June 17, 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. 24 June 17, 2016

Legislative Session Heads to Finish with Home Care Wins, Safeguards and Table-setters In the flurry of the 2016 State Legislative Session’s final days and hours, bills of priority focus to home care have been passed, advanced or held, thus far substantially in line with HCA advocacy positions and efforts as of ASAP press time. We note, however, that session remains open, and this article reflects developments known at this time. (We will update the membership accordingly after session has ended, and if any new developments occur.)

Several priority bills in play – mostly HCA-initiated, drafted and proactively targeting top home care measures – have been summarized in the last several editions of ASAP. These bills comprise both this-year See SESSION p. 5

Register NOW for Public Policy Summit and Capitol Hill Advocacy Day on July 12-13 Hotel deadline is June 20 July is a great time for federal advocacy in Washington, D.C., just before Congress heads into the summer months of district work. With that in mind, please join us for the first-ever multi-state Public Policy Summit and Capitol Hill Advocacy Day on

Inside ASAP

See SUMMIT p. 3

Summer ASAP Schedule Change and New Communications Offerings As in the past, HCA will be publishing our ASAP newsletter every other week during July and August. Our final weekly newsletter for the summer will be on July 1, and we will resume the weekly schedule in September.

We’ll still be providing you with critical updates as they occur – not only in our newsletter every two weeks over the summer, but also through member e-mail alerts as needed, any day of the week.

See NEW p. 2

Legislative Session Concludes.........................................................…1 Summer ASAP Schedule, New Communications Offerings…..............1 Register NOW for Public Policy Summit, D.C. Advocacy Day…..........1 Member Hiring Announcements…................................................3, 5 New Resource on Home Care’s Value for DSRIP, VBP…........................4 Upcoming Education Programs...........................................................8 With Nearing 2015-16 QIVAPP Phase, HCA Presses Changes…..........9 EO 38 Legal Update, MLTC Disclosures Due 6/29 ….........................10 CHHA Medicaid Cost Report Software Update….............................11 Can We Rely on You to Go BIG and Bring The Vote Home NY?..........12 Congratulations Ginger Hall: Winner of BTVH-NY Contest…..........12 Revised Rule Posted on Payment of Wages…....................................13 MedPAC Releases June 2016 Report…..............................................13 NGS Update…............................................................................14 Publications...................................................................…......14

Helping New Yorkers Feel Right At Home

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

Volume 21, No. 24 June 17, 2016 

NEW from p. 1 We also wanted to let you know that HCA is using this time to plan and implement some exciting new communications offerings.

The first of these is a web-based news-clips service through a company called Meltwater. This is a powerful new tool that will allow us to aggregate important home-care-related news clips from traditional media, blogs, and other sources that we can e-mail to you as links on a weekly basis to flag certain articles of interest.

The clips will be sent to key contacts in our member database and you are welcome to circulate them to your staff (though we stress that this will be an HCA-member-only service). The clips will appear in e-mail form as a series of headline links, curated by HCA’s communications team for relevance, allowing you to pick and choose which stories about home care you want to read. You can expect to start seeing these clips in late June or early July.

We have some other new plans in store for HCA’s communications and will be presenting them to you as the summer progresses, so please stay tuned for further updates. And once you start seeing our news clips feature, please tell us what you think so that we can make sure we are providing you with relevant, interesting and helpful information.

For any questions about HCA’s communications, please contact HCA Communications Director Roger Noyes at rnoyes@hcanys.org.

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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Volume 21, No. 24 June 17, 2016

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

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SUMMIT from p. 1 July 12 to 13. All members concerned about federal home care issues are strongly urged to attend.

For this program, we’re bringing together home care representatives from all over the country – through the Council of State Home Care Associations (which includes HCA) – as well as Congressional leaders, Medicare contractors, the U.S. Centers for Medicare and Medicaid Services, and D.C. insiders for learning and advocacy.

We have an incredible agenda planned by the Council, making this a unique state-level association-led program. With so many issues confronting us – such as Medicare payment changes, the Face-to-Face requirement, the prospect of home health copays, new delivery models and a dynamic political environment – we invite you to learn more and engage with federal officials during this exciting program.

The brochure linked at the back of this week’s ASAP provides all the details you need to know about the agenda, registration options and logistics.

The June 20 hotel deadline is fast approaching for the discount rate, so make your reservations now.

Links to register online and make your hotel reservations are below. We look forward to seeing you in Washington. 

Download the brochure: http://hca-nys.org/wp-content/uploads/2016/06/Public-PolicySummit-Brochure-July-2016.pdf

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Register online: http://www.thehomecarecouncil.org/index.php?pID=28

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Make your hotel reservations: https://aws.passkey.com/g/58264721

HIRING Job Position: Patient Service Manager-Quality Management (Montefiore Home Health Agency) BS in Nursing required. Candidate must have a New York State Registered Professional Nurse License and current Registration to practice nursing. Must have a valid NYS driver’s license with registration and insurance. Candidate is responsible for planning, supervising, coordinating, and evaluating patient care services provided by the nursing staff employed directly by MMC or through contract with the CHHA/LTHHCP. Required Qualifications: Current NYS RN License and Registration; BSN required, Master’s in Nursing preferred; minimum of three years of Home Care QI experience; knowledge of Home Care regulations (i.e., Joint Commission/ DOH). 

OASIS certified preferred. Coding certified preferred.

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Knowledge of Excel/Power Point.

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Education experience preferred/strong presentation skills.

Please apply directly through our website: www.montefiore.org/careers.

MMC is an equal opportunity employer and will not discriminate against any employee or applicant for employment because of race, color, religion, gender, sexual orientation or national origin.

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

Volume 21, No. 24 June 17, 2016 

New Resour ce on Home Car e’ alue Pr oposition Resource Care’ e’ss V Value Proposition Please Circulate to DSRIP, VBP Leads In preparation for today’s HCA conference on Value Based Payments, we’ve prepared a special resource document that we hope all members find useful. The piece is called Don’ Don’tt Reinvent the Wheel: Home Car e is Alr eady Y our Hub for Community-based DSRIP and V alue Based Services Services.

Care Already Your Value Why did HCA create this piece? For several reasons. One, we have heard from many members that Delivery System Reform Incentive Payment (DSRIP) Performing Provider Systems (PPSs) and their committees may not understand home care’s role in the system and the infrastructure you already provide.

What’s more, in some cases, these committees and potential Value Based Payment (VBP) partners appear to be considering options for duplicating home care services from within other settings – in ways that may even interfere with the jurisdictional requirements of Article 36 (an area of concern that HCA is working to address in other venues).

We encourage you to share this document at PPS committee meetings and VBP stakeholder or partnership interactions so that the committees: know more about what home care does; learn some data on home care’s success in meeting PPS and VBP outcomes goals; and understand the regulatory structure that governs home care.

When sharing this document, we also encourage you to present agency-specific data and narratives to support your organization’s successes in achieving the broader points about home care’s valueproposition.

The document can be downloaded in two PDF formats. One format is a four-page document that can be printed and stapled in standard paper size. The other format is designed for 11-by-17-inch printing, front and back, so that it can be produced as a bi-fold. (HCA is happy to assist if you have difficulty printing this piece or need HCA to mail you copies.) Links are below: 

Standard (8.5-by-11-inch), four-page format: http://hca-nys.org/wp-content/uploads/2016/06/ Dont-Reinvent-the-Wheel-4-page-color.pdf

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11-by-17-inch bi-fold: http://hca-nys.org/wp-content/uploads/2016/06/Dont-Reinvent-theWheel-one-page-color.pdf

Want to co-brand?

Also, HCA is happy to work with you to include your logo on this piece so that it is a co-branded document with your organization’s imprint alongside HCA’s logo.

Please contact HCA’s Communications Director Roger Noyes if you are interested in co-branding with HCA. Just send an e-mail to rnoyes@hcanys.org and we’ll work with you to make this document as effective as possible for your purposes.

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Volume 21, No. 24 June 17, 2016 

SESSION from p. 1 priorities and post-session table-setters. Following the final wrap-up of the session, anticipated later today or this evening, HCA will report to the membership on the status of all of these initiatives.

Summarized below, however, are several high-profile bills with significant home care implications where the Legislature’s final action (or decision to hold and reconsider) reflects the most important home care gains and/ or adversities averted.

Advanced home health aides (S.8110/A.10707) – Passed Both Houses A new “advanced home health aide” proposal that emerged last week was finalized early this week and passed today by both houses of the Legislature. The bill amends the Nurse Practice Act and the public health law, establishing the level of “advanced home health aide” (AHHA) that, upon nurse assignment, oversight and discretion, may provide certain services which otherwise would fall within the scope of nursing.

The bill directs the state departments of Education and Health to formulate in rules and regulation many of the details, including the array of permissible tasks, the required training and qualifications, and other implementing elements. The bill requires that a workgroup be convened to provide input from the field.

Passage of this bill follows several years of impasse in the State Legislature, and between constituencies with differing perspectives on how this long-sought-after flexibility in nurse/patient direction and aide services should best be accomplished. The measure gained new momentum in just the past several weeks, particularly with the intense focus of Senate Higher Education Committee Chairman Kenneth LaValle, Assembly sponsor Deborah Glick, and the Administration, to forge an agreement.

Over the years, HCA initiated and led efforts to provide increased flexibility for nurses in home care and hospice agencies to work with aides and patients to enable a greater span of service, where appropriate, and

HIRING

Financial Operations Manager

The Financial Operations Manager position is a mid-level leadership role responsible for overseeing the financial operations responsibilities for Consumer Directed Choices in Albany, NY. This position reports to the CFO, and will have three direct reports. This position is responsible for the overall management, accuracy, and efficiency of accounting operations; annual audits; financial statement reporting and analysis; cash management and forecasting; trend analysis; Medicaid billing, receivables and cost reporting; reimbursement rate analysis; budgeting; and maintaining internal financial and accounting controls for a not-for-profit organization grossing in excess of $25.0 MM. This individual works closely with the CFO to ensure the highest standards of performance are achieved Required Qualifications: BA/BS Accounting or Finance; minimum of 6 years’ experience in A/R, A/P, and general accounting functions coupled with a minimum of 3 years’ experience in a managerial/supervisory role. The successful candidate will be well versed in Generally Accepted Accounting Principles (GAAP) and have expert knowledge of QuickBooks and Microsoft Excel for analysis and complex modeling, as well as the ability to learn new financial applications and systems. The ideal individual will possess the requisite skills and experience, preferably from a Consumer Directed Personal Assistance or Home Health related Medicaid billing environment.

Additional Qualifications: Must possess strong written and verbal communications skills; be team focused; and foster a collaborative approach to problem solving.

Please send résumés and cover letters, including salary requirements, to: HR@CDChoices.org. (Résumés without cover letters will not be considered.) No Phone Calls, Please! Our website is www.CDChoices.org.

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consistent with existing nurse discretion to educate, train and assign family members in a patient’s care. This flexibility offers critical support with the challenges and needs facing patients and the health care system. HCA drafted and repeatedly gained introduction and wide support for legislation on this score. Over time as the concept was further embraced, separate and varied proposals emerged from the Legislature, the Administration and various other groups (e.g., labor, consumers), ultimately taking the form passed in this year’s session finale.

HCA appreciates the sponsors for finally advancing this concept to passage, but had proposed and urged inclusion of critical amendments to ensure this bill’s ability for viable and appropriate implementation by home care and hospice providers, nurses, home care aides, patients and managed care plans. HCA is pleased that some of our recommended changes were included in the final bill; however, HCA is concerned that a number of important elements still remain outstanding. HCA will be advocating for these critical improvements in either the implementing regulations/guidelines or in legislative amendments, if necessary. These priority areas include: provider reimbursement for training, AHHA compensation, and other costs of implementation and oversight; streamlining of regulations; provision of liability safeguards for nurses and agencies; alignment of AHHA rules with managed care authorizations and payments; participation in AHHA training by home care agencies; and others.

HCA will provide a further, detailed summary of the AHHA bill, and additional background on next steps. The bill must still go the Governor for signature. Following presumed signature, HCA looks forward to participating on the implementing workgroup, and to compiling the input of HCA agencies and nurses, especially in the clinical and operational details of the AHHA program.

Essential personnel (S.6692/A.9381-B) – Passed Both Houses An amended version of HCA’s “essential personnel” bill has passed both houses of the Legislature. This bill was conceived and drafted by HCA several years ago and has since been a top priority.

We have worked with stakeholders over the past several weeks to adjust the bill’s language in a way that is believed to respond to concerns of various county emergency managers that had been the basis for Governor Cuomo’s past veto (despite unanimous approval of both houses of the Legislature and existing bill language believed to have already ameliorated these local manager concerns).

The bill has been extensively described for the membership; but, in short, it would extend “essential-personnel” status to home care and hospice staff during declared emergencies, so they can reach patients when curfews or other restrictions are in effect, and it would include home care and hospice within local emergency planning efforts.

The bill joins a series of HCA educational and outreach efforts, including an ongoing series of consortiums that HCA has organized with the New York State Association of Health Care Providers (HCP) to bring together local emergency management officials and home care providers in several counties for shared learning about roles, gaps, partnerships and community-level emergency preparedness needs.

Providers, consumer advocates and others involved in emergency preparedness must mount a wide campaign urging the Governor – this time – to sign this very-needed legislation.

Off-site services amendments (S.8081/A.7714-C) – Passed Both Houses HCA has also worked with the Healthcare Association of New York State (HANYS) to reframe another bill to facilitate “house-calls” to home care patients from physicians and primary care practitioners in hospitals and 6

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clinics. The “offsite” house-call visits would be allowed for patients that have pre-existing relationships with such professionals and who are unable to travel on-site for care, thus requiring the visit.

ameliorate the problems for home care. If no adjustments are made, HCA urges that the measure be reconsidered or dropped.

For a number of bills, HCA worked to reshape, reconsider or withdraw legislation in ways that successfully avoided serious problems for home care. These proposals included a Community Paramedicine measure (S.5481/A.7503) which HCA worked to redraft to another approach with the hospital and emergency medical services community; while prepared for post-session discussion, this bill (as of ASAP press time) was not advanced in its current problematic form.

Another of these bills (S.7414/A.10383) would have added a new layer of background check to existing checks by home care agencies (through the state’s “Justice Center”). While passing the Senate, this bill remained in the Assembly Codes Committee at ASAP press time.

HCA fashioned the amendments to permit primary care offsite, but expressly not home care services (professional or aide-level services) that are otherwise the jurisdiction of Article 36 home care agencies, and to ensure that home care input is included in any implementing regulations or guidance. The original bill would have essentially allowed hospitals and clinics to provide “off-site” services in the home without restricting crossover into home care, creating multilevel problems and conflicts.

In an environment where partnership models and new outcomes requirements are creating fluidity in the service-delivery system, this now-amended bill helps protect the jurisdictional and long-established scope of service role for home care, and facilitates home care’s mutual goal of enhanced physician-home care patient primary care engagement.

Additional Home Care Priority/Table-setting Bills in Queue As described in recent HCA communications, HCA worked extensively to write and gain introduction of additional priority bills that will significantly assist with home care priority advocacy and table-setting for pre-budget/postsession development. These include: our Minimum Wage Payment and Implementation Accountability Bill; a Home Quality Innovation Bill; a Homecare-Primary Care Initiative Bill; Prompt Pay/Fair Claims Settlement Practices for Home Care; Insurance Modernization for Home Care; a Home Care Clinical and Health Information Technology Bill; HomecarePhysician Collaboratives Addressing Health Disparities; a Priority Access through Home Care Bill; Amendments to Home Care Telehealth Insurance and Medicaid Coverage; Home CareHousing Legislation; Veterans Home Care; Regulatory Streamlining and Alignment for Home Care and Managed Care; and others.

On a related note, HCA has prepared a new instructional resource that we are encouraging home care providers to share with Delivery System Reform Incentive Payment (DSRIP) and Value Based Payment (VBP) leads to explain the role of home care and its Article 36 licensure, while offering some persuasive cases for why the existing home care infrastructure should be included in these new models of care to address targeted outcomes metrics.

(See related p. 4 story.)

Potentially Adverse Bills Not Advanced The Assembly and Senate altogether introduced thousands of bills. Many of these bills directly or indirectly affect the structure or environment for home care recipients, agencies and payors. HCA casts a wide net in its watch, and in its involvement, to ensure bills support and do not adversely impact the home care community. For bills presenting adversity, HCA usually takes the route of recommending ways to revise the bill or to otherwise

HCA also supported legislation to maintain home care’s intended exemption from the Domestic Workers Bill of Rights. HCA will include these in our comprehensive post-session report.

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Upcoming HCA Education Programs: Register from our Website Today To register for these upcoming sessions, please visit the education page of our website and click the brochure or online registration option for each program. Visit: http://hca-nys.org/eventseducation/upcoming-events.

Blueprint for OASIS Accuracy

Skin & Wound Care Management Live Training Courses

June 22 and 23, 2016 Workshop (8 a.m. to 4 p.m.)

June 24 COS-C Exam (9 to 11:30 a.m.)

Workshop/Exam Location: Holiday Inn Express Hotel & Suites, 860 Holt Road Webster, NY 14580

HCA members receive a discounted rate ($300 off standard rate) for day trainings offered by The Wound Care Education Institute. The courses are designed for LPN/LVNs, RNs, NPs, PAs and OTs and offer the opportunity to take a certification exam. Use the discount code “HCANYS” for these sessions:

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Individuals may register for the workshop, the exam or both.

This two-day OASIS-C1 workshop on Data Collection Rules and Guidance is followed by an optional Certificate for OASIS SpecialistClinical (COS-C) exam, both held at the same location. You can register for the workshop, the exam, or both!

July 11-15, 2016 at Uniondale, NY October 24-28, 2016 at Elmhurst, NY

Also available free to HCA Members through the Wound Care Education Institute is an array of ondemand webinars using the code “HCANYS”. Visit our website for brochures and details.

Gain effective, up-to-the-minute education targeted for field data collectors, their supervisors and those preparing for the COSC exam.

Home Health Quality Initiatives Update June 23, 2016 3 to 4:30 p.m.

Webinar The U.S. Centers for Medicare and Medicaid Services’ (CMS) quality initiatives for home health have picked up the pace over the last year. Quality of Patient Care and Patient Survey 5-Star Ratings are available on the Medicare Home Health Compare website; agencies must now meet an OASIS quality reporting threshold; and a pay-for-performance demonstration project has begun in nine states.

New Conditions of Participation that require a Quality Assessment and Performance Improvement program are on the horizon. The OASIS data collection continues to evolve and OASIS-C2 is scheduled to be implemented in 2017 with a new cross-setting item.

Presenter Heather Jones, MPH, CHES, COS-C, is the Associate Vice President for Quality Initiatives and State Relations for AHHC/SCHCA. In this webinar, she will provide an update on the CMS initiatives and specify resources that are available to support agencies’ quality improvement efforts.

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Experience the comprehensive and nationally acclaimed two-day Blueprint for OASIS Accuracy workshop and learn to confidently teach, audit and collect OASIS-C1 items accurately.

The Art of ICD-10-CM Coding for Home Health July 13 and 14, 2016 8 a.m. to 4 p.m.

Nanuet, NY This two-day diagnostic coding workshop is structured to develop basic ICD-10-CM coding skills and foster good habits crucial to coding success. This critical foundational knowledge, along with application through workshop exercises and coding scenarios, will lead to coding accuracy and regulatory compliance. The program is appropriate for all levels of coders.

Continued on next page

Volume 21, No. 24 June 17, 2016

ASAP – a publication of the Home Care Association of New York State Continued from previous page Addressing Factors that Increase Workers’ Compensation Costs and Developing Ways that Home Care Providers Can Reduce Their Expenses

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With Nearing 2015-16 QIVAPP Phase, HCA Reiterates Need for Process, Criteria Changes The state Department of Health (DOH) has informed HCA that it intends to soon issue written information about the Quality Incentive Vital Access Provider Pool (QIVAPP) for the period April 1, 2015 to March 31, 2016.

September 28, 2016 130 East 59th Street New York, NY 10022 9 to 9:30 a.m. registration and continental breakfast; 9:30 a.m. to noon program This program will address fixed and variable costs affecting Workers’ Compensation insurance for home care agencies, and ways in which those agencies can affect the variable costs to significantly improve their bottom lines. The financial burden of Workers’ Compensation has been increasing for home care providers due to numerous factors. Agencies face the potential for additional increases due to the recently enacted $15 minimum wage and a shrinking Workers’ Compensation insurance market.

This program will help agencies develop a cohesive Workers’ Compensation riskmanagement strategy and play an active role in reducing their costs.

Presenter John Malone is a Commercial Insurance Broker with the firm Marshall & Sterling, Inc. He represents some of the region’s largest and most highly respected businesses to negotiate commercial insurance and riskmanagement program terms, conditions and pricing.

DOH has indicated that it will use the same eligibility criteria as used for the prior period, but it agreed with HCA to allow any provider found ineligible for the 2014-15 period (from April 1, 2014 to March 31, 2015) to submit proof to demonstrate its eligibility for the 2015-16 period.

This week, HCA sent a communication to DOH to reiterate our earlier expressed concerns with the eligibility criteria used for the 2014-15 period. Among our objections was the requirement that home care agencies provide “comprehensive” health insurance that met a very strict level of benefits; instead, we advocated this be changed (for 2015-16) to meet the Affordable Care Act threshold.

In addition, we reiterated our strong opposition to the “30-percent threshold” under which a minimum of 30 percent of an agency’s total workforce must be enrolled in the health benefit. We explained that this artificially-set threshold does not consider that many aides may not take the health plan because their spouse has other coverage, they are on Medicaid, or they prefer to forgo health benefits and instead receive higher wages.

We also indicated that if DOH intended to retain the same criteria as in 2014-15, then it should take the following actions: 1. Provide an opportunity for home care agencies that were denied funding for the 2014-15 period to apply for the 2015-16 period; 2. Change the requirement that the agency provide “comprehensive” health insurance as of September 2, 2014 to “providing such insurance as of April 1, 2015”; and 3. Calculate the 30-percent threshold over an annual period (April 1, 2015 to March 31, 2016).

HCA will inform members of DOH’s response to our concerns and when DOH releases any information on the 2015-16 QIVAPP program.

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

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EO 38 Legal Update, MLTC Disclosures Due 6/29 The deadline for MLTC plans to submit the Disclosure Form under Executive Order (EO) 38 and its implementing regulations is June 29.

The due date for CHHAs and LTHHCPs to submit the Disclosure Form is August 15, and September 15 for personal care providers. These dates are based on the date that these “covered providers” must submit their 2015 Cost Reports.

EO 38 and its implementing regulations set limits on executive compensation and administrative expenditures by covered entities, including health care providers and managed care plans that receive state funds or state-authorized payments above certain minimum thresholds.

Court Decisions As previously reported to the membership, on December 30, 2015, the New York State Appellate Division, Second Department issued decisions in two cases upholding both EO 38 and the state Department of Health’s (DOH) implementing regulations. The two cases are: Agencies for Children’s Therapy Services, Inc. v. NYS Department of Health, and its companion appeal, Concerned Home Care Providers, Inc. v. NYS Department of Health.

The Court’s decisions resolve a lower court split within the Second Department by reversing the Supreme Court, Nassau County’s April 8, 2014 decision that struck down EO 38 and the regulations, while affirming the Supreme Court, Suffolk County’s July 29, 2014 decision that upheld EO 38 and the regulations.

The plaintiffs in both cases appealed to the Court of Appeals, but their appeals were denied. (See page 11.)

Nassau County Implications For Nassau County providers, it remains unclear as to the immediate impact of the Second Department’s decisions and subsequent denial of an appeal to the Court of Appeals. After the Supreme Court, Nassau County issued its April 2014 decision in Agencies for Children’s Therapy Services, the state posted a legal notice on its Executive Order No. 38 website stating that providers conducting business in Nassau County are not required to file Executive Order 38 disclosures; but at the same time, it cautioned providers to check periodically for changes to the legal notice.

As of today’s ASAP, the legal notice remains posted and unchanged on the website notwithstanding the Second Department decisions upholding the EO and regulations. HCA advises providers that are conducting business in Nassau County to check the state’s website (www.executiveorder38.ny.gov) on a regular basis for changes to the legal notice and potentially new compliance requirements.

Implications of Related Ruling Meanwhile, on November 13, 2015, the Supreme Court, Albany County, in LeadingAge New York, Inc. et al v. Shah (litigation in which HCA is co-petitioner), struck down the EO 38 DOH regulations to the extent they limit executive compensation that is paid from all funds (both state and non-state funds), but the court 10

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upheld the DOH regulations insofar as they limit the payment of executive compensation and administrative expenses only from state funds or state authorized payments.

In December 2015, HCA and the other petitioners initiated an appeal of the unfavorable aspects of the LeadingAge decision to the New York State Appellate Division, Third Department. On January 4, 2016, the state likewise initiated to the Third Department an appeal of the decision aimed at parts of the regulations it finds unfavorable.

Court of Appeals Ruling The petitioners sought to appeal the Second Department decisions to the Court of Appeals, the State’s highest court. The Court of Appeals dismissed both appeals and thus has so far chosen not to review EO 38 and its implementing regulations.

Depending on the Third Department’s eventual decision in the LeadingAge/HCA appeal, that case could also make its way to the Court of Appeals. If, for example, the Third Department renders a decision that is in conflict with the decisions of the Second Department, that would set the stage for the Court of Appeals to determine the fate of EO 38 and its implementing regulations.

HCA will be closely monitoring any new legal developments and actions taken by the state that impact Nassau County providers, as well as providers throughout the state, and will keep members informed.

CHHA Medicaid Cost Report Software Update DOH experiencing programming delays, hopes to post to HCS soon This week, state Department of Health (DOH) official Tim Casey confirmed to HCA that there has been a delay in the posting of the 2015 CHHA Medicaid Cost Report software to the Health Commerce System (HCS). This delay is due to programming issues.

Mr. Casey said that DOH expects to post both the CHHA Cost Report software as well as the 2016 fee-forservice (FFS) CHHA final (hotline) rates by the end of the month. He also confirmed that CHHAs will have a full 60 days to complete their 2015 Medicaid Cost Report.

Earlier this month, DOH posted the 2015 LTHHCP Medicaid Cost Report software and 2016 final LTHHCP Medicaid rates as well as the non-NYC 2015 Personal Care Cost Report software and 2016 final non-NYC personal care rates to the HCS. HCA will notify the membership as soon as DOH posts the 2015 CHHA Cost Report software and 2016 CHHA final (Non Episodic Payment System) rates.

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

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Can We Rely on You to Go BIG and Bring The Vote Home NY? By now you’ve heard about our Bring The Vote Home NY initiative: at our Annual Conference, in member meetings, through ASAP and in e-mail alerts. Now we need you to sign up!

Signing-up does not obligate you to participate. It just means you are interested, willing to consider committing, and would like to hear more about this initiative during upcoming conference calls or webinars where we’ll be telling you a lot more about the campaign very soon.

Here’s a little political sound bite about what this campaign does: “Bring The Vote Home is a national initiative designed to help seniors and people with disabilities vote. For those who may have difficulty traveling to the polls, we can help them register to vote or cast an absentee ballot.”

So far, we’ve had a good response to this campaign (HCA is handling the New York component of this national effort), but it can be a LOT better. Some small agencies are saying they will participate in a big way by distributing 100s of voter registration forms, absentee ballots and instructions to their patients. Can we rely on you to join them? Can we rely on you to go big?

For now, HCA simply asks you to state your interest in participating so that we can further instruct you and prepare you to Bring The Vote Home at your agency.

HCA plans to make this initiative fun in other ways, so be on the look-out for more promotions and an upcoming series of instructional calls or webinars as we ramp up this campaign over the summer.

To learn more, visit our campaign website at www.bringthevotehomeny.org. There, you will find a “Join Us” button to register so that we can count you among the agencies interested in participating. Click this button and fill out the form today.

Congratulations Ginger Hall: Winner of Bring The Vote Home Contest Congratulations to Ginger Hall, Director of Public Health at Jefferson County Public Health Service and HCA Board member, who was randomly selected from our first fifteen Bring The Vote Home registrants to receive a $250 gift card.

We appreciate Ms. Hall’s participation in Bring The Vote Home NY along with her other great peers who have signed up. To learn more about this campaign, please see the related story above.

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

Volume 21, No. 24 June 17, 2016 

Revised Rule Posted on Payment of Wages The state Department of Labor (DOL) has posted a revised rule that provides clarification on permissible methods of wage payments. The rule covers: wage payments by cash, check, direct deposit and payroll debit cards; written notice and consent requirements; and prohibited practices. According to a Governor’s press release, in May 2015 about 13,000 businesses in New York paid 200,000 workers through debit cards.

The rule is can be viewed here: http://docs.dos.ny.gov/info/register/2016/june15/pdf/rulemaking.pdf (page 16).

MedPAC Releases June 2016 Report The Medicare Payment Advisory Commission (MedPAC) has released its June 2016 Report to the Congress: Medicare and the Health Care Delivery System.

The report includes chapters on the following topics that affect home health providers: 

Developing a unified payment system for post-acute care



Telehealth services and the Medicare program



Issues affecting dual-eligible beneficiaries: CMS’s financial alignment demonstration and the Medicare Savings Programs

HCA will be reviewing MedPAC’s recommendations, as they are typically very influential with Congress. In the past, MedPAC has advocated, and HCA has strenuously opposed, reductions in home health payment updates; rebasing; and copayments for Medicare home health beneficiaries.

The Report can be viewed here: http://medpac.gov/documents/reports/june-2016-report-to-the-congressmedicare-and-the-health-care-delivery-system.pdf?sfvrsn=0.

HCA urges members to participate in our multi-state Public Policy Summit and Capitol Hill Advocacy Day on July 12 to 13 which will cover several issues in MedPAC’s purview. (See related p.1 story.) We are bringing together home care representatives from across the country, through the Council of State Home Care Associations (of which HCA is a member), as well as Congressional leaders, Medicare contractors, the U.S. Centers for Medicare and Medicaid Services, and D.C. insiders for learning and advocacy.

Some of the topics that will be covered at the Summit include: caring for individuals with chronic conditions; focusing on Medicare’s Face-to-Face rule; and home health care reform.

The program brochure is available at http://hca-nys.org/wp-content/uploads/2016/06/Public-PolicySummit-Brochure-July-2016.pdf.

13

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

Volume 21, No. 24 June 17, 2016 

NGS Update National Government Services (NGS), New York’s Medicare Administrative Contractor (MAC), posted the following update to its website. 

July 1, 2016 Dark Day for the Common Working File Host – For the upcoming July 2016 Release, the common working file (CWF) will be observing one business “dark” day on Friday, July 1 to accommodate the anticipated duration of this activity and to ensure the completion of processing and scheduled data center maintenance.



Calling NGS’s Provider Contact Center – Provider Contact Center (PCC) representatives are available to assist providers with a wide range of Medicare coverage and billing-related inquiries. PCCs can: 1) clarify why a claim processed the way it did; 2) assist with Medicare information and billing questions; 3) provide guidance on how to use the Interactive Voice Response (IVR) system and the website; and 4) assist with other complex issues that cannot be addressed through the IVR system.

PCCs cannot: 1) provide claim status, beneficiary eligibility, or any other information that is available through the IVR system; 2) provide information on what modifiers, diagnosis codes, CPT codes or HCPCS to use for specific claims or beneficiaries; 3) preauthorize any type of service or supply; and 4) answer inquiries from beneficiaries or their representatives.

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

Publications 

“Medicare Fee-For-Service: Opportunities Remain to Improve Appeals Process,” by the Government Accountability Office http://www.gao.gov/assets/680/677034.pdf



“How States Can Support an Aging Population: Actions Policy Makers Can Take,” Milbank Memorial Fund http://www.milbank.org/uploads/documents/MMF%20%20NYAM%20Aging%20Report.pdf



“Preventing Central Line-Associated Bloodstream Infection (CLABSI) in the Home Care Setting,” by the United Hospital Fund http://www.uhfnyc.org/assets/1485



“Step-by-step guide to enrolling in a pooled income trust for Medicaid spend-down,” by New York Legal Assistance Group http://www.wnylc.com/health/entry/44/

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

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Platinum Sponsor Gold Sponsors

July 12 – 13, 2016 Marriott Marquis Washington, DC

Public Policy Summit Washington, DC

Day 1 Tuesday, July 12, 2016 Shaw/LeDroit Park Room 7:30am– 8:30am

Registration and Continental Breakfast 8:30am – 9:45am

Caring for Individuals with Chronic Conditions Speaker: Laurence Wilson, Director, Chronic Care Policy Group, CMS Payment reform for post-acute care services is among the top issues facing the home health community. CMS Chronic Care Policy Group (CCPG) is responsible for developing and evaluating Medicare payment policies across the spectrum of post-acute care settings, including home health and hospice programs. As the Director of the CCPG, Laurence Wilson stands at the center of this rapidly evolving area of health care. This will be an informative session on recent developments in post-acute care reform and the future of care for individuals with chronic health conditions.

9:45am –10:00am – Break 10:00am – 10:45am

Insights from CMS Speaker: Pierre L. Yong, MD, MPH, MS, Acting Director of Quality Measurement and Value-Based Incentives Group (QMVIG) in the Center for Clinical Standards and Quality at the Centers for Medicare & Medicaid Services (CMS) Dr. Yong oversees development and operations for a variety of CMS quality reporting and value-based purchasing programs. Previously, he was the Director of the Division of Quality Measurement in QMVIG, and the Director of Health Care Quality and Outcomes in the Office of the Assistant Secretary of Planning Evaluation at the U.S. Department of Health and Human Services, where he oversaw projects on value based purchasing, quality, comparative effectiveness research, and data infrastructure for patient-centered outcomes research. Pierre also previously worked at the Institute of Medicine, where he focused on a portfolio of projects related to value and costs in health care.

10:45am – 11:45am

Improving Care and Support of America’s Seniors and Adults with Disabilities Speaker: Michael Nardone, Director, Disabled and Elderly Health Programs, CMS DEHPG leads the Center’s work on Medicaid coverage and care coordination for the elderly and individuals with disabilities. This includes initiatives to promote community-based care options and to enhance the availability of long-term services and supports. DEHPG also manages the Medicaid prescription drug benefit and manufacturer rebates, and oversees benefits and managed care delivery system issues across the Medicaid program, including development of the new alternative benefit plans (ABPs) associated with the Affordable Care Act. 12:00 – 1:45pm

Lunch Speaker: Yvette Fontenot, Partner, Avenue Solutions Prior to joining Avenue Solutions, Yvette served as the Deputy Director of the Office of Health Reform at the Department of Health and Human Services. The office is charged with developing policy and coordinating and clearing all matters related to the Affordable Care Act and providing outreach to Congress and other stakeholders with interests in health care reform. Prior to joining HHS, Yvette was a Senior Policy Director in the White House Office of Health Reform. At the White House, Yvette was responsible for coordinating the Administration’s work on implementation of the Affordable Care Act. She also briefed and advised senior White House officials about aspects of the legislation and implementation efforts. Before working at the White House, Yvette was Professional Staff with the Senate Finance Committee. Yvette had principle responsibility for provisions of the Affordable Care Act such as individual and employer responsibility requirements, tax credits for the purchase of health coverage, health insurance exchanges, health insurance rating reform, and consumer protection proposals.

Public Policy Summit Washington, DC

Day 1 Tuesday, July 12, 2016 – continued 1:45pm –2:45pm

6:15pm – 7:00pm

Perspective of the MACs

Cocktail Reception – Marriott Marquis

Panelists: Sandy Decker, Senior Provider Education Consultant, CGS Lauri Domingo, RN, Home Care Clinical Consultant, NGS Harry Feliciano, MD, MPH, Senior Medical Director, Palmetto Charles Canaan, Senior Provider Education Consultant, Palmetto Four of the nation’s MAC contractors will discuss the lessons learned and results of the “Probe and Educate” audits currently underway, as well as prior authorization and the face to face regulation.

7:00pm – 9:00pm Dinner – Marriott Marquis Speaker: Vicki Kennedy, Esq., Greenberg Traurig The spouse of the late Senator Edward Kennedy (D-MA) shares stories about Senator Kennedy’s monumental impact on Washington, DC, his mark on the shaping of decades of far-reaching federal policy in health and social services and the importance of caregiving and quality end-of-life care.

2:45pm– 3:45pm

Medicaid Policy Developments – Priorities of State Medicaid Directors Speaker: Matt Salo, Executive Director, National Association of Medicaid Directors The nation’s Medicaid directors are the engineers of health care policy and Medicaid changes at the state level, initiating significant changes to access to health care as well as modifications that prompted the creation of new models of care delivery and payment reform.

3:45pm – 4:45pm

Panel Discussion: Preparing for Regulatory, Legislative, and Legal Issues Facing Home Health Care Providers Speakers: Nancy Taylor, Shareholder at Greenberg Traurig, LLP Colin Roskey, Executive Vice President of Partnership for Quality Home Healthcare Regulations and legislation affecting Home Health Care delivery are constantly evolving. This panel discussion will provide insight from two experienced healthcare attorneys on issues relating to current fraud efforts, faceto-face requirements, Medicaid changes and other issues.

4:45pm – 5:15pm

The Intersection of Policy and Politics Speaker: The Honorable Billy Tauzin One of Washington’s most colorful, entertaining and influential former lawmakers is Louisiana Congressman Billy Tauzin, who continues to make significant and long lasting impacts on Capitol Hill, helping to shape and affect health care policy.

Day 2 Wednesday, July 13, 2016 8:30am – 10:00am

Congressional Breakfast Briefing – Perspectives of Key Staff U.S. Capitol Visitors Center Speakers: Kim Brandt, Chief Healthcare Investigative Counsel, Committee on Finance, United States Senate Wendell Primus, Senior Policy Advisor, Office of the House Minority Leader Danielle Steele, Senior Health Policy Advisor, Representative Michael C. Burgess, M.D. (R-TX) This session offers perspectives of several of the most influential staff serving on Capitol Hill on the remainder of the 114th Congress, as well as how the November Elections are likely to affect the policy environment on Capitol Hill.

10:00am – 4:00pm

Meetings with Your State’s Members of Congress and Staff (Scheduled by your State Association)

Public Policy Summit July 12 – 13, 2016 Washington, DC

REGISTRATION

Hotel Information

Register online at:

www.thehomecarecouncil.org/index.php?pID=28 Or, FAX this completed form to the Council of State Home Care Associations at:

(717) 975-9456 Or mail check to: Council of State Home Care Associations 600 N. 12th Street, Suite 200 Lemoyne, PA 17043

_____________________________________________________________ Name _____________________________________________________________ Professional Designations _____________________________________________________________ Title _____________________________________________________________ Agency Name ______________________________________________________________ Agency Address ______________________________________________________________ City State Zip _______________________________ ______________________________ Email Phone If registering for more than one person, please list names and emails: Name(s) Email(s) __________________________ ___________________________________ __________________________ ___________________________________ __________________________ ___________________________________

PAYMENT INFORMATION

$195 per person x ________ = $_______ # People

Total

Marriott Marquis 901 Massachusetts Avenue, NW Washington, DC 20001 A discounted group rate of $229 is available through June 20. Call (202) 824-9200 to reserve your room at the discounted rate or reserve online at: https://aws.passkey.com/g/58264721