counties and $10.50 in the rest of the state on December 31, 2016; to $13.75 in New York City and Nassau, Suffolk, and Westchester counties and $11.55 in the rest of the state on December 31, 2017; and to $15.00 in New York City and Nassau, Suffolk, and Westchester counties and $12.60 in the rest of the state on December 31, 2018. On and after December 31, 2019, the minimum wage would be indexed to the rate of inflation.

A version of the Assembly proposal was considered in the state budget process, along with an original version proposed by the Executive; however neither proposal was accepted in the final budget. Though similar to the Executive proposal, the Assembly would have included standards beyond the Governor’s language, such as nurse-to-aide ratios.

HCA will be carefully reviewing this latest Assembly iteration, along with any similar Senate or Executive proposals that follow.

Meanwhile, we continue to work internally and with other interested parties on how best to work from these proposals to formulate an agreeable and successful approach this session.

We have long supported proposals for the flexible assignment of home care personnel; and the need for such flexibility is of growing importance given the evolving models and approaches to care and coverage within the health care system.

With respect to the Executive’s and Assembly’s proposals, HCA has stressed the need for financing to support the major new costs associated with the approaches taken in these bills, such as changes in agency operations, training and regulatory compliance. Also essential is alignment of any such new provisions with managed care and managed long term care-home care protocols, the need to avoid and/or streamline any prospective regulatory layers on agencies or plans or new administrative burdens on RNs, address liability issues, and address the opportunity of

• A.2150, which would authorize an attending physician to make decisions regarding hospice on behalf of an incapable adult without a surrogate, was also referred to the Codes Committee.

Telehealth In another important legislative development, HCA met with key legislative staff, and reached out to state 6

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Department of Health representatives, to continue our efforts to remedy the inadvertent limitations to home care under the new telehealth/telemedicine coverage law signed in December. This new law, which was substantially rewritten earlier this year to make technical and structural improvements, bases its new telehealth insurance coverage on whatever is the coverage for a particular service or sector (e.g., hospital care, home care, physician care) under the existing insurance law.

The new law’s coverage for home telehealth is therefore inherently limited given the insurance law provisions that currently dictate home care coverage – and which HCA is seeking to address through legislation like S.5076, our home care insurance modernization legislation (referenced earlier in this article).

HCA is discussing with the Legislature and Department some draft amendments to help ameliorate these issues. Such amendments would be further and substantially complemented by S.5076.

This time of year is a period of intense legislative activity. HCA will continue to keep you apprised on all major developments with our priority legislation and other bills that effect home care services, reimbursement and operations.

HIRING Jewish Home Lifecare is currently hiring for the following positions: Supervisor of Rehabilitation Services, Part-Time Weekend RNs, Fee for Service Nutritionists, Fee for Service positions in OT, PT, SLP, and LMSW for our CHHA. We are also currently recruiting for an RN Instructor and Fee for Service RNs for our LHCSA. In addition to the above mentioned positions, we are looking for a Director to oversee Quality and Performance Improvement.

The Director of Clinical Excellence for QAPI (Quality Assurance Performance Improvement) is responsible for directing the development, implementation, and evaluation of the Quality Assurance Performance Improvement program for the organization’s Certified Home Health Agency (CHHA). This involves collaboration with the administrative and clinical leadership in order to effectuate a successful and regulatory compliant program. The Director of Clinical Excellence for QAPI fosters a culture that promotes a commitment to continually improving quality of care for clients and that empowers staff to build quality improvement processes into daily work activities.

License and current registration as a Registered Professional Nurse, Bachelor’s Degree in Nursing required. Minimum three years home care experience; knowledge of home health regulations, accreditation and quality standards.

We offer competitive compensation, excellent benefits, and a positive work environment. For further consideration, please send a cover letter and resume to: Victoria Izraylevsky, Director of Human Resources at vizraylevsky@jewishhome.org.

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Save the Date for HCA’s Technology Symposium Save June 16 on your calendar for HCA’s Technology Symposium!

This education program is designed to bring you the latest information on what direction New York State is taking on technology support for new payment models and other policy initiatives.

Learn how home care is connecting electronically with hospitals and how your organization can connect to a Regional Health Information Organization (RHIO).

In addition, you’ll hear from providers giving case examples for how they utilize technologies to achieve enhanced patient care and greater efficiencies. Kicking it up a notch, we’ll also learn about the future of health care technology and what’s being developed in the area of nanoscience.

Throughout the day, ten vendors will be on hand so you can review their technology products or services that are aimed at reducing re-hospitalizations, providing patient education and easing patient care.

The program will be held at the Albany Marriott and is geared for home care leaders as well as supervisors in the areas of information technology and patient care. The program will include valuable handout materials and resources as well as the opportunity to network with peers during lunch. Watch for more details coming soon.

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

CMS Issues FY 2016 Proposed Hospice Rule Rule includes updates to the FY 2016 Medicare payment rate and wage index The U.S. Centers for Medicare and Medicaid Services (CMS) has issued a proposed rule (CMS-1629-P) that would update the fiscal year (FY) 2016 Medicare payment rates and the wage index for hospices serving Medicare beneficiaries.

The proposed rule is on display and can be currently downloaded at https://s3.amazonaws.com/publicinspection.federalregister.gov/2015-10422.pdf. Starting on May 6, CMS will make this proposed rule available in the Federal Register at http://federalregister.gov/a/2015-10422.

Highlights of CMS’s FY 2016 hospice proposed rule are summarized below.

Payment changes CMS forecasts that hospices nationally will see an estimated 1.3 percent ($200 million) increase in their payments for FY 2016.

The increase reflects the distributional effects of the 1.8 percent proposed FY 2016 hospice payment update percentage ($290 million increase), the use of updated wage index data and the phase-out of the wage index budget neutrality adjustment factor (-0.7 percent/$120 million decrease). and the proposed implementation of

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the new Office of Management and Budget (OMB) Core Based Statistical Areas (CBSA) delineations for the wage index with a one-year transition (0.2 percent/$30 million increase).

Budget Neutrality Adjustment Factor (BNAF) phase-out CMS’s proposed rule describes the final year of the BNAF phase out, a provision of the FY 2010 Hospice Wage Index rule. The BNAF was implemented in 1997, when the former Health Care Financing Administration (HCFA), now CMS, moved from an outdated wage index to a more current method for determining hospice payments.

The FY 2010 Hospice Wage Index final rule established a schedule to phase-out the BNAF over seven years, reducing it by 10 percent in FY 2010 and by 15 percent reductions each year from FY 2011 through FY 2016.

Alignment of Cap Year The proposed rule seeks to align the cap accounting year for both the inpatient cap and the hospice aggregate cap with the fiscal year and for future FYs. CMS believes this will allow for the timely implementation of the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014 changes (implementation in FY 2016) while better aligning the cap accounting year with the timeframes described in the IMPACT Act of 2014.

The IMPACT Act mandates that the hospice aggregate cap be updated by the hospice payment update rather than using the Consumer Price Index-Urban (CPI-U) for a specified time. In addition, CMS will align the timeframe for counting the number of beneficiaries with the fiscal year, rather than the accounting year.

Wage Index Update: CBSA-OMB delineations CMS’s FY 2016 rule proposes to adopt changes to the hospice wage index. OMB Bulletin No. 13-01 (https:/ /www.whitehouse.gov/sites/default/files/omb/bulletins/2013/b13-01.pdf ) specifies these changes including the delineation of Metropolitan Statistical Areas, Micropolitan Statistical Areas, and Combined Statistical Areas, and guidance on these delineations.

These changes would be implemented using a blended wage index with a one-year transition, which aligns with the policy finalized for nursing facilities and home health agencies in each sector’s 2015 Prospective Payment System (PPS) rule. For each county, a blended wage index would be calculated as fifty percent of the FY 2015 wage index using the current OMB delineations and fifty percent of the FY 2015 wage index using the revised OMB delineations.

CMS’s proposed FY 2016 wage index can be found at http://www.cms.gov/Center/Provider-Type/HospiceCenter.html under the “Spotlight” section. The wage index table provides a crosswalk between the FY 2016 wage index using the current OMB delineations in effect in FY 2015 and the FY 2016 wage index using the

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proposed revised OMB delineations, as well as the proposed transition wage index values that would be in effect in FY 2016 if the proposed changes are finalized.

Proposed Routine Home Care Rates CMS is proposing two different payment rates for routine home care (RHC) that would result in a higher base payment rate for the first 60 days of hospice care and a reduced base payment rate for 61 or more days of hospice care. CMS believes these differing payment rates would further the goal of more accurately aligning the per diem payments with visit intensity and the cost of providing care.

Service Intensity Add-On CMS’s FY 2016 rule also proposes a Service Intensity Add-On (SIA) payment for FY 2016 and beyond in conjunction with the proposed RHC rates. The proposed SIA payment is a payment that would be made for the last seven days of life in addition to the per diem rate for the RHC level of care if certain criteria were met.

The payment would not be made to providers with patients residing in Skilled Nursing or Nursing Facilities due to concerns with the provision of hospice care in these settings as highlighted by the Office of Inspector General (OIG) and the Medicare Payment Advisory Commission (MedPAC). CMS believes the SIA payment policy will encourage visits to patients at the end of life and will improve provider accountability. Additionally, the policy begins to address industry and other organizations’ concerns regarding the need for increased payment for more resource intensive days.

Clarification Regarding Diagnoses on Claim Form In the proposed rule, CMS expresses concerns that some hospices are neither conducting a comprehensive assessment nor updating the plan of care as articulated by the Conditions of Participation (CoPs) to recognize the conditions that affect an individual’s terminal prognosis. CMS is basing these concerns from the numerous comments received in previous rulemaking, and anecdotal reports from hospices, hospice beneficiaries, and non-hospice providers.

Consequently, CMS clarifies in the proposed rule that hospices are required to report all diagnoses identified in the initial and comprehensive assessments on hospice claims, whether related or unrelated to the terminal prognosis of the individual. This is in keeping with the requirements of determining whether an individual is terminally ill. It would also include the reporting of any mental health disorders and conditions that would affect the plan of care as hospices are to assess and provide care for identified psychosocial and emotional needs, as well as for physical and spiritual needs.

Next Steps CMS’s proposed rule will be open for public comment until 5 p.m. on June 29, 2015. Over the next few weeks, HCA will be carefully reviewing CMS’s 177-page rule and we plan to submit comments on behalf of the membership. HCA Vice President Patrick Conole will be reaching out to our hospice members later this month for your input or concerns and recommendations regarding CMS’s FY 2016 proposed rule.

HCA will share our comments to CMS with the membership shortly after they are submitted. Hospice members interested in submitting their own comments can do so either electronically or by mail. Electronic comments can be sent to http://www.regulations.gov. (Follow the instructions under the “More Search Options” tab.) Mailed 10

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comments can be addressed to CMS, Department of Health and Human Services, Attention: CMS-1629P, P.O. Box 8010, Baltimore, MD 21244-8010.

For further information on CMS’s FY 2016 hospice proposed rule, contact Patrick Conole at (518) 810-0661 or pconole@hcanys.org.

DOH Posts New QIVAPP FAQs HCA expresses concerns about health insurance requirement This week, the state Department of Health (DOH) posted a comprehensive Frequently Asked Questions (FAQs) document on the Quality Incentive Vital Access Provider Pool (QIVAPP) program (http:// www.health.ny.gov/health_care/medicaid/redesign/docs/qivapp_faq4.pdf ).

The FAQs include 63 questions, many raised by HCA prior to and during the April 15 QIVAPP webinar held by DOH. Some important information conveyed in the FAQs includes: •

A minimum of 30 percent of a home care agency’s total workforce must be enrolled in the agency’s health benefit in order to meet the requirement that the agency “participates in a health benefit fund for their home health care and/or personal care aides and/or provides comprehensive health insurance coverage to their employees.” This week, in a communication to DOH, HCA took issue with this “new” requirement that was not part of the original QIVAPP instructions, holds agencies responsible for actions taken by workers that are beyond their control and actually

HIRING Jefferson County Public Health Service Director of Patient Services is responsible for the administrative, professional and financial operations of the home health programs. Minimum qualifications include licensure as a registered nurse with two years of experience as a Supervising Public Health Nurse; or two years of home care nursing experience plus a master’s degree in nursing, public health, business administration or another health related field. Master’s degree preferred.

Supervising Public Health Nurse is responsible for supervising a nursing team to ensure comprehensive home care services are provided to achieve positive patient outcomes. Minimum qualifications include BS degree in nursing, two years of experience as a public health nurse and licensed to practice as an RN in NYS. Physical Therapist is responsible for evaluating, planning and providing physical therapy treatment to patients in accordance with physician orders. Minimum qualifications include licensure and currently registration by the New York State Education Department as a Physical Therapist.

Applications Accepted At: Jefferson County Department of Human Resources, 175 Arsenal Street, Watertown, NY 13601, (315)-785-3147. EOE. http://www.co.jefferson.ny.us

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limits choice for their aides. We also pointed out there may be very legitimate reasons why aides don’t opt for health benefits, including other coverage they have or a desire to select a higher wage over health benefits when that option is available.

•

While home care agencies must provide comprehensive health insurance benefits, as outlined at http:// www.health.ny.gov/health_care/medicaid/redesign/docs/ohip_qivapp_ppt-final_04142015.pdf (slide 7), some Managed Long Term Care (MLTC) plans have requested an exception in cases where their home care contracted providers don’t provide all of these benefits and DOH is reviewing these exception requests.

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DOH will be conducting a “validation” to ensure that all QIVAPP program requirements have been met. It is up to each MLTC plan (when it signs the attestation form for each contracted home care provider) to assure that these providers who are getting the QIVAPP funds meet all the eligibility requirements.

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If a home care provider is considered not eligible for any part of QIVAPP funds it received, the plan would have the responsibility to recoup those funds from the provider. In such cases, DOH will be providing a form for the plans to submit about recoupments.

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Home care providers are expected to provide more than one hour above the minimum training program requirements (40 hours for personal care aides and 75 hours for home health aides) in order to meet the QIVAPP requirement that they “shall maintain or participate in a specialty training program for home health aides and personal care aides.”

•

The hours reported for live-in cases should be included on the data sent to DOH and be calculated in accordance with MLTC Policy 14.08 at http://www.health.ny.gov/health_care/medicaid/redesign/ docs/mltc_policy_14-08_paying_for_live_in_cases.pdf.

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DOH is confident that the U.S. Centers for Medicare and Medicaid Services (CMS) will approve the $35 million federal share for QIVAPP.

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Regarding future QIVAPP funding, DOH indicated that, “we have a commitment to this year and we are going to see how that goes before we commit to any future years.”

As announced to members in an alert this week, today (Friday, May 1) is the deadline for MLTC plans to send DOH the attestation forms (for each home care provider) and a reconciliation spreadsheet that includes data on their contracted home care providers’ aide services in New York City (actual hours of aide services from April 1, 2014 to February 28, 2015 and estimated hours for March 1 to March 31, 2015) so that the home care agencies can qualify for QIVAPP funding.

Since QIVAPP was announced, HCA has worked to ensure that all home care providers have the opportunity to qualify for funds. We have raised questions about the process for awarding the state-share of QIVAPP, and this week took issue with DOH’s position that a minimum of 30 percent of a home care agency’s total workforce must be enrolled in the agency’s health benefit in order to meet the health coverage requirement.

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

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Medicare Home Health Patient Survey Information Posted CMS forum next week In preparation for a Special Open Door Forum on the Home Health Patient Survey (HHCAHPS) Star Ratings (May 7), the U.S. Centers for Medicare and Medicaid Services (CMS) has posted materials, including background information, Frequently Asked Questions and Forum slides.

The materials are at https://www.homehealthcahps.org/GeneralInformation/CMSOpenDoorForumMaterials.aspx.

Starting in January 2016, CMS will add HHCAHPS Star Ratings to the Home Health Compare website.

Five HHCAHPS Star Ratings will appear on Home Health Compare: one for each of the three publicly reported HHCAHPS composite measures, one for the Overall Rating of Care measure, and one Survey Summary Star, which is a simple average of the four HHCAHPS measure star ratings.

HHCAHPS Star Ratings are based on the same patient survey results publicly reported on Home Health Compare since April 2012. The first public reporting of the HHCAHPS Star Ratings in January 2016 will be based on patients who received home health care between July 2014 and June 2015.

HHCAHPS Star Ratings will be applied to each of the three publicly reported composite Measures (care of patients, communication between providers and patients, and specific care issues), which are created from specific questions on the HHCAHPS Survey, and to the publicly reported global rating (overall rating of care).

According to CMS, the distribution of agencies across the Star Ratings will change with each additional public reporting period, as the oldest quarter of data is removed and the newest quarter of data is added. Since the cluster distribution of agencies is recomputed with each 12-month public reporting period, it is possible for a home health agency’s Star Rating to change from quarter to quarter.

CMS will conduct a Dry Run (a test of the Star Ratings and Preview Report process) of the HHCAHPS Star Ratings for the October 2015 public reporting period and post Dry Run data around the beginning of October.

The Star Ratings will be assigned for the data that will be posted on Home Health Compare on the third Thursday in October. However, Home Health Compare will not have these dry run Star Ratings publicly reported.

Home health agencies will be provided with a Preview Report in October 2015 showing the dry run Star Ratings assigned based on HHCAHPS Survey data collected from April 2014 through March 2015.

HHAs can access their Preview Reports by logging onto the HHCAHPS website (https://homehealthcahps.org) and selecting the “Preview Reports” link under the “For HHAs” tab (top of screen on far right side).

The Special Open Door Forum on the HHCAHPS Star Ratings is on May 7, from 1:30 to 2:30 p.m. The dialin number is 1-800-603-1774 and the conference identification code is 96436960.

The Patient Survey Star Ratings are in addition to the Quality of Patient Care Star Ratings which will start in July 2015 and have been discussed in many previous editions of ASAP. Questions or feedback about HHCAHPS Star Ratings can be sent to hhcahps@rti.org.

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HCA Quality Committee Progressing in Major Areas The HCA Quality Committee met last week and is progressing on major areas of work while exploring additional, critical initiatives for health improvement through home care.

The committee is focusing on initiatives aimed at measuring and advancing direct agency and service quality, as well as initiatives harnessing home care in tackling some of the top clinical and public health priorities across the health care system. This body of work also further strengthens and expands home care’s contribution as a critical partner in virtually all of the emerging models and priority directions in health care, including Delivery System Reform Incentive Payment (DSRIP) programs, value based payment (VBP) models, managed care, and other forms of integrated care and coverage.

The items taken up by the committee included: •

The progress, status and models for potential automation and provider incorporation of the new (almost finalized) HCA Quality, Risk and Compliance Tool.

•

A review of the “INTERACT Tool for Home Health” aimed at preventing avoidable hospitalizations, with faculty presentations from Florida Atlantic University, and exploration of statewide home care agency training and incorporation of the Tool.

•

The state/federal transition to VBP and implications and opportunities for home care participation and contribution to quality and savings under this model.

•

The coming U.S. Centers for Medicare and Medicaid Services (CMS) Five Star Rating System for home health, implications for New York State’s home care community and strategies for addressing the inherit problems and inaccuracies of the CMS model.

•

Initiative of the HCA workgroup on sepsis, reporting on the workgroup’s progress in shaping a statewide HCA initiative for an expanded home care role in sepsis early recognition and intervention.

•

HCA collaborative initiative with state and industry partners on falls prevention, and associated training, resource and program development.

•

Home care participation in the national home health cardiovascular initiative, being promoted by HCA in partnership with our region’s Quality Improvement Organization, IPRO, and the national Home Health Quality Improvement (HHQI) campaign.

•

An array of additional home health-public health improvement areas (such as maternal/child health, primary care access, addressing health care disparities through home care, veterans home care, and others) on which HCA has initiated discussions with the state Health Department, the state Legislature and health sector partners.

HCA and the committee continue our diligent work in all of these areas, advancing home care’s capabilities and positioning in quality innovation and improvement. We will keep the membership closely apprised of the

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developments. HCA extends appreciation to our provider, health plan and organizational members for devotion of their time, expertise and commitment to quality advancement for the entire field.

For further information or to contribute to any of these initiatives, please contact Al Cardillo at acardillo@hcanys.org.

DOH Issues Final 2015 LTHHCP Rates The state Department of Health this week posted to the Health Commerce System (HCS) the 2015 final “Hotline” Medicaid rates for Long Term Home Health Care Programs (LTHHCPs).

HCA expects DOH to also post in the near future the 2015 final (or hotline) rates for non-hospital based Certified Home Health Agencies (CHHAs) Personal Care and Consumer Directed Personal Assistance Programs (CDPAPs).

The LTHHCP rate calculations sheets are located in the “Rate Publication Selection List” drop-down section of the HCS dated April 23, 2015. DOH has also posted a corresponding Dear Administrator Letter (DAL).

These rates, effective January 1, 2015, reflect the application of a zero percent roll factor adjustment. The rates also reflect a 4.7 percent uniform percentage rate add-on payment for the Recruitment, Training & Retention (RT&R) funding (Section 3614.9) to qualifying providers for the period of January 1, 2014 through December 31, 2014 as well as the 3 percent rate add-on for the RT&R funding (Section 3614.8) to qualifying providers (LTHHCPs submitted a signed attestation) for the same time period. According to DOH, the statewide administrative and general (A&G) cap for LTHHCPs in 2015 is 25.69 percent.

LTHHCPs have 30 days (from the receipt of the DAL) to file an appeal with DOH. However, the appeals process only applies in cases where the 2015 final rates have changed from the 2015 initial rates.

The DAL also mentions that the Department expects to make available the 2014 cost report software on the HCS website on or about June 1, 2015. The 2014 cost report will be due on or about August 15, 2015.

If you have specific questions about your rates, contact DOH’s Russ Smith at (518) 473-4421.

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

HCA Data Webpage Now Includes 2013 CHHA & LTHHCP Cost Report Data This week, HCA staff posted to our HCA Data website an HCA-developed spreadsheet of the 2013 Medicaid Cost Reports for all non-hospital based Certified Home Health Agencies (CHHAs) and all Long Term Home Health Care Programs (LTHHCPs) in the state.

Important: 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. The page is not visible on our site unless you are logged in with an HCA member website account.

Our log-in page is here: http://hca-nys.org/login. Upon login, the HCA Data link will appear in the site menu at the top right. You can also enter your e-mail address to obtain your password. Or, simply e-mail 15

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HCA’s Communications Director Roger Noyes at rnoyes@hcanys.org if you do not yet have an HCA website account.

HCA has recently submitted a freedom of information law (FOIL) request for the fourth quarter 2014 Medicaid Managed Care Operating Reports (MMCORs) from each Managed Long Term Care (MLTC) and Program of All-Inclusive Care for the Elderly (PACE) plan in the state. Upon receipt of this data, HCA will prepare a spreadsheet summarizing key MMCOR data, including such items as: plan enrollments; per-member-permonth premium revenue and premium income; unit costs; and other information.

HCA Data currently has 2013 MMCOR data available to members and hopes to have 2014 data available sometime in June.

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

Influenza Mask Mandate Still in Effect While today is the deadline to submit the Healthcare Personnel Vaccination Report, HCA has confirmed with the state Department of Health (DOH) that the ‘flu mask’ requirement still is in effect.

Under this mandate, home care and other health care providers are required 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.

According to DOH, the decision to stop requiring unvaccinated personnel to wear masks is based on DOH state surveillance data. When the decision to stop requiring masks is made, DOH will inform providers through the Health Commerce System (HCS) and its website (www.health.ny.gov/flumaskreg).

DOH also posts Weekly Influenza Surveillance Reports on the HCS (under Newsroom Highlights) that includes data on influenza activity throughout the state. The HCS is accessed at https://commerce.health.state.ny.us/ public/hcs_login.html.

NYSE-CON Update The state Department of Health (DOH) is expanding the New York State Electronic Certificate of Need (NYSE-CON) application to include the pre-opening inspection phase for CON applications.

This will be a multi-step process, the first of which is the introduction of a new tab in NYSE-CON labeled “Regional Office.”

The “Regional Office” tab is available April 30, 2015, and will be accessible after the CON application has been approved and contingencies have been satisfied. The tab and functionality will also be available for projects already approved.

The “Regional Office” tab enables applicants to propose pre-opening survey dates and request Department staff to schedule surveys. Additionally, the tab enables entry of applicant contact information and electronic communication during the pre-opening process.

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Continued from p. 16 Information contained on the “Regional Office” tab is available through the Health Commerce System (HCS) and Public Authentication NYSE-CON systems.

The Department will be expanding functionality of the “Regional Office” tab for additional pre-opening activities as part of future system releases.

DOH has released two training guides, one for users with secure HCS accounts and one for users with Public Authenticated accounts.

For a copy of either, send an e-mail to Andrew Koski at akoski@hcanys.org.

Questions about this new function or the NYSE-CON should be directed to DOH nysecon@health.ny.gov.

Funding Announced on Health Information Technology The Office of the National Coordinator recently released a Funding Opportunity Announcement for the Community Interoperability and Health Information Exchange Cooperative Agreement Program.

This program makes available a total of $1 million for up to 10 awardees nationwide to expand resources for doctors, patients and communities to work together to unlock health information data. Funding is intended to help communities create opportunities for long-term services and supports and behavioral health providers who may not currently participate in the collection and exchange of health information.

According to the announcement, this funding will assist entities to work collaboratively with non-eligible care providers (post-acute care and other providers not eligible for the U.S. Centers for Medicare and Medicaid Services’ Electronic Health Record Incentive Programs) to identify opportunities to support and extend the use of secure, interoperable health information technology tools and health information exchange services.

Entities eligible to apply include domestic non-profit organizations, state or local governments, agencies or groups in a designated community.

Applicants should submit a non-binding e-mail notice of intent to apply; it is due May 15; the deadline for applications is June 15, 2015.

An informational webinar is scheduled for May 6 at 3 p.m. Registration is at http://tinyurl.com/kour6ob.

The full funding opportunity announcement can be obtained at http://www.grants.gov/web/grants/view-opportunity.html?oppId=275875.

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Resources Posted on Medicaid Validation eMedNY has posted additional information about the revalidation requirements for home care and other health care providers under Medicaid.

The material, including Frequently Asked Questions, is at https://www.emedny.org/info/ProviderEnrollment/revalidation/index.aspx.

Medicaid providers are required to revalidate every five years. Revalidation includes providing information on the provider’s ownership, managing employees, agents, persons with a control interest, as well as current addresses, specialties, etc.

The Office of the Medicaid Inspector General has also developed guidance on revalidation. It is at www.omig.ny.gov/images/stories/compliance_alerts/20150127_Compliance_Guidance_2015_01_final_1_27_15.pdf

Incident Reporting Changes for NHTD and TBI Providers eMedNY has posted some changes to the Incident Reporting Process for the Nursing Home Transition and Diversion (NHTD) and Traumatic Brain Injury (TBI) waiver programs.

Currently, under both waiver programs, critical events and incidents must be reported for review and followup action by the Regional Resource Development Center (RRDC) and state Department of Health (DOH).

Effective April 1, 2015, NHTD providers are now requested to submit quarterly reports to the RRDC. These reports: contain information regarding investigations conducted by the provider during the quarter, identify trends, and indicate remedial activity.

A copy of the report form is available at https://www.emedny.org/Listserv/HCBS-TBIWaiver/ TBI_SRI_QuarterlyReportTemplate_3-15.pdf.

This reporting process is currently in effect for TBI waiver providers and is only new for NHTD. Reports are to be submitted to the RRDC according to the following schedule: • • • •

Quarter 1, 2015 ( January 1 to March 31, 2015): Due as soon as possible Quarter 2, 2015 (April 1 to June 30, 2015): Due July 15, 2015 Quarter 3, 2015 ( July 1 to September 30, 2015): Due October 15, 2015 Quarter 4, 2015 (October 1 to December 31, 2015: Due January 15, 2016

The required Investigation Report form, used for completing an investigation into an incident, is at https:// www.emedny.org/Listserv/HCBS-TBIWaiver/Incident_Reporting_TBI-NHTD_investigation_format_3-2015.pdf.

The RRDC will analyze information contained in the provider quarterly reports and will compile the data into a regional summary for submission to DOH. DOH waiver management staff review the reports for statewide trend analysis and systems issues. DOH waiver management staff and the RRDC may investigate the conduct,

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performance, and/or alleged misconduct of administrators or employees of any waiver provider or individual serving as a waiver provider.

Questions about the NHTD or TBI programs can be directed to (518) 474-5271 or nhtdwaiver@health.ny.gov or tbi@health.ny.gov.

NAHC and UPenn Seek Your Response on Telehealth Survey for Study The National Association for Home Care and Hospice (NAHC), in partnership with the University of Pennsylvania Institutional Review Board, is seeking responses from home care providers on a survey regarding telehealth use. The survey specifically seeks feedback from social workers and nurses at your agency.

Please complete one survey for yourself and forward it to one direct service provider (e.g. social worker, registered nurse or psychiatric nurse) from your agency. This survey is for agencies that have or have not adopted telehealth.

A link to the online survey is at https://upenn.co1.qualtrics.com/SE/?SID=SV_6GAAqqjqdJRySHz. The online survey will take approximately 10-15 minutes to complete. At the end of the survey, if you are interested, you may wish to share your e-mail address to enter three random draws of e-gift cards worth $30, $20 or $10.

Your participation will have a valuable contribution to a new and growing body of knowledge about the benefits and challenges of utilizing innovative technologies like telehealth for patients. Individual agencies will not be named in research reports or publications, and any identifying information will be changed to protect the confidentiality of the agency. Your participation in this study is entirely voluntary.

CMS Clarifies Ordering and Certifying Documentation Maintenance Requirements The U.S. Centers for Medicare and Medicaid Services (CMS) recently issued Change Request (CR) 9112 that provides instructions and clarification on its existing policy for the ordering and certifying documentation maintenance requirement.

CMS’s CR can be downloaded at: http://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/ Downloads/R587PI.pdf.

Back on May 5, 2010, CMS issued an interim final rule (CMS-6010-IFR), and on April 27, 2012, a final rule (CMS-6010-F), which established Medicare Ordering and Referring, and Documentation Maintenance Requirements.

CMS implemented a requirement that a provider or a supplier that furnishes covered home health services, items of durable medical equipment, prosthetics, orthotics and supplies (DMEPOS), clinical laboratory, or imaging services is required to maintain documentation for seven years from the date of service and, upon the request of CMS or a Medicare contractor, to provide access to that documentation. The requirement also applies to a physician who orders/ certifies home health services, items of DMEPOS, clinical laboratory services, or imaging services.

In CR 9112, CMS clarifies the term “access to documentation” to mean that the documentation is actually provided or made available in the manner requested by CMS or a Medicare contractor. Examples of sufficient and deficient access to documentation are also provided in the CR. Continued on next page 19

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Continued from p. 19 CR 9112 also describes the process for requesting the documentation and provides a model letter the contractors are to send. Failure to respond to the contractor’s request within 30 days will result in a revocation of billing privileges for a period of one year.

Current regulations at 42 CFR 424.535(10) provide CMS with authority to revoke a provider’s, supplier’s or physician’s billing privileges for failure to respond to a request for documentation outlined in 42 CFR 424.516(f ).

Since the interim final rule has an effective date of July 6, 2010, the Medicare contractors may not request documentation for written orders or certifications prior to July 6, 2010.

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

NGS Updates National Government Services (NGS), New York’s Medicare Administrative Contractor (MAC), has recently posted the following information to its website.

Electronic Signature and EDI Enrollment Forms Beginning June 29, 2015, Electronic Data Interchange (EDI) will be have electronic signature for the following two online EDI enrollment forms: 1) EDI Enrollment Agreement and 2) EDI ERA Enrollment forms. All EDI enrollment forms are completed and submitted online through the EDI website at: www.ngsmedicare.com.

For the time being, however, providers will still be required to print, sign, date and fax the Third Party Provider Authorization, Submitter Action Request, Part A Logon Request and Claim Status Inquiry Forms.

For providers that have completed an EDI Enrollment Agreement and/or EDI ERA Enrollment form online prior to the implementation of electronic signature, you must fax the signed form within ten days of the online submission for EDI to process your request. You will not need to complete any new enrollment forms for requests that have already been submitted.

Contact Information for Recovery Auditor Review Questions If a provider has questions concerning a Recovery Auditor’s (RA’s) audit –such as the reason for the audit, the findings, or the type of audit the RA is conducting (automated or complex) – the provider will need to contact the RA directly to obtain the required information. NGS does not have this information.

If the RA conducted a complex review of the claim, it will send the provider a ‘review results’ letter. The RA creates adjustment records to reflect the RA’s review results and sends them to NGS electronically. NGS processes the adjustments through the standard system (FISS for Part A, MCS for Part B) and sends a demand letter when an adjustment results in an overpayment determination. The provider may contact NGS with questions about information found in the demand letter, the overpayment collection process, or appeals.

Providers who disagree with the RA decision may contact the RA to enter into a discussion or submit an appeal to NGS. Performant Recovery, Inc. is the RA for New York providers. It can be reached by e-mail, phone or on the web at: info@dcsrac.com; 866-201-0580; http://www.dcsrac.com/.

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

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Publications •

“Medicare: Potential Uses of Electronically Readable Cards for Beneficiaries and Providers,” by the U.S. Government Accountability Office http://www.gao.gov/assets/670/669228.pdf

•

“New York Scorecard on Medicaid Payment Reform,” by the New York State Health Foundation http://nyshealthfoundation.org/uploads/resources/new-york-scorecard-on-medicaid-paymentreform.pdf

•

“Applying for Medicaid Personal Care Services in New York City: Big Changes Since 2013,” by the New York Legal Assistance Group http://www.wnylc.com/health/entry/176/

•

“New York State Health Workforce Planning Data Guide 2014,” by the Center for Health Workforce Studies http://chws.albany.edu/archive/uploads/2015/02/NYS_Health_Workforce_Planning_DataGuide_2014.pdf

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

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Are You Ready to Navigate New Models of Care and Coverage?

Thursday, May 28, 2015 Empire State Plaza – Albany NY Meeting Room 2-4

AGENDA 9:00am

Who should attend Home health provider and health plan CEOs, CFOs, COOs and those who need a better understanding of emerging care models to position successfully in a new service and payment delivery environment.

With the enactment of far‐ reaching health care reforms at the federal and state levels, changes to the health care delivery and payment systems are evolving quickly. To jump‐ start these initiatives, policymakers are incentivizing the creation of new models that focus on the seamless integration of health care delivery, providing value, high quality care and targeted outcomes.

It is critical for the home care community to understand how these new models work, how they are financed, and how they are constructed. In addition, the provider community needs to be prepared to position themselves competitively and effectively in these new models.

This workshop is designed to be informative, thought‐ provoking and relevant as you position your organization in this environment of change and in this environment of health care service delivery and payment reform evolution. Don’t miss this opportunity!

Welcome and HCA Update Joanne Cunningham, President 9:15am to 10:30am

The State’s Roadmap on New Models of Care New York State continues to rapidly reform its Medicaid program and work collaboratively with the federal government on introducing and facilitating the adoption of new models of care, coverage, service delivery and financing. Hear from New York’s health care and Medicaid reform leader about the state’s vision in the adoption of new models of care delivery, as New York State’s Medicaid program evolves with a focus on care delivery through Managed Long Term Care plans, Fully‐Integrated Duals Advantage plans, Delivery System Reform Incentive Payments (DSRIP) and others. This session will help you understand the state’s continued priorities, areas of focus, and expectations for how you can fully participate in these and emerging models.

Jason Helgerson, State Medicaid Director, Deputy Commissioner, New York State Department of Health 10:30am to 11:30am

Value Based Payment – Positioning for Home Health Providers State and federal reforms are prompting massive and far‐reaching changes that affect how health care and home care services are delivered. These reforms are also driving change in the financing of and payment for care. Understanding how new payment models work, how they are constructed and how the payment incentives function is critical as you plan for a successful future. With the advent of Value Based Payment Models, successful providers are compelled to learn ways of positioning themselves competitively. Hear from the State of New York’s lead contractor about how VBP models work, how outcomes are measured and how this model aims to improve value and outcomes while reducing the costs of care.

Marc Berg, MD, Ph.D., Partner, Global Center of Excellence for Health, KPMG 11:45am to 12:45pm

DSRIP Lessons Learned and Next Steps One of the most recent innovations in delivery system reform came in the form of a waiver with the federal government that set in motion the plan for a larger focus on outcomes, payment and service delivery integration. This initiative, the Delivery System Reform Incentive Payment (DSRIP) program, aims to promote collaboration among health care and community care providers, transform health care service and reduce re‐hospitalizations while offering incentives and rewards for high quality outcomes. Hear from the state’s DSRIP implementer about how DSRIP is transforming payment and services for patients and the lessons learned in the rollout and adoption of this innovative initiative.

Greg Allen, Director of the Division of Program Development and Management within the New York State Office of Health Insurance Programs (OHIP).

AGENDA 12:45pm to 1:30pm

Lunch and the Opportunity to Share Ideas with Your Peers 1:30pm to 2:30pm

Re‐Tooling Your Operation to Achieve Success in New Models of Care and Service Delivery DSRIP implementation poses unprecedented challenges and opportunities for performing providers systems (PPSs) and the providers who participate in them. This session will focus on assisting participating providers to anticipate, understand, and tackle DSRIP developments in the first year, including fund flow models and potential funding opportunities emerging from PPSs, project participation, regulatory waivers, and PPS compliance and HIPAA requirements.

Tracy E. Miller, Bond Schoeneck and King Ms. Miller practices health care and not‐for‐profit corporate law, focusing on corporate, regulatory and compliance matters for health care providers, health systems, managed care plans and charitable organizations.

2:30pm to 3:30pm

Strengthening Your Business Model in an Era of New Models Successful health care organizations in a new environment of evolving service, coverage, payment and delivery system reforms must challenge themselves to make necessary changes to their business models in order to adapt and successfully partner. The future success of home health as critical partners in new models will depend on the ability to become more efficient, streamline functions, and provide a high level of care with excellent outcomes at a competitive cost. In this final session, learn what others across the nation are doing to strengthen their business models and boost their offerings of support to their partners.

Presenter TBA

Are you Ready to Navigate New Models of Care and Coverage?

Thursday, May 28, 2015 Empire State Plaza, Meeting Rooms 2-4, Albany NY REGISTRATION FORM – Fax to (518) 426‐8788 or Mail to the address below.

Please register by May 22 to guarantee your seat, lunch and handout materials.

Name: _____________________________________________________________________________________________ Title:_______________________________________________________________________________________________ Agency:_____________________________________________________________________________________________ Address:____________________________________________________________________________________________ City/State/Zip:______________________________________________________________________________________ Phone:______________________________________ Ext.________________ Fax: __________________________________________________________ Email: ___________________________________________________

REGISTRATION FEE HCA Members

$229 per person ________

Non‐Members

$329 per person ________

PAYMENT Please check method of payment:

____MasterCard ____VISA ____ American Express ________ Check* *Make checks payable to HCA Education and Research and mail to:

388 Broadway, 4th Floor, Albany, NY 12207 (checks must be received one week prior to program)

Please print clearly.

Credit Card #: ____________________________________ Exp. Date:__________ Security Code: ____________ _____________________________________________________________________________________________________ Name and/or Company Name on Card _____________________________________________________________________________________________________ Billing Address of card (including City, State and Zip Code) _____________________________________________________________________________________________________ Authorized Signature

Cancellations received by May 18 are refundable less a 25% administrative fee. Cancellations must be received in writing via e‐mail to info@hcanys.org. No refunds after that time or for no shows. Substitutions are permitted. Questions? Call HCA at (518) 426‐8764.

FAX TO: (518) 426‐8788

2015 Annual Membership Conference May 6 & 7, 2015 ACHE Leadership Institute May 8, 2015 Saratoga Hilton – Saratoga Springs, NY

Dear Members and Friends of 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.

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

Let us know if we can help make that happen!

NAB Continuing Education Clock Hours This educational offering has been reviewed by the National Continuing Education Review Service (NCERS) of the National Association of Long Term Care Administrator Boards (NAB) and approved for 12.25 clock hours and 8.25 participant hours.

A sea of change is happening in health care, and we all have weathered its rough waters over the past two years. But with change comes renewed purpose. Today you are no doubt seeing this outcome as you run a tighter ship, diversify what you offer your community, and extend new lines of outreach well beyond the deck of your organization, engaging new players and partners in an increasingly coordinated system.

On this new course, home care needs to ride the wave of opportunity, and avoid getting overwhelmed by the flow of new information, expectations and shifting currents. This takes skill, intelligence, strategic thinking, patience and courage. HCA’s 2015 Annual Membership Conference aims to support you in this effort by bringing you tips, tools and strategies to help you successfully point your ship in the right direction and embark on a course of positive change.

Our conference is now a two-day event, on May 6 and 7, reducing the cost to you and limiting the amount of time spent away from your office while offering you the same caliber of excellent learning and networking opportunities that have always been a signature of our conference. Also new this year, we are adding a half-day Leadership Institute on May 8, brought to you by the American College of Healthcare Executives. You can choose to attend both programs – the HCA Annual Conference and the Leadership Institute – or only one. All programs will take place at the Saratoga Hilton, in Saratoga Springs, where we’ll have an exciting lineup of world-renowned speakers and industry experts offering thought-provoking ideas and valuable learning opportunities.

The Annual Conference is an ideal setting to network with your peers, pay tribute to outstanding individuals in the industry through our awards program, and visit with an assortment of vendors who will be on hand showcasing their latest products or services. If you are new to home care, new to your agency or if your agency just recently joined HCA, the Annual Conference is a perfect way to get your feet wet, meet HCA’s team, make new contacts, and learn. To broaden your team’s learning experience, HCA is also offering one of your staff members the opportunity to attend the conference at half price and the leadership institute at the lowest price possible if they’ve never attended HCA’s conference before. To take advantage of this “first-timer” opportunity, you must register yourself and your staff person by April 6. This is a great way to show your appreciation to a valuable member of your staff. (Online registration for this offer is not available; please use the registration form in this brochure.)

So what are you waiting for? Check out the agenda and register today! I look forward to seeing you there.

Joanne Cunningham President HCA

We also extend a special thanks to HCA’s Board of Directors who donate their time and talents for the success of HCA.

Hotel Information The Saratoga Hilton, Saratoga Springs, NY is the site of the HCA Annual Conference. Rooms at the Saratoga Hilton are per night. This discounted rate is available until April 5. After this date, higher rates will prevail. Parking is $5 per night.

$162

To make a reservation, call 888-866-3596 or register online at https://resweb.passkey.com/go/HCANYS2015 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.

Marie Andreacchio Allen Health Care Services Susan Brett, People Care, Inc. Maura Cahill-Bordas Hebrew Hospital Home, Inc. Anne Calvo, Winthrop University Hospital Home Health Agency Susan Caputo, Individual Member Northport, NY Shelly Eggleton Lourdes At Home/Hospice At Lourdes Michael Feinman Any-Time Home Care, Inc. Ann Frisch, New York City HHC – Health & Home Care Bridget Gallagher Jewish Home Lifecare Ginger Hall, Jefferson County Public Health Services Pamela Joachim, Montefiore Medical Center Home Health Agency Orael Keenan Visiting Nurse Association of Long Island

Additional Sponsors Arthur J. Gallagher Risk Management Services, Inc. Bassett Healthcare Network, At Home Care Brookhaven Memorial Hospital Medical Center Byram Healthcare Dominican Sisters Family Health Service, Inc. Hinman Straub, P.C. People Care, Inc. RBC Limited Healthcare and Management Consultants VNS Westchester Winthrop University Hospital

Kenneth Kilroy Progressive Home Health Services Sue Larman, VNA Home Health Russell Lusak Selfhelp Community Services Irina Mitzner, North Shore – Long Island Jewish Health Care Network Laurie Neander Basset Healthcare Network: At Home Care Karen O’Kane, Brookhaven Memorial Hospital Medical Center

Exhibitors AccuPoint, LLC Avanti Health Care Services Black Tree Healthcare Consulting Bosch Healthcare Brinster & Bergman, LLP Cardiocom, a Medtronic Company ContinuLink The Corridor Group Delta Health Technologies, LLC Fazzi Associates Forcura Friedlander Group Grassi & Co. CPA’s Homecare Homebase

Homecare Software Solutions. LLC LCG Community Trust Mobile Health MobilexUSA Mom’s Meals Nourish Care MyCNAjobs Philips Hospital to Home Quality in Real Time Senior Planning Services MLTC Simione Healthcare Consultants Stay at Home Solutions TSG Financial Total Program Management United Healthcare Community Plan

Mary Kate Rolf, VNA Homecare Paul Rosenfeld, CenterLight Health System Brian Schiel, Bestcare

Rae Szymanski, Visiting Nurse Association of Hudson Valley Vivian Torres-Suarez, Individual Member Bayside, NY Joseph Twardy, VNS of Northeastern NY Mary Wagner Metropolitan Jewish Health System

Sponsorship and Exhibitor opportunities are still available. Visit

Mary Zagajeski Dominican Sisters Family Health Service

www.hcaannualconference.com

Elizabeth Zicari, HCR Homecare

to learn about all the benefits you will receive as a supporter.

Wednesday, May 6 10:00am – 5:00pm Hotel Lobby

HCA Registration Opens At the registration desk, you will obtain your conference program, name badge and directions to your first session.

1:00pm to 1:30pm

HCA Annual Meeting of the Corporation (Note New Time) All HCA members are invited to attend the Annual Meeting of the Corporation. This brief meeting of the HCA corporation will include membership review and passage of the 2014 audit and financials, a synopsis of the year’s activities, and ratification of the Slate of Board of Directors members. (The HCA Board of Directors meeting, which all members are encouraged to attend, will be held on Thursday, May 7, from 4:15pm to 6:00pm.)

1:30pm to 1:45pm – HCA Welcome 1:45pm to 2:45pm

The Healing of America: Opportunities for Home Care T.R. Reid, author of the national best-seller ‘The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care,’ will examine why all other industrialized democracies manage to provide high-quality universal health care but still spend half as much as the U.S. does. Mr. Reid’s PBS documentary, ‘U.S. Health Care: The Good News,’ reveals how some U.S. communities have found ways to improve the quality of care, and contain costs, by orchestrating their local health care providers to work together, rather than waiting for Washington to tell them what to do.

T.R.Reid has become one of the nation’s best known reporters through his books, articles, and documentary films. His work includes reporting for the Washington Post, NPR’s Morning Edition and PBS. 3:00pm to 4:30pm

You Can Never NOT Communicate We all understand the importance of communicating effectively in the health care field.

But do you realize that you can never NOT communicate? In this presentation, Janene Schneider will help you bring communication to the conscience level by focusing on nonverbal communication and providing you with tips to enhance your professional interactions.

Janene Schneider is chair of the English Department for Franklin Academy in Wake Forest, NC. With a Master’s in Communication from the University of Iowa, she has developed a passion for nonverbal communication and is a frequent speaker for Duke University’s Population Care Coordinator Program.

3:00pm

Exhibit Gallery Opens HCA is pleased to have 31 exclusive vendors on hand to showcase the latest home health products and services expressly for HCA conference participants. Take advantage of this one-stop shopping opportunity – no appointment needed.

Wednesday, May 6 – continued 4:30pm to 6:00pm

Welcome Reception Before heading out to dinner at one of Saratoga’s many fine restaurants, be sure to take the time to visit with old friends and new, peruse the exhibits of our home health vendors and register for their great raffle prizes.

Dinner is on your own this evening.

8:30pm to 11:00pm

PAC Beach Party and Trivia Night Join in the fun at this fundraiser for HCA’s Political Action Committee (PAC). Attendees who make a $50 minimum personal donation will get to enjoy drinks and light refreshments while making their best guesses for prizes in response to questions on pop culture, sports, geography, science, history and more. Anyone who has attended HCA’s popular PAC fundraisers in the past will know what a great time to expect at this year’s event, so please encourage your peers to join you.

Thursday, May 7 7:00am

Registration Opens The registration desk is open bright and early for those who haven’t yet obtained their conference program, name badge and directions.

7:30am to 8:30am

Exhibit Gallery Enjoy coffee while meeting with vendors to learn more about their latest products or services that support home health.

8:30am to 9:30am

HCA’s Breakfast of Champions During this morning’s breakfast, HCA pays tribute to recipients of the Ruth F. Wilson Award, the Caring Award and the Advocacy “Giraffe” Award – a highlight of our annual conference.

Join your peers as we recognize these champions over an elegant breakfast.

9:30am to 10:00am

Catching the Wave – An Address by HCA’s President, Joanne Cunningham Home care is a vital line of support for the patients you serve, and HCA’s ongoing goal is to help you navigate potential obstacles, tie-up alongside partner organizations in integrated models, and keep home care in its flagship role as the driver of community-level support services.

10:15am to 11:15am

The Art of Audacity Can one person really change the world? National Geographic journalist Tom Clynes will bring us along on assignment to some of the most dramatic and intriguing places on Earth. Through his provocative stories and stunning photos, we’ll meet the extraordinary people who dared to challenge and change the status quo: The explorer whose Congo Basin expedition led to the biggest African conservation victory in decades … the “elephant whisperer” who rescued the animals in the Baghdad Zoo … as well as virus hunters, Ebola doctors, climatologists, and a pre-teen nuclear physicist.

Along the way we’ll discover the life lessons behind the success of those who dared to follow their audacious dreams, and to shape once-ordinary lives into world-changing adventures.

Tom Clynes is an author and photographer who covers the adventurous side of science, the environment and public health. He writes regularly for National Geographic and Popular Science where he is a contributing editor.

Thursday, May 7 – continued 11:15am to 3:00pm

Three Workshops in Two Sessions Session 1 (11:15am to 12:15pm) Session 2 (2:00pm to 3:00pm) All three of the programs summarized below are held concurrently from 11:15 a.m. to 12:15 p.m. (Session 1) and then repeated, again concurrently, from 2 to 3 p.m. (session 2). These workshops will help you gain further knowledge on: specific regulatory compliance issues like the Medicare face-to-face requirement, workforce recruitment and retention, and population health – all of which are vital to the success of your organization.

Session 1 & 2 Descriptions Certifying Home Health Services On January 1, the U.S. Centers for Medicare and Medicaid Services (CMS) changed the requirements for the face-to-face documentation mandate. New York’s Medicare Administrative Contractor, National Government Services (NGS), is your main point of interaction for Medicare payment and is empowered with enforcement activity related to face-to-face. Hear directly from a representative of NGS who will help you gain a greater understanding of patient eligibility, face-to-face encounters and certification requirements for home health. Attendees will receive NGS/CMS resources and the opportunity to ask questions.

Shelly Bernardini, RN, CPHM, is the Medicare Home Health Clinical Consultant for Jurisdictions K and 6 at NGS where she provides outreach and education.

A Caregiver’s Perspective: Data-Driven Recruitment Get under the hood to discover the perspective of Certified Nursing Assistants and Home Health Aides on working in home care. This session will unveil key insights from a caregiver's point of view – gleaned from thousands of survey results – alongside key strategies to drive more caregivers to apply to your jobs, show up for the interview, entice them to want to work for you, and stay with your organization for the long run.

Maggie Keen is Director of Customer Success for myCNAjobs. She is a national caregiver recruitment speaker, and key researcher behind The Caregiver Trend Report. Her team consults with home care recruiters across the country to optimize local recruitment efforts.

Population Health Explore how multilevel care coordination can help your organization be best positioned to improve clinical and financial outcomes by increasing communication across settings, effectively analyzing patterns and addressing health care needs for your entire patient population.

Sharon Rushton, MSN, MS, RN, CCM is Assistant Professor at Duke University School of Nursing.

Her interests include care coordination of complex patients, transitions of care, resource utilization and patient/family education.

Thursday, May 7 – continued 12:15pm to 1:15pm

Networking Buffet Lunch 12:30pm to 2:00pm

Desserts in the Exhibit Gallery While enjoying dessert, take advantage of this last opportunity to meet with vendors who are showcasing their products and services exclusively for you.

2:00pm to 3:00pm

Session 2 – Workshops Workshops from Session 1 (held at 11:15am) are repeated. Please refer to previous page for session descriptions.

3:00pm to 4:00pm

Physicians and Home Health: Partners in Care In this closing segment, you’ll discover new strategies for working more collaboratively with your local physician groups in achieving the same goals: better coordination of care for the patients you serve and reduced re-hospitalizations.

Linda Lambert, CAE, is Executive Director for the New York Chapter of the American College of Physicians, the state's largest medical specialty organization representing over 12,000 internal medicine physicians dedicated to advancing the specialty of Internal Medicine and improving patient care through education, advocacy and quality improvement.

4:15pm to 6:00pm – HCA Annual Board of Directors Meeting All HCA members are encouraged to attend the HCA Board of Directors meeting, which will focus on Board discussion and debate of federal and state policy and advocacy strategy as well as organizational and operational priorities. This event is an important tradition and includes an invited guest speaker from the public policy arena.

Dinner is on your own this evening at one of the many fine restaurants Saratoga Springs has to offer.

8:00pm – Pat’s Pub Crawl After dinner, join HCA Staff and your peers for our first-ever Saratoga Pub Crawl. Visit a variety of venues that offer something for every taste including the upscale atmosphere of wine bars, authentic brew pubs and jazzy lounges. Free drink coupons for all pub crawl participants. Watch for further details coming soon.

Friday, May 8 - Bonus Session!

7:30am to 8:45am

Value Based Payment Workshop and Breakfast Enjoy a full buffet breakfast and the opportunity to learn more about an emerging policy and payment priority at both the State and the National level focusing on value-based payment. Hear from expert faculty on how value based payments are developed, and how home health agencies can position themselves to benefit in value based payment models.

Be sure to take advantage of HCA’s Leadership Institute on Friday, May 8th!

Program Agenda Friday, May 8 7:30am to 8:45am

Breakfast and Value Based Payment Workshop Enjoy a full buffet breakfast and the opportunity to learn more about an emerging policy and payment priority at both the State and the National level focusing on value-based payment. Hear from expert faculty on how value based payments are developed, and how home health agencies can position themselves to benefit in value based payment models. (Coffee will be available beginning at 7:00 am.)

9:00am to1:00pm

The Courage to Lead: Critical Skills for Healthcare Leaders This session, presented by the American College of Healthcare Executives (ACHE), is exclusively for HCA onlocation.

Leadership is an applied skill, but too often it is left to chance as something to be picked up on the job.

Progressing as a successful leader requires more. In this half-day session, designed for health care leaders at all levels of their careers, you will use proven tools and techniques to identify and develop your leadership philosophy and to develop your leadership skills even if you have little formal authority.

You will also learn how to: • Create an action plan using course content through an illustrative case study, leadership tools and integrative discussions.

• Increase your influence and effectiveness by becoming a quiet but strong leader.

• Practice ways to recognize and reward employee contributions and build a winning team.

This program is presented by Jody Rogers, PhD, FACHE, visiting professor in the health care administration graduate program, Trinity University, San Antonio, TX. He has more than 30 years of experience as a health care executive in public and private health care organizations and is a certified master facilitator of The Leadership Challenge.

Accreditation Participants will receive ACHE Face-to-Face Education credits as well as contact hours from the National Association of Boards of Examiners of Long Term Care Administrators (NAB).

About the American College of Healthcare Executives The American College of Healthcare Executives is an international professional society of more than 40,000 health care executives who lead hospitals, healthcare systems and other healthcare organizations. ACHE offers its prestigious FACHEÂŽ credential, signifying board certification in healthcare management. ACHE's established network of 80 chapters provides access to networking, education and career development at the local level. In addition, ACHE is known for its magazine, Healthcare Executive, and its career development and public policy programs. Through such efforts, ACHE works toward its goal of being the premier professional society for healthcare executives dedicated to improving healthcare delivery.

HCA’s Leadership Institute can be purchased in conjunction with the Annual Conference registration which offers the best value. The Leadership Institute is also available for purchase separate from the HCA Annual Conference. See the registration form for fees and discounts.

2015 ANNUAL CONFERENCE REGISTRATION Catch the Wave! Are You Ready for the Turn-Around?

Return this completed registration form with your payment by fax to (518) 426-8788 or mail it to 388 Broadway, 4th Floor, Albany, NY 12207. You may duplicate this form for additional attendees. Please save a copy for your records.

Register online at: www.eventville.com/hcanys CONFERENCE PARTICIPANT REGISTRATION NAME ______________________________________________________________

TITLE ____________________________________________________

AFFILIATION ____________________________________________________________________________________________________________________ ADDRESS ______________________________________________________________________________________________________________________ CITY/STATE/ZIP _________________________________________________________________________________________________________________ PHONE _____________________________________________________________ FAX _____________________________________________________ E-MAIL ________________________________________________________________________________________________________________________

METHOD OF PAYMENT:

REGISTRATION FEE:

Please select your method of payment: ________MasterCard

________Visa

________American Express

Credit Card No.________________________________________________

We encourage you to attend both the Annual Conference and ACHE Leadership Institute for the best value. No credits can be given for meals not taken or unattended education programs.

REGISTRATION FEE Seven Registration Options Please indicate your registration choice below:

Name on Card_________________________________________________

Expiration Date __________________ Security Code _________________ _____________________________________________________________ Billing Address for Card _____________________________________________________________ City, State, Zip Authorized Signature____________________________________________

_____Check* Make payable to: HCA Education and Research Mail to: 388 Broadway, 4th Floor, Albany, NY 12207 Checks must be received by May 2.

Cancellation Policy: Cancellations received by April 22 will receive a full refund, less 25% of total due as an administrative fee. Cancellations received on April 23 or later will forfeit their registration fee, as will those who register and do not attend. Substitutions are permitted.

1. HCA Member – Annual Conf. and Leadership Inst.

$768 

2. HCA Member – Annual Conference Only

$489 

3. Non-Member – Annual Conf. and Leadership Inst.

$948 

4. Non-Member – Annual Conference Only

$599 

5. Leadership Institute Only (Members and Non-Members)

$349 

6. *First Time Attendee HCA Member – Annual Conf. Only

$244 

7. *First Time Attended HCA Member – Ann. Conf. & Ldr. Inst. $523  *Must register by April 6.

TOTAL DUE: $__________

Beach and Trivia Night HCA PAC Party Wednesday, May 6th – Saratoga Hilton Lounge

I will attend the HCA PAC Fundraiser



My personal donation will be submitted separately.

In accordance with the Americans with Disabilities Act or special meal needs, please let us know how we can accommodate you: ___________________________________________________________ ____________________________________________________________ I will attend the Pat’s Pub Crawl

FAX THIS FORM TO (518) 426-8788



388 Broadway Fourth Floor Albany, New York 12207