May 20, 2016 Edition of ASAP

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. 20 May 20, 2016

HCA Urges NY Congressional Delegation to Oppose Medicare Prior-Authorization Proposal This week, HCA urged New York’s Congressional Delegation to take action to oppose a priorauthorization demonstration for Medicare home health services planned for five states, with an expectation that the demo will be adopted nationwide at a future point by the U.S. Centers for Medicare and Medicaid Services (CMS).

See OPPOSE p. 2

Newly Announced: KPMG Expert to Lead Lineup of Speakers at HCA Value-based Payment Conference Registration fee for members-only program designed so multiple staff from your team can learn about highstakes structural changes in payment, clinical expectations for home care HCA’s June 17 conference, Cut Through the Volume: Learn What Value-based Payment Really Means for Your Organization in Nanuet, has a newly announced introductory speaker: KPMG expert Jason Ganns.

KPMG is one of the “big-four” global auditing firms, with teams specializing in health care professional services, including New York State

Inside ASAP

At HCA’s Urging, DOH Posts FLSA Distribution Methods HCA continues to press case for a sensible, timely and complete distribution process As urged by HCA, the state Department of Health (DOH) has posted a chart listing the method chosen by each MLTC plan for the distribution of Fair Labor Standards Act (FLSA) cost coverages to home care contractors.

See FLSA p. 3 ASAP Schedule Due to an editorial planning change, HCA will be publishing next week’s ASAP on Thursday, May 26, not our normal Friday publication date. Our offices will be closed on Memorial Day, May 30, and will reopen on May 31. We will continue with our regular Friday edition on June 3.

See VBP p. 4

HCA Urges Congress to Oppose Medicare Prior-Auth Proposal.......1 KPMG Expert to Lead Lineup at HCA VBP Conference........................1 At HCA’s Urging, DOH Posts FLSA Distribution Methods..................1 Home Care Legislative Developments.................................................4 Reminder: TALs Info Required on June 1..............................................5 MSSNY-HCA Task Force on Physician-Home Care Collaboration......6 Want Your Staff to Receive ASAP? Want an HCA Website Account?....6 CBO Planning Grants for DSRIP: Home Care Not Eligible..................7 DOH Posts Letter on CARE Act: What You Need to Know..................8 Changes to “White Collar” Worker OT Rule Finalized.........................8 Bootcamp: HIPAA eRisks & Responses for Home Care Agencies.....10 Final OHSA Rule: Additional Information Provided...........................10 NGS Offices Closed on Memorial Day 2016.......................................11 Publications: New & Updated.............................................................11

Helping New Yorkers Feel Right At Home

ASAP – a publication of the Home Care Association of New York State OPPOSE from p. 1 Specifically, HCA asked the Delegation to lend support for a Congressional sign-on letter authored by Reps. Jim McGovern (DMA) and Tom Price (R-GA) to CMS that outlines significant concerns and issues with the demo.

HCA has already communicated opposition and concern directly to CMS on the proposal, which requires priorauthorization by Medicare contractors before home health agencies can begin providing services to patients. HCA targets the demo’s unprecedented reach in diminishing the Medicare home health benefit. (HCA’s original comment letter to CMS can be read at http://hca-nys.org/ letters-and-comments/hca-opposes-cmsprior-authorization-proposal.)

In HCA’s letter to Congress this week, HCA President Joanne Cunningham explains: “This demonstration would hand decisionmaking about eligibility over to a Medicare contractor with no direct knowledge about a patient’s clinical condition – especially a

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patient’s urgent need for timely initiation of services – forcing many patients to remain idle in costlier settings (like hospitals) or without needed care as they await service determinations from contractors.”

HCA’s letter to the New York Congressional Delegation also reiterates other serious concerns, including: the cost for serving beneficiaries who will experience delays in their transition to cost-effective home care settings while awaiting prepayment authorizations; and the fact that existing audit contractors are already conducting aggressive post-payment audits.

In addition, because this proposal stems from a program integrity mindset within CMS, HCA also urged CMS and Congress to target areas where the integrity risk is greatest, rather than subjecting all providers’ claims to an onerous pre-payment review process assumed by bureaucrats, contradicting the point-of-care professional judgment of physicians, discharge planners and home health agencies.

HCA also noted in its letter to Congress that the demonstration places home health agencies at additional risk for payment obstacles already suffered under the duplicative, confusing and unnecessary physician face-toface (F2F) requirement. This requirement is causing Continued on next page

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

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ASAP – a publication of the Home Care Association of New York State Continued from previous page enough distress during postpayment audits; such financial stresses (and accompanying care-access issues) would only worsen if extended to a pre-payment phase of medical review, with little to no benefit in terms of assuring Medicare integrity. Indeed, data indicates that most “improper” payments for home care have nothing to do with the patient’s need or eligibility for Medicare home health services.

Existing CMS contractors, through a process called Comprehensive Error Rate Testing (CERT), find that 90 percent of home health billing errors are documentation-related, and these findings are substantially related to F2F documentation reviews.

HCA’s letter urges New York’s Congressional Delegation to voice concern and opposition to the priorauthorization demonstration. This outreach is part of an aggressive multi-tiered strategy to get this program rescinded, as HCA joins forces with association colleagues nationally. We will keep the membership informed of grassroots advocacy opportunities as well as other key developments in this effort.

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FLSA from p. 1 The release of this chart information comes after a meeting HCA and other associations held with DOH last week, at which we described issues that both home care providers and plans have had with the state’s distribution of FLSA monies. (See last week’s ASAP.) At that meeting, and prior engagements with DOH to advocate on behalf of members, HCA voiced the following concerns requiring remediation: 

Home care providers have not received monies from some of their contracted MLTC plans;

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Providers have not been informed of how the funds were distributed and, thus, are unable to assess their allotments (one reason why DOH’s chart with this information is so necessary);

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Providers have received amounts that vary by plan, from less than $.01 to over $0.50 per hour of aide services; and

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Providers have received onerous requests to document overtime, travel and other FLSA-related services.

HCA will be reviewing the reported distribution methods in detail. We ask that members also review the methods and let us know if these methods conflict with your understanding of the basis on which the monies are being distributed.

An initial, cursory review shows that many plans based their distribution on the number of aide hours provided by their home care contractors from October 13, 2015 to March 31, 2016, as well as the percentage of hours provided by a home care agency compared to all their contractors (market share). The posted document also indicates that multiple plans have not paid their contractors but expect to do so next week.

HCA has also requested, where available, a list of the amounts of money given by plans to each of their home care contractors. In response, DOH indicated that it does not have that information for many of the plans, and that HCA would need to submit a Freedom of Information Act request to obtain this data. We will be submitting this request early next week.

The list of distribution methods is posted at http:// www.health.ny.gov/health_care/medicaid/redesign/2016/docs/ dist_meth.pdf.

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

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ASAP – a publication of the Home Care Association of New York State VBP from p. 1 contracts for design of its value-based payment (VBP) program. Mr. Ganns will bring to the June 17 HCA conference a unique inside look at the design process, goals and expectations of New York’s VBP Roadmap, which he and other members of the KPMG contract team for New York are intimately involved in.

Among the many health care initiatives underway in New York State, VBP is garnering perhaps the greatest focus from state policymakers – and the stakes are huge. As State Medicaid Director Jason Helgerson remarked in press reports on the program’s goals: “Really very little of our total payment in health care is actually tied to performance, and we need to change that ... there is going to be consolidation, there’s going to have to be closure of certain services, and those services are going to have to be replaced with other services that better meet the needs of the community.” But the program is also being prioritized at the federal level as well.

Providers must gain as much information as possible in order to succeed in an environment stressing a shift from “volume” to “value” under Medicaid and Medicare. This realignment is being achieved through specific program models like: the state’s value-based payment program; a federal

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VBP pilot; continued emphasis on Accountable Care Organizations and bundled payment arrangements; and the Comprehensive Care for Joint Replacement Model (CJR), which began in parts of the state and nation on April 1.

The June 17 conference will not only provide you with insights about how to operate in the many VBP arrangements driven by the state and federal governments, but you can also expect insights on using your data to create meaningful benchmarks, focus on clinical outcomes, and prepare your staff for VBP. HCA has designed the registration fee schedule for this conference to allow participation from multiple members of your team. We have already gotten inquiries from members wanting to bring whole groups of staff to attend. This is why we have made this a members-only program, and a benefit exclusive to you as a member.

Seats are filling up fast, so send us your registration as soon as possible. You can read the full line-up of speakers in our brochure linked below.

Cut Through the Volume: Learn What Value-based Payment Really Means for Your Organization June 17, 2016 Nanuet, NY Download the registration form at http://hca-nys.org/wp-content/uploads/2016/04/ HCAVBPProgramBrochureJune172016.pdf.

Home Care Legislative Developments HCA continues to build on the legislative momentum for home care reported in last week’s ASAP. These developments are summarized below.

Minimum Wage Implementation Accountability: Leading our initiatives is legislation developed with colleague associations to ensure adequate funding and distribution for the increased costs of minimum wage, the Fair Labor Standards Act, wage parity, workers compensation, and other labor laws and requirements, plus vital coverage of agency administrative-and-general costs. HCA and colleagues worked over the past week to refine the legislative language, which is designed to ensure that adequate dollars reach managed care premiums, and, in turn, cover the rates reimbursed to providers. HCA will be posting a campaign to our Legislative Action Center for member grassroots advocacy on this critical bill when ready for action.

Home Care Quality Innovation and Primary Care Initiative: HCA also conducted outreach to potential allies in support of a newly introduced HCA Home Care Quality Innovations bill (S.7810) and the HCA 4

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Home care-Primary care Initiative Bill (S.7763), both sponsored by Senator Kemp Hannon. HCA will also be posting guidance on our Legislative Action Center for member support of these key bills.

Home Telehealth Coverage: Meanwhile, the Senate Health Committee is scheduled next week (Tuesday, May 24) to consider HCA legislation (S.5852) amending the 2015 telehealth/telemedicine coverage act to ensure proper accommodation of home care. The bill is sponsored by Senate Finance Chair Catharine Young.

HCA worked with Senator Young’s office to draft this important bill. The Committee has also scheduled to take up S.5789-A by Senator David Valesky, enacting the Telehealth/Telemedicine Development Act. This legislation was also originally written by HCA. It would establish and coordinate state policies and funding to promote telehealth, telehealth innovation, access and research.

Home Care and Hospice “Essential Personnel” Status in Emergency Response: HCA’s “Essential Personnel” bill (S.6692, sponsored by Senator Andrew Lanza), is on the Senate Homeland Security Committee agenda for Monday, May 23. The legislation is a key priority in emergency preparedness. Despite support within segments of his administration, Governor Cuomo has twice vetoed the bill, offering no avenues in substitution, even as the measure gained unanimous support from the Legislature. HCA will work with the bill sponsors, including both Senator Lanza and Assemblyman Michael Cusick (who sponsored the companion bill, A.9381), on an avenue to ensure passage and signature of this important legislation.

Meanwhile, the Committee is planning to take up another emergency preparedness bill (S.6446), which would require local emergency plans to include provisions for necessary supplies to hospitals, pharmacies and nursing homes in emergencies. HCA has written to the sponsor and Committee Chairman, Senator Thomas Croci, seeking amendments to include home care and hospice.

Hospital/Clinic Offsite Services (HCA Strongly Opposed): On May 24, the Senate Health Committee is considering legislation (S.5522-B) that would authorize hospitals and clinics under Article 28 license to provide services in patients’ homes. HCA strongly opposes this legislation, which was tabled last year after HCA raised similar concerns. HCA is currently exchanging amendments with the Healthcare Association of New York State (HANYS), a proponent of the bill, to ensure that it does not override Article 36 designations for home care. HCA will keep the membership carefully apprised of these efforts.

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

Reminder: Transportation Assistance Levels (TALs) Info Required on June 1 HCA reminds providers that on June 1, home care and hospice providers are required to have Transportation Assistance Levels (TALs) incorporated into their patient rosters.

This guidance stems from a Dear Administrator Letter (DAL) issued on March 4 from the Office of Health Emergency Preparedness (OHEP) and Office of Primary Care and Health Systems Management (OPCHSM).

The full DAL is at http://hca-nys.org/wp-content/uploads/2016/03/DHCBSDAL1602TALsImplementation.pdf.

Members can direct any questions about TALs to OHEP, via Katharine Logan at (518) 474-2893 or katharine.logan@health.ny.gov. Questions related to Emergency Preparedness requirements should be directed to the Division of Home and Community Based Services at (518) 408-1638 or homecare@health.ny.gov.

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MSSNY-HCA Task Force on Physician-Home Care Collaboration HCA and the Medical Society of the State of New York (MSSNY) are creating a joint task force for supporting physician-home care collaboration.

This task force recognizes the increasing focus on primary and community based care, the opportunities for positive outcomes from physician-home care partnerships, and the regulatory layers that hinder this process.

The task force will consist of MSSNY’s Long Term Care Committee physician and government-relations representatives, and HCA provider and executive representatives.

Earlier this year, HCA joined home care provider and MLTC plan representatives in a presentation to MSSNY’s Long Term Care Committee on opportunities and challenge areas when it comes to collaboration.

That discussion led the MSSNY leadership to adopt a formal Resolution establishing a task force to examine these issues.

HCA will update and seek input from members as the task force proceeds.

Quality Measurement and Advancement This week, IPRO’s Healthcare Quality Directors Sara Butterfield and Pauline Kinney joined HCA to address the MSSNY Long Term Care Committee on home care and nursing home quality measures, benchmarks and related developments. Physicians raised a number of issues for follow-up, including questions on New York’s level of immunization and rehospitalization rates; implications for observation status/same-day hospital discharges; adequacy of risk adjustment factors in the reported quality benchmarks for home care; and other issues with the benchmarks. HCA appreciates Ms. Butterfield’s and Ms. Kinney’s collaboration in this discussion with MSSNY. For further information, please contact Al Cardillo at acardillo@hcanys.org.

Want Your Staff to Receive ASAP? Want an HCA Website Account?

HCA wants to make sure that all of your staff who need HCA’s news are receiving it. If you would like to subscribe your staff, or if they are having difficulty receiving ASAP by e-mail, please do the following:  To subscribe to ASAP, send an e-mail with the subject line “ASAP Subscription” to Roger Noyes at rnoyes@hcanys.org. Please provide the name, e-mail address and title of the staff who would like to subscribe.  If you are having difficulty receiving ASAP, please make sure that your IT department whitelists HCA’s e-mail addresses. You can also let your IT department know that HCA sends ASAP using a group e-mail system called “Constant Contact,” and we can assist in ensuring that IP addresses from Constant Contact are recognized by your systems.  Also, please let us know if we can establish a user account for yourself or a staff member to locate ASAP and other members-only content on our website. This is a great way to find all of

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the important communications from HCA. Your first place to look should be our main blog on the home page in the middle column, below our site menu. This blog is a running journal of recent posts, and it is an easy way to find items you may have missed by e-mail; but you must be logged in with an HCA user account to see all of these items. To establish a website account, e-mail Roger Noyes at rnoyes@hcanys.org with the subject line “Website Account” and we’ll send you a username and password so that you can find ASAP on your own at any time using our blog or at the main ASAP feed (http://hca-nys.org/category/asap-newsletter).

CBO Planning Grants for DSRIP Announced: Home Care Not Eligible The state Department of Health (DOH) has issued a Request for Applications (RFA) for funds to support Community Based Organizations (CBOs) in specific targeted areas that remain un-served/underserved as part of the Delivery System Reform Incentive Payment (DSRIP) program.

Unfortunately, these funds are not available to organizations that bill Medicaid, effectively excluding home care agencies from eligibility. Applicants may not include: for-profits; hospitals; health care providers; health care provider associations; research centers; and academic institutions that are part of hospitals or health systems.

While other health care providers are also ineligible, HCA finds this exclusion of home care provider agencies particularly troubling, given the dedication of this RFA funding for community-based purposes.

HCA has participated in several discussions with DOH officials about the need for funding targeted to CBOs, and we have repeatedly urged a policy that allows home care agencies to apply for such funding, meeting needs similar to traditional CBOs. This also comes after countless member reports claiming a marginalization of home care in the DSRIP process and a lack of true support for home care’s critical place in the evolving health care system.

According to the RFA, this money is intended to assist CBO Consortiums in the short-term with planning activities, strategy development, and meeting requirements for stronger DSRIP participation. It will also be used to support longer term plans that the CBO consortium may envision in system transformation.

Overall, this will allow CBOs to better position themselves for continuing engagement with Performing Provider Systems (PPSs) in DSRIP projects and, consequently, value-based payment and contracting.

Eligible applicants must be organizations authorized to apply on behalf of a consortium of public or private not-for-profit CBOs, located in and conducting business in high-need areas of New York State. Applicants must be pre-qualified through the Grants Gateway. A minimum of $2.5 million is allocated, and potentially up to $7.5 million may be available to support this initiative in three regions of the state: New York City, Long Island/Mid-Hudson, and “Rest of State.” The anticipated contract term is December 1, 2016 through November 30, 2017.

A Letter of Intent is not required, but it is strongly encouraged and must be submitted by July 8. An applicant conference call will be held on June 8 (registration deadline is June 2); questions are due June 17; and applications are due August 16.

The RFA is available at http://www.health.ny.gov/funding/rfa/1512160408/index.htm.

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DOH Posts Letter on CARE Act: What You Need to Know The state Department of Health has posted a “Dear Chief Executive Officer Letter” about recently enacted legislation known as the CARE (Caregiver Advise, Record and Enable) Act. See the full letter at http://hca-nys.org/wp-content/uploads/2016/05/DALCARE-Act051116.pdf.

It summarizes the hospital’s responsibilities to comply with the new law and reinforces existing regulatory requirements for a patient-designated family member or representative’s participation in the patient’s discharge plan. Some of those responsibilities include: 

Hospitals must give patients an opportunity to identify a caregiver (such as a relative, partner, friend or neighbor) who would provide after-care assistance prior to the discharge or transfer;

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In conjunction with the patient, the hospital must consult with the identified caregiver regarding after-care needs at home prior to discharge, and as soon as possible (ideally 24 hours prior to discharge);

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Hospitals must offer caregivers instructions in all after-care tasks, taking into account the capabilities and limitations of the caregiver, for all patients being discharged home. Written or verbal instruction to the caregiver must include a demonstration of the after-care tasks and answers to any questions about the after-care tasks.

We note that the CARE Act does not change existing requirements that hospitals develop a discharge plan to meet a patient’s post-hospital needs, including any need for home health, hospice, day care, respite, nursing home or other services. Further, if a patient is being discharged home and the patient chooses to designate a CARE Act caregiver, the discharge plan under this requirement must include: the name and contact information of the caregiver; a description of the after-care tasks the caregiver is recommended to provide; and contact information for health care, community resources and long-term care supports to help the caregiver provide after-care assistance.

Questions about the CARE Act should be directed to the DOH Division of Hospitals and Diagnostic & Treatment Centers at (518) 402-1003 or hospinfo@health.ny.gov.

Changes to “White Collar” Worker OT Rule Finalized This week, the U.S. Department of Labor (U.S. DOL) issued a final rule that makes changes to the overtime exemption rules for “white-collar” workers. The following is a summary of the rule based on a preliminary analysis; HCA will follow up with a more in-depth memorandum on the rule and will also hold a training this fall on this rule and other labor issues.

The final rule increases the salary amount to determine whether a “white-collar” worker is excluded from being paid overtime, starting December 1, 2016. To qualify for exemption, “white-collar” employees generally must: 

Be salaried, meaning that they are paid a predetermined and fixed salary which is not subject to reduction because of variations in the quality or quantity of work performed (the “salary basis test”); Continued on next page 8

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Continued from previous page 

Be paid more than a specified weekly salary level. For purposes of this rule, the weekly level is being increased to $913 per week, which is the equivalent of $47,476 annually for a full-year worker (the “salary level test”). This threshold is an increase from the state requirement of $675 per week or $35,100 per year (the federal level was $455 weekly or $23,660 annually).

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Primarily perform “executive”, “administrative”, or “professional” duties, as defined in the Department’s regulations (the “duties test”). These terms are defined in a U.S. DOL fact sheet at https://www.dol.gov/whd/overtime/fs17a_overview.pdf.

The final rule provides for automatic increases in the “white-collar” exemption salary levels every three years, starting January 1, 2020. In addition, the rule permits employers to count nondiscretionary bonuses, incentives, and commissions toward up to 10 percent of the required salary level for the standard exemption, so long as employers pay those amounts on a quarterly or more frequent basis.

According to U.S. DOL, employers have a range of options for responding to the updated standard salary level. For each affected employee that is newly entitled to overtime pay, employers may make any of the following changes: 

Increase the salary of an employee (who meets the duties test) to the new salary level for retaining his or her exempt status;

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Pay an overtime premium of one-and-a-half times the employee’s regular rate of pay for any overtime hours worked;

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Reduce or eliminate overtime hours;

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Reduce the amount of pay allocated to base salary (provided that the employee still earns at least the applicable hourly minimum wage) and add pay to account for overtime for hours worked over 40 in the workweek, to hold total weekly pay constant.

Lastly, U.S. DOL announced that it will publish a time-limited non-enforcement policy in the Federal Register for providers of Medicaid-funded services to individuals with intellectual or developmental disabilities in residential homes and facilities with 15 or fewer beds.

The final rule and several materials are posted at https://www.dol.gov/WHD/overtime/final2016/.

The U.S. DOL’s regulations also provide an exemption for certain highly compensated employees (“HCE”) who earn a higher total annual compensation level ($134,004 under this rule, up from $100,000) and satisfy a minimal duties test. More information on the rules for HCE is at https://www.dol.gov/whd/overtime/fs17h_highly_comp.pdf.

The effect of these exemptions on those administrative, professional and other operational employees paid on a “fee basis” is explained in another U.S. DOL fact sheet at https://www.dol.gov/whd/overtime/fs17g_salary.pdf.

This rule will have various impacts for home care agencies depending on the number of your employees who meet these “duty” and “salary” tests, as well as the concentration of overtime hours worked by these 9

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employees. HCA welcomes any feedback you have on the impact of this rule for your agency as we design future education program about this rule and other labor changes at the federal and state levels.

Bootcamp: HIPAA eRisks and Responses for Home Care Agencies June 15, 2016 130 East 59th Street (near Lexington Ave.) 7th Floor New York, NY 10022 9:30 a.m. to noon The complexities of the HIPAA and HITECH regulatory framework, including cyber security, are some of the most critical compliance issues facing home care and other health care providers. In an environment where data breaches occur with increasing frequency, federal regulators have amplified their auditing and investigations of provider compliance with the HIPAA/HITECH. Recent violations have resulted in substantial financial penalties levied against providers.

HCA reminds members that we are holding a June 15 workshop in New York City that will review what constitutes Protected Health Information (PHI) and the regulations related to the sharing of PHI. Most importantly, you will learn about the critical aspects of cybersecurity compliance, common areas for HIPAA violations, compliance with the HIPAA Privacy, Security and Breach Notification Rules and what’s required (from a compliance perspective) when the inevitable data breach occurs, such as a stolen laptop or lost thumb drive that contains protected health information.

Registration for this program is at http://hca-nys.org/wp-content/uploads/2016/03/June-15-SurvivalBootcamp-HIPAA-eRisks-Registration-Form.pdf.

Final OHSA Rule: Additional Information Provided Following up on a story in last week’s ASAP, HCA has obtained additional information from the Occupational Safety and Health Administration (OSHA) on its recent final rule that revises requirements for recording and reporting occupational injuries and illnesses. That rule requires employers in certain industries to electronically submit to OSHA a set of injury and illness data that employers are already required to keep under existing OSHA regulations. The frequency and content of these establishment-specific submissions are set out in the final rule and depend on the size and industry of the employer.

HCA previously clarified with OSHA that electronic submission of this information does not apply to home health and in-home hospice agencies with between 20 and 249 employees; however, we know now that agencies with 250 or more employees are subject to OSHA’s record-keeping regulation. Therefore, those larger agencies will have to electronically submit to OSHA some of the information from the “Log of WorkRelated Injuries and Illnesses” (OSHA Form 300), the summary of “Work-Related Injuries and Illnesses” (Form 300A) and the “Injury and Illness Incident Report” (Form 301).

These agencies will be required to submit Form 300A for 2017 by July 1, 2017; Forms 300A, 300 and 301 by July 1, 2018; and Forms 300A, 300 and 301 by March 2 for 2019 and following years.

Continued on next page

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Continued from previous page Currently, home health and hospice agencies with 10 or more employees are required to maintain injury and illness reporting records (OSHA Form 300), with supporting documentation (Form 301) and a posted summary of that information (Form 301A) from February 1 to April 30.

The rule is at https://www.gpo.gov/fdsys/pkg/FR-2016-05-12/pdf/2016-10443.pdf.

U.S. DOL guidance materials are at http://www.osha.gov/recordkeeping/finalrule/index.html.

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

NGS Offices Closed on Memorial Day 2016 National Government Services (NGS) will be closed on Monday, May 30. This includes the: Electronic Data Interchange (EDI) Help Desk; Provider Contact Center; Provider Enrollment Line; and Telephone Reopening Unit.

Electronic claim files transmitted after 5 p.m. on Friday, May 27, 2016 will have a claim receipt date of Tuesday, May 31, 2016. EDI front-end acknowledgement transactions will be created as expected as EDI claim files are received. The FISS/DDE Provider Online System will be available on Friday, during regular hours. While DDE will be available, there will be no support available to respond to any issues. However, providers will be able to use NGS’s Interactive Voice Response (IVR) system at 1-866-275-3033.

Publications: New & Updated 

“Medicare Claim Review Programs Could Be Improved with Additional Prepayment Reviews and Better Data,” by the Government Accountability Office http://www.gao.gov/assets/680/676526.pdf

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“Your Rights as a Hospital Patient in New York State,” the Hospital Patient and Health Care Proxy Publications has been updated and translated into six languages by DOH http://www.health.ny.gov/professionals/patients/patient_rights/index.htm

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“New York Health Care Proxy – Appointing Your Health Care Agent in New York State” has been updated by DOH http://www.health.ny.gov/professionals/patients/health_care_proxy/

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