ASAP
A Weekly Publication Of HCA Home Care Association of New York State
Legislative Issues Public Policy
News
Volume 21, No. 31 September 2, 2016
This is the Final Edition of ASAP – Ever! But don’t worry: We have a new newsletter, with a new name, and a new publication schedule soon coming to you on Mondays! As previously announced, HCA is changing our newsletter publication schedule, name and design. The revamped newsletter will first come to you on September 12, a Monday, which is our new publication day. (We won’t be publishing a newsletter during the Labor Day holiday week of September 5 to 9, but, as always, will inform you of breaking news with e-mail alerts). We decided to move our newsletter to Mondays because there are so many late-breaking news items that occur on Fridays, and we wanted to give you a chance to start each week with a full digest of all the See ASAP p. 2
HCA’s offices will be closed on Monday, September 5, for Labor Day. We will reopen on September 6.
HCA Meets with DOH on Medicaid Face-to-Face Requirement
September “Emergently” Opens Emergency Preparedness Month
This week, HCA brought together a coalition of HCA and the state’s hospital and physician associations to meet with Andrew Segal, the new Director of the Division of Long Term Care at the state Department of Health (DOH), urging mitigation of the state’s action related to a new
September has opened national emergency preparedness month with true urgency, as the U.S. Eastern seaboard – from Florida to New York – prepares for the potential impact of Hurricane Hermine.
Inside ASAP
See F2F p. 4
This is the Final Edition of ASAP – Ever!................................................1 HCA Meets with DOH on Medicaid F2F.............................................1 September “Emergently” Opens Emergency Preparedness Month........1 Registration Open for HCA Compliance Symposium: Oct. 6.............3 Seagate, HCA Partner on HCA Member Group-Purchasing Savings......6 DOH Establishes Exemptions from 90-Day Billing Requirement…....7 Member Hiring Announcements….....................................................8 OMIG Compliance Guidance Posted..............................................9 HCA Forums Coming for HCC & Upstate LHCSA Members….........9 Media Outreach on BTVH-NY….........................................................11 Naylor Invites Advertising Options in HCA Member Directory......…12 HCA & Partners Plan Sepsis PR, 9/30 Webinar on Screening Tool….13 Sponsors, Exhibitors at HCA Women’s Leadership Summit............14 NYSHealth Launches 2017 Special Projects Fund RFP…..................14 Is Your Agency Interested in Reducing Workers’ Comp. Costs?.......15 Further Court Action Issued on Jimmo Case.....................................15 IMPACT Act Forum and Provider Call Scheduled...............................16 September eMedNY Trainings.........................................................17 NGS Updates....................................................................................18 Publications............................................................................................................18
DOH plans release of preparedness survey for Hurricane Hermine: details expected soon today!
While the full course and the power of Hermine cannot exactly be predicted, the state Department of Health (DOH), in preparation yesterday, See PREPAREDNESS p. 5
Helping New Yorkers Feel Right At Home
ASAP – a publication of the Home Care Association of New York State
Volume 21, No. 31 September 2, 2016
ASAP from p. 1 important home care policy, regulatory, advocacy and education developments from the previous week. The new publication will have a different look but the same commitment to rigorous analysis, advocacy and insightful news. Our newsletter will also have a new name: The Situation Report. We chose this name for several reasons. If you follow cable news shows regularly, you know that the “Situation Room” is where the President and top security or military officials gather to make urgent decisions. Also, the term “situation report” is used in emergency preparedness and military contexts as a medium for keeping stakeholders attuned to an urgent incident or development under active management. We know that the weekly “situation” of home care policy, regulatory and advocacy updates typically come to you with a level of urgency; and your need for this information is often immediate. The stories in our weekly news report to you all concern the financing, compliance, clinical standards, new innovations, novel program designs, and, yes, the emergency preparedness (see related story on page 1) of your organization. This week’s final newsletter title ASAP (a.k.a., “As Soon As Possible”) has long served to convey the immediacy of home care’s information need, engagement and grassroots action. Our new name, The Situation Report, is a
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 Fitz 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 Wilson, Manager, Meeting and Events, bwilson@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
nod to this HCA communications tradition and an extension of our overall purpose in reporting to you on a weekly basis, as we revitalize HCA’s communications offerings. By now, you also have seen some other new communications features, including our twice-per-week HCA News Clips (including one distribution today), which provide links to home care-related stories from blogs, digital media and news websites. We hope these articles interest you and inform you on a different but equally valuable level. If you have any recommendations for how we can improve our outreach to you, don’t hesitate to contact HCA’s Communications Director Roger Noyes at (518) 810-0665 or rnoyes@hcanys.org. We hope you enjoy our new look, name and schedule.
Registration Open for Must-Attend HCA Compliance Symposium: Oct. 6 Registration is now open for HCA’s annual Corporate Compliance Symposium, on October 6 in Albany, a mustattend event that includes presentations from national and state compliance experts helping you to sharpen your knowledge and strategies for identifying risks, addressing them, and developing an ironclad compliance program. Few other organizational priorities require the substantial level of knowledge and action-plan development that comes with the job of compliance manager, a role that runs throughout the work activities of your entire organization. HCA’s Corporate Compliance program is a highly anticipated annual event which brings together the top state and federal regulators (like Medicaid Inspector General Dennis Rosen and staff from the federal Office of the Inspector General), legal experts and organizational compliance consultants. These experts will keep your team up to date on: new requirements, changes in laws and regulations, tools, resources and best-practices for fulfilling your compliance responsibilities. Your compliance officers and senior management need routine training in all of these areas to avoid both financial risk and potential harm to your organization’s reputation and patients. This program gives access to top state and federal government auditors and experts so that your team has the understanding to ensure your compliance program is functioning at the highest level. If you plan on staying over the night before the conference, please note that the deadline for HCA’s room-block at the conference site, the Renaissance Albany Hotel, is September 19. All details and a full agenda are included in the brochure at the link below: http://hca-nys.org/wp-content/uploads/2016/09/HCA-Corporate-Compliance-SymposiumBrochure-2016.pdf. 3
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Volume 21, No. 31 September 2, 2016
F2F from p. 1 Medicaid face-to-face (F2F) requirement for home health services.
As reported in prior editions of ASAP, the U.S. Centers for Medicare and Medicaid Services (CMS) issued a final rule in early February of this year regarding a new physician F2F documentation requirement for Medicaid home health services.
under the Delivery System Reform Incentive Payment (DSRIP) program and value based payments (VBP) and other system changes, including accountable care organizations (ACOs), as a face-to-face requirement runs contrary to the state’s reform efforts which rely on a robust home care system for timely discharges, care transitions and care coordination. In addition, reimbursement under VBP and ACOs and other reform efforts differ from Medicaid fee-for-service payments, which is what the face-to-face requirement is intended to apply to.
The final rule went into effect on July 1, 2016; however, CMS acknowledges that states and providers may need more time. As a result, CMS is delaying compliance for up to one year in states like New York, and possibly two years for those states whose Legislature meets every two years.
HCA also pointed out the multiple problems our home care providers, hospitals, and doctors have encountered with Medicare F2F. Mr. Segal acknowledged and wellunderstood these issues from the Medicare context.
The federal government does not require a F2F for managed care enrollees, but CMS is deferring to states to determine the application of the F2F requirement to managed care. CMS also is not prescribing a specific documentation format, but is allowing states to determine what constitutes appropriate documentation. In addition, personal care services are not subject to the Medicaid F2F requirement, but home health aide services are.
Mr. Segal agreed to bring our concerns and recommendations to DOH leaders.
Our partners represented at the meeting included the Healthcare Association of New York State, Iroquois Healthcare Alliance, and the Medical Society of the State of New York.
HCA has worked strenuously for repeal of the already active F2F rule for Medicare; barring repeal, we seek changes that will simplify the confusing and time-consuming documentation and process issues which have led to payment denials based on confusing requirements for payment. We will continue to advance such efforts and also advance a campaign to ensure that Medicaid F2F is implemented in a feasible and less burdensome way.
Prior to this meeting, HCA has been in close contact with DOH to find out their implementation plans and to advocate exemption of Medicaid F2F wherever possible, such as for managed care. HCA brought together the major stakeholders to meet directly with the responsible DOH staff to share our larger concerns about face-to-face and to urge exemptions wherever possible on DOH’s pending guidance.
HCA thanks DOH for listening to our concerns and our partner associations who joined in our advocacy for limiting the impact of a face-to-face requirement.
At this week’s meeting, HCA advocated that the state should not apply this requirement to patients in managed care, as CMS allows for this exemption.
HCA will keep members informed of any developments on this issue.
HCA also requested that the state consider expanding this exemption to include services provided
For more information, contact the HCA Policy staff. 4
ASAP – a publication of the Home Care Association of New York State PREPAREDNESS from p. 1 issued guidance for health care providers in readying for the possibilities. The New York City Advance Warning System (AWS) also provided its alert and advisory.
Volume 21, No. 31 September 2, 2016
planned in conjunction with DOH and other emergency preparedness partners throughout Emergency Preparedness Month. A sample of these include:
Use of the Preparedness Month theme as a springboard for intensive HCA efforts to garner wide and vocal support for the Governor’s signature of HCA’s “Essential Personnel” legislation for home care and hospice – a bill that was unanimously passed by the State Legislature in June. Governor Cuomo has twice vetoed (on the basis of technical misinterpretations by some localities) this critically important legislation that is designed to ensure home care and hospice patients have access to care in emergencies. HCA will especially use this September theme period to also target and ensure clarification of any misreads or concerns over the implementation of this legislation.
Convening of a special workgroup of DOH, HCA, the New York State Association of Health Care Providers (HCP) and home care agencies to compile a provider toolkit to assist home care patients and families in emergency preparedness.
Psychological First Aid (PFA) training sessions for providers; HCA has been serving on the project committee for the statewide PFA initiative being led by the University at Albany School of Public Health.
Preparations and provider recruitment this month for a major Western and Central New York emergency drill and exercise known as “WRECKIT” which will involve hospitals, the emergency management system and home care, and will “unfold” in a simulated severe weather “emergency” over a week at the end of October/ November. (HCA has been working with DOH officials on the planning and preparations for announcement and kickoff this month.)
Plans and announcements for local emergency preparedness networking sessions jointly
The DOH guidance can be accessed on the Health Commerce System (HCS) at: https:// commerce.health.state.ny.us/hpn/ctrldocs/ alrtview/postings/Notification_20862.pdf. The NYC AWS can be accessed at http://hcanys.org/wp-content/uploads/2016/09/ September-1-NYC-AWS-Hermine.pdf. Organizations that serve people with disabilities or access and functional needs can register for AWS Alerts at: https:// advancewarningsystemnyc.org/. Be sure your HCS emergency contact information is accurate and updated Providers and MLTC plans are reminded that it is critical for you to ensure your contact principals and information are accurate and updated in your organization’s HCS account, especially your emergency contacts, as the HCS is a main avenue for emergency management leaders to reach the provider community with “situation reports” and potential reporting requirements as developments unfold. September “Aware Prepare” issued DOH has issued its September Aware Prepare document. This publication is full of important information, activities and announcements relevant to emergency preparedness for this month ahead. Providers and MLTCs can access this document at http://hca-nys.org/wpcontent/uploads/2016/09/ 2016_September_AP.pdf. Exercises, training, more information on the way for Emergency Preparedness Month HCA will be providing you with further information on a full slate of emergency preparedness guidance, activities and exercises 5
ASAP – a publication of the Home Care Association of New York State
conducted by HCA and HCP for home care agencies, hospices, county offices of emergency management and local public health offices; these encompass the next phase of sessions HCA and HCP conducted in 17 counties in the Western New York region in April. Phase 2 will involve 17 counties in the broader Capital Region, from the Schoharie Valley to the Canadian Border. The plan is to methodically convene these sessions across the entire state.
Health Emergency Preparedness Coalition meetings being conducted across the state, and Regional Training Center education offerings for providers and emergency managers.
HCA is a collaborating partner to DOH and health care associations across the continuum in supporting the operation of New York’s emergency preparedness system and coordinating and serving as informational conduit and advocate for the home and community based care community. Our Primer document on emergency preparedness, which helps inform key participants in the emergency preparedness and response process about home care preparedness, can be accessed at http://hca-nys.org/wpcontent/uploads/2016/09/EPPrimer.pdf. We encourage you to print it (the publication is formatted for bifold printing) and distribute it to your local managers and key health system partners. Please contact HCA with questions, comments and ideas.
Volume 21, No. 31 September 2, 2016
Seagate Alliance Partners with HCA for Group-Purchasing Discounts to Members Rochester-based Seagate Alliance is partnering with HCA to provide HCA members with group-purchasing discounts and one-stop-shopping for supplies. A representative from Seagate will address members at our upcoming Senior and Financial Manager’s Retreat, on September 8 to 9, and executive level members at HCA agencies can expect to receive a communication from Seagate in the near future about this unique grouppurchasing arrangement. Seagate is a membership organization that includes facilities across the continuum of health care. Seagate Alliance is an owner of Premier, Inc., one of the largest health care purchasing alliances in the country. Seagate members have joined together to collaborate and develop contracts and service agreements that have significantly reduced their membership supply chain and labor costs. Seagate works with various suppliers that include medical supply manufacturers and distributors, office supply companies, cell phone, IT vendors, and much more. They will analyze existing agreements and develop a customized member service plan to fit your specialized agency requirements. HCA-member HCR Home Care has been working with Seagate Alliance and has experienced the benefits of the membership. “Since we started working with Seagate Alliance in 2013, we have experienced a noticeable reduction in our perpatient medical supply expenses,” said Elizabeth Zicari, HCR President and HCA Board Member. “We continue to see significant savings on a per-item basis compared to what we were paying prior to engaging their services. They’ve been a great partner and we look forward to continuing our relationship as we strive to provide best-inclass care for our patients.” Seagate will be reaching out to introduce their organization in the coming weeks. Please consider having a conversation with them to see how they may be able to help your organization’s bottom line, or meet their representative at HCA’s upcoming Senior and Financial Manager’s Retreat. 6
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DOH Establishes HCA-Advocated Exemptions from 90-Day Billing Requirement Change makes billing requirements consistent with recently-extended physician-order deadline As reported in an e-mail alert earlier this week, the August Medicaid Update includes an article referencing a long-anticipated change in the home care billing requirements under Medicaid fee-for-service, making them consistent with recent extensions to the physician-order deadlines for home care. (See p. 7 here: http:// www.health.ny.gov/health_care/medicaid/program/update/2016/aug16_mu.pdf.) Both changes (physician-orders and billing) were long sought by HCA which worked hard for their consideration. The first of these changes, permitting agencies more time (up to a year) to obtain signed orders, was announced in a May 4 Dear Administrator Letter (at http://hca-nys.org/wp-content/uploads/2016/05/DAL_PhysicianOrders-for-Home-Care_5-5-16.pdf ). Previously, agencies had to obtain the signed orders within 30 days after admission to the agency, or prior to billing, whichever was sooner. (We note that this timeframe change applies to written signatures based on verbal orders, but does not affect the requirements to obtain orders or the frequencies by which they must be reviewed and/or revised.) At the time of this physician-order change, in May, DOH indicated that it would also change the 90-day limit for submitting home care claims when delays are attributable to the timing of physician signatures. This 90day time period conflicted with the now-extended deadline for physician orders, given that the physician orders (obtainable within one year) are required, first, in order to bill (within 90 days). “In order to accommodate the provisions of the revised regulation, the 90-day timely filing requirement found in NYCRR Title 10, Section 540.6 has been extended to exempt appropriately submitted home care claims from certain timely filing edit denials,” the Medicaid Update article states. “Home care providers must submit their claims within 30 days of the date of the signed physician order. No Delay Reason Code should be included with these claims.” This change makes it clear that home care providers do not have to submit home care claims within 90 days of the service date, with the additional time intended to align with the revised deadline to obtain physician orders (within one year). However, DOH’s article stresses that once home care providers receive the signed physician order (for example, it could be 6 or 7 months from the last date of service), they will have 30 days from the date of the physician order to submit their claim to Medicaid, as specified in the excerpt above. The Medicaid Update article also establishes the following details:
In cases where a claim is returned to a provider due to data insufficiency or claiming errors (rejected or denied), it must be corrected and resubmitted within 60 days of the date of notification to the provider. Claims not correctly resubmitted within 60 days, or those continuing to not be payable after the second resubmission, are neither valid nor enforceable.
All claims must be finally submitted to the fiscal agent and be payable within two years from the date the care, services or supplies were furnished in order to be valid and enforceable. (The two-year timeframe would apply in cases where there is a dispute over the claim or a delayed reason code is challenged by DOH.) 7
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HIRING Essex County Dept. of Public Health’s Certified Home Health Agency (CHHA) HIRING: DIRECTOR OF PATIENT SERVICES Essex County Nursing Services, Elizabethtown, New York, located in the heart of the Adirondacks is seeking an experienced individual who has the will and determination to successfully lead the agency in today’s home health care environment. This position involves planning, organizing, directing, coordinating and evaluating patient care services provided by the certified home health agency. The Director of Patient Services is responsible for the professional and financial operations of the agency; provides and ensures that quality improvement is the main focus of the agency. MINIMUM QUALIFICATIONS: A Masters or Baccalaureate Degree in Nursing from an approved program, or from a nonapproved program supplemented by content which can be equated to an approved program, and either: A) Two years of experience in a management level position in a certified home health agency; or B) A combination of education and experience which is deemed equivalent to the experience requirement as specified in (a) by the State Office of Health Systems Management. BENEFITS: Excellent county/government benefits including New York State Retirement System. Great team of professionals to work with. Candidates must possess a limited permit to practice or licensure and current registration to practice as a Registered Professional Nurse in New York State at the time of appointment. LAST DATE TO FILE FOR PROVISIONAL APPOINTMENT IS SEPTEMBER 14, 2016. Qualified candidates will be subject to a civil service examination to be announced at a later date. Applications will be accepted until the announced closing date for the examination. Please go to www.co.essex.ny.us/job.asp to complete an application and to view a complete job description.
Director of Patient Services – Full Time Living Resources Certified Home Health Agency in Albany is growing and we are seeking a dynamic leader to fill this pivotal position. This position is responsible for overall strategic, clinical, operational and financial leadership to the CHHA and ensures high quality, cost effective care. This individual will work in collaboration with the Living Resources Corporation’s CEO and Associate Executive Director to ensure the integrity of the agency in accordance with the goals and objectives of the agency as set forth by the Board of Directors. Qualifications: Current RN license, required Bachelor’s degree, Master’s degree preferred; minimum of three years of management experience in home health care or related field. For immediate consideration, please forward résumé/cover letter and salary requirements in confidence to Lisa Razanousky at lrazanousky@livingresources.org. Additional opportunities available: Clinical Manager, RNs, Physical Therapists, Occupational Therapists, Home Health Aides and PCAs.
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Compliance Guidance Posted by OMIG The state Office of the Medicaid Inspector General (OMIG) has posted on its website OMIG Compliance Guidance 2016-01. It requires that the Certifying Official on certifications of Medicaid providers’ compliance programs must be the person to whom the Compliance Officer reports on the activities of the compliance program. This eliminates the previous direction by OMIG that only recommended that the Certifying Official be someone to whom the Compliance Officer reports. The guidance also states that the Certifying Official and the Compliance Officer not be the same person for a provider. Additionally, the Certifying Official should be one of the following: 1. The required provider’s chief executive (e.g., Chief Executive Officer, most senior administrator, owner, etc.); 2. A senior administrator of the required provider formally designated by the chief executive to whom the Compliance Officer reports (e.g., Chief Operating Officer, Vice President or other officer level staff, etc.); 3. A member of the required provider’s governing body to whom the Compliance Officer periodically reports (e.g., chair of the board’s Compliance Committee, board chair, etc.). Directions on the certification form to reflect this new direction will be made when the certification form is updated starting on December 1, 2016. OMIG Compliance Guidance 2016-01 is available at: http://on.ny.gov/2c3OTUS. Questions about this guidance or any or any OMIG compliance matter can be directed to OMIG’s Bureau of Compliance at (518) 408-0401 or compliance@omig.ny.gov.
Upcoming HCA Member Forums for HCC and Upstate LHCSA Providers on Sept. 19 & 20 HCA has two member forums coming up for Home Care Council (HCC) of HCA members and our upstate LHCSA members. These forums are a benefit of your membership in HCA and they address issues of direct impact or importance to your agency type. (If you are not an HCA member and would like to join HCA so you can take part in these and other benefits, please contact HCA’s Membership Director Laura Constable at lconstable@hcanys.org.) A light breakfast will be provided at both forums. The HCC Member Forum is on September 19 from 10 a.m. to 12:30 p.m. at the Hunter College Brookdale Campus in New York City. It is geared for home-attendant agencies in New York City who were previously members of the Home Care Council. Continued on next page 9
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Continued from previous page The Upstate LHCSA Forum is on September 20 from 10 a.m. to 12:30 p.m. at the Mohawk Valley Health System Community Room in Utica, NY. These Forums are led by HCA’s Policy and leadership team. For the HCC Forum, we’ll be delving into such issues as:
HRA update on contracts and other important topics;
Current issues with billing and receivables;
Quality Incentive Vital Access Provider Pool (QIVAPP) final awards;
Fair Labor Standards Act (FLSA) funding and DOH survey;
Minimum wage increase and funding for home care providers;
Other policy changes; and
Education programs.
The Upstate LHCSA Forum will address:
Companionship exemption changes;
FLSA funding and state survey;
CDPAP;
State and federal legislative developments;
Minimum wage increase and state funding;
DOH regulatory changes (physician orders, LTHHCP status and others);
DSRIP and value based payment; and
Issues in your region
Participation in HCA Member Forums gives you an opportunity to interact with HCA staff and members, and exchange valuable information with your colleagues. As always, members are welcome to bring any issues of concern to the HCA team at these forums so we can troubleshoot or advocate on your behalf. You can register for each respective forum by downloading the registration forms at the links below and sending them to HCA.
HCC Forum: http://hca-nys.org/wp-content/uploads/2016/08/HCC-Forum-9-19-16Registration-Form.pdf
Upstate LHCSA Forum: http://hca-nys.org/wp-content/uploads/2016/08/HCA-UpstateLHCSA-Forum-September-20-Registration-Form.pdf
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Media Outreach on BTVH-NY: New Op-Ed by HCA Board Member Zicari, Crain’s Interview with HCA, Selfhelp HCA and members have begun working the media angle on our Bring The Vote Home-New York campaign, and we hope you can join us. Over the past weekend, HCA Board Member Elizabeth Zicari had an op-ed published in the Rochester Democrat and Chronicle newspaper about the work her organization is doing to participate in Bring The Vote Home-NY. Ms. Zicari is President of HCR Home Care. “During this year’s presidential election season, we hear a lot about voter turnout, polls, and voter registration issues, but one important constituency demands attention: the 400,000 elderly, chronically ill, and persons with disabilities in New York state who receive home care services,” Ms. Zicari writes. “Many of these individuals are homebound, meaning they have difficulty getting to the polls on Election Day. Others have life-limiting illnesses or disabilities that hinder their access to election sites because of transportation issues or the incredibly taxing effort it takes to leave home – access issues that many of us take for granted.” “But caregivers around New York are stepping in to help, including HCR Home Care,” she adds. “Our agency and colleagues are engaging in a new nationwide campaign called Bring The Vote Home. This campaign is delivering voter registration and ballot materials to thousands of home care patients as part of an outreach initiative designed to reach this unique and especially vulnerable population.” You can read her op-ed online at http://www.democratandchronicle.com/story/opinion/guest-column/ 2016/08/27/campaigning-help-make-voting-easier-patients/89462544/. On Tuesday, HCA also sent out a press release to select media contacts about Bring The Vote Home-NY. The press release is posted to the press release section of HCA’s website (at http://hca-nys.org/category/ press-releases) and it draws attention to the work that home care agencies are doing to deliver thousands of voter materials to patients. The press release was picked up by Crain’s Health Pulse today, who interviewed HCA President Joanne Cunningham and one of our active campaign participants in New York City: Selfhelp Community Services. As Selfhelp told Crain’s, its “agency is asking its 1,800 home care clients in New York City and Nassau County about their registration status and informing them how they can sign up to receive a recurring absentee ballot for every election.” Sandy Myers, Director of Government and external relations at Selfhelp, explained the value of the campaign: “It’s a way to empower people who otherwise don’t have their voices heard in the voting booth to participate in the process,” she said. Continued on next page 11
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Continued from previous page HCA extends thanks to Selfhelp and HCR for helping to spread the word. We encourage all members to read our press release and share it with your local media with a note about your organization’s work on Bring The Vote Home-NY. Are You In? If you are not yet participating in this important campaign, we hope that this media opportunity gives you a good reason to take part. Time is running out, and we need as many agencies as possible to begin the process of orienting their staff so they can supply patients with voting materials well before the fall deadlines to register to vote and obtain an absentee ballot. As you can see, Bring The Vote Home-NY offers an opportunity for you to show the good work you are doing in the community: Delivering vital home care services, yes, but also helping patients in other ways. Your participation in Bring The Vote Home-NY gives you a new angle to talk about your agency and its overall role in community work. If you need assistance with any press outreach on Bring The Vote Home-NY, or further information about the campaign, please contact HCA’s Communications Director Roger Noyes at rnoyes@hcanys.org or (518) 810-0665. More information, including a video and background are available on our Bring The Vote Home-NY website at www.bringthevotehomeny.org.
Naylor Advertising Option in HCA Membership Directory Offers you Exposure to Discharge Planners and Care Managers Options are in addition to free member listing By now, HCA members may have received a notice about advertising options for our Membership Directory and Reference Guide. This guide is produced each year as a publishing arrangement between HCA and Naylor Associate Solutions. Once published, the guide will be sent to discharge planners, local districts and other case managers as a special member marketing benefit, listing all HCA member home care agencies, free of charge, so that referral sources know where to turn to arrange for home care services with your agency. Your agency will be listed by geographic region in alphabetical order, with contact information and a listing of the services you provide, based on the information HCA has on file for you, so that key case managers and referral sources can reach you. The guide will be published and circulated in late November. In addition to your free agency listing, HCA and Naylor are offering some options for home care agencies to promote their brand even further among referral sources with full-color advertisements in the guide, targeted to your region of the state. We encourage members to review the options for additional exposure by reviewing the advertisement selection form. If you have not received this form yet, you can download it from HCA’s website at http://hca-nys.org/wpcontent/uploads/2016/08/HCNR0017PDischargePlannerGuide.pdf. The deadline to reserve an ad is September 29, 2016. For questions about the guide, please contact Naylor’s Ashley Benton at abenton@naylor.com or HCA’s Membership Director Laura Constable at (518) 810-0660 or lconstable@hcanys.org. 12
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HCA and Partners Engage in PR Campaign on Sepsis, Plan Sept. 30 Webinar on Sepsis Screening Tool HCA this week joined quality improvement experts from IPRO in the first of a series of PR efforts aimed at raising public awareness of the sepsis crisis and the role that home care can play in tackling it. We will also be soon announcing registration for a series of webinars highlighting a sepsis screening tool – developed by the HCA Quality committee in conjunction with national medical experts – that home care clinicians can use to assess sepsis risk in patients at home and then intervene accordingly.
From left: HCA Executive V ice President Al Cardillo; IPRO's Director of Health Care Quality Improvement Sara Butterfield; and IPRO Quality Improvement Specialist Eve Bankert discuss sepsis prevention and intervention with radio news host Diane Donato. (Photo courtesy of Carolyn Snedeker, IPRO Quality Improvement Specialist).
On the PR front, HCA Executive Vice President Al Cardillo, IPRO Senior Director of Health Care Quality Improvement Sara Butterfield, and IPRO Quality Improvement Specialist Eve Bankert recorded an interview on Wednesday with radio news host Diane Donato for her program “Upstate Issues.” The program is broadcast on several iHeart radio outlets in the Capital Region, including WGY 810 AM and 103.1 FM. Though the interview was scheduled a few weeks ago, it followed a major media campaign last week by the U.S. Centers for Disease Control and Prevention (CDC) highlighting the enormous risk of sepsis and the fact that as much as 80 percent of sepsis cases occur in community settings, further substantiating the need for a robust home care response to the crises. (HCA members may have seen some news stories on this issue in our HCA News Clips this past week.) During the interview, HCA and IPRO discussed the sepsis risk factors, signs and symptoms, mortality rates and other incidence data, as well as HCA’s efforts with IPRO to pilot an HCA screening tool that home care providers can use to identify and intervene in combatting this public health crisis, which is the number-one driver of Medicare hospital readmissions in New York State. HCA expects the segment will air later in September, and we have several other PR efforts underway to highlight sepsis action and response during National Sepsis Awareness Month in September. September 30 webinar on sepsis screening tool HCA is also soon announcing registration for a September 30 webinar for home care providers that will provide an overview of sepsis and the HCA home care screening tool recently piloted by IPRO as part of its 13
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federal sepsis intervention project. (HCA and the National Sepsis Alliance are partners to IPRO on the federal pilot.) The webinar will include CDC and other officials supporting the launch of this first-in-thenation sepsis screening tool for home care developed by HCA. Two additional webinars are in the works, dealing with agency adoption and integration of the tool into electronic health records (EHRs), and a train-the-trainer session. Please stay tuned for additional information on our PR efforts and registration links for the upcoming training sessions, with details announced in an upcoming alert to the membership.
Check Out Our Sponsors and Exhibitors at HCA Women in Healthcare Leadership Summit: Register Today! HCA’s Women in Healthcare Leadership Summit, on September 28-29 in Saratoga Springs, is HCA’s firstever program geared for all of the exceptional women leaders in healthcare, and we have a world-class lineup of speakers offering skills in communications, negotiations, networking and other tools designed to support women in their healthcare leadership careers. This week, HCA posted a list of sponsors and exhibitors supporting our conference, including several vendors who will be on-site as part of our Women’s Health Mini-Expo at the summit. This fun showcase includes an array of fashion, lifestyle, and health & wellness opportunities (make-up, chair massages, product demos and more). Plus, FREE for all attendees, we are offering an Executive Headshot Station for you to get a professional photo to use on your C.V. or networking platforms! Sponsor and exhibitor information, registration options and more are all posted on our website at http://hcanys.org/general-news/hcas-first-ever-women-in-healthcare-leadership-summit-sept-28-29-in-saratoga. Be on the lookout next week for a special message from HCA President Joanne Cunningham on the summit and why you should plan on attending.
NYSHealth Launches 2017 Special Projects Fund Request for Proposals The New York State Health Foundation (NYSHealth) 2017 Special Projects Fund Request for Proposals (RFP) is now available (see http://tinyurl.com/jbbrsxb). Applicants must submit an online inquiry form to determine whether a proposed project fits the funding criteria. There are two funding cycles for the Special Projects Fund. Deadlines for the online inquiry form are September 27, 2016 and March 15, 2017. Selected organizations will be invited to submit full proposals, with deadlines of November 18, 2016 and May 17, 2017. NYSHealth Special Projects Fund awards are one-time, nonrenewable funding opportunities consistent with the Foundation’s mission to improve the health of all New Yorkers but outside of its main priority areas. Eligible projects are coordinated interventions that take place over a specified period of time to achieve quantifiable results. Under the Special Projects Fund, the Foundation gives preference to projects that: help 14
ASAP – a publication of the Home Care Association of New York State low-income and elderly consumers understand and navigate the health system; improve access to health care in service areas with acute shortages; improve quality in measurable ways; support and strengthen safety-net providers to reach more people; and address statewide health system issues that could improve the efficiency or effectiveness of the system.
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Is Your Agency Interested in Reducing Workers’ Compensation Costs? Presumably the answer is a resounding yes! Please reserve your seat today at the next session in our Home Care Survival Bootcamp Education Series: Addressing Factors that Increase Workers’ Compensation Costs and Developing Ways that Home Care Providers Can Reduce Their Expenses.
Further Court Action Issued on Jimmo Case On August 17, the U.S. District Court for the District of Vermont issued an Opinion and Order related to a prior court case, Jimmo v. Burwell, with implications for the Medicare home health benefit.
This session will be held on September 28 from 9:30 a.m. to noon at 130 East 59th St., 7th Floor (near Lexington Ave.), New York, NY 10022. 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.
The Opinion and Order is at http:// www.medicareadvocacy.org/wp-content/ uploads/2016/08/Jimmo-2.pdf. The court decided that U.S. Department of Health and Human Services must provide additional education about the issues decided in the Jimmo case, but does not have to make further revisions to the Medicare Benefit Policy Manual than it had previously done in response to the case.
By developing a cohesive Workers’ Compensation risk-management strategy, home care agencies can play an active role in reducing their costs. Learn from an insurance industry expert with the Reis Group about pricing issues and the need to understand how insurance companies and their agents decide these issues.
The Jimmo court case challenged Medicare’s use of an “improvement standard” in determining medical necessity for skilled services provided at home, in nursing homes and in outpatient settings, on the grounds that this standard violated Medicare law and deprived Medicare beneficiaries of needed care.
When it comes to Workers’ Compensation, in particular, the goal is to help employers understand what the insurance underwriters are doing, why they’re doing it, and how they’re doing it, so that your agency can leverage that information to positively impact your bottom line.
Under the settlement, the U.S. Centers for Medicare and Medicaid Services (CMS) agreed to revise its Medicare manuals to clarify that home health and skilled nursing facility “coverage of nursing care does not turn on the presence or absence of an individual’s potential for improvement from the nursing care, but rather on the beneficiary’s need for skilled care.” Furthermore, skilled care may be necessary to
To register, please download the brochure at http://hca-nys.org/wp-content/uploads/ 2016/06/Sept-28-Survival-Bootcamp-WorkComp-Costs-and-Expense-Reduction.pdf. 15
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improve a patient’s current condition, to maintain the patient’s current condition, or to prevent or slow further deterioration of the patient’s condition. Also, CMS agreed to engage in certain educational activities to implement the Medicare manual changes and to educate stakeholders regarding the “maintenance coverage” standard. The plaintiffs’ asserted that CMS had not adequately revised the Medicare manuals to reflect the maintenance coverage standard and that CMS’s educational campaign was “deficient,” prompting a return to court to seek further action. In particular, the plaintiffs took issue with Medicare manual section 40.1.2.1 that includes a reference to skilled observation services being covered for three weeks (“three-week rule”), and another section that seems to preclude observation and assessment to address a long standing pattern of a patient’s condition, particularly when the treatment plan does not require changes to meet the patient’s needs or maintain his or her condition. The court did not agree that CMS violated the Settlement Agreement by failing to revise these Medicare manual provisions, but did find that some of the information in CMS’s educational campaign was “inaccurate, nonresponsive, and failed to reflect the maintenance coverage standard.” As a result, the court required CMS to propose corrective action on its educational campaign within 45 days of the order. HCA will keep members advised of any actions taken by CMS to comply with this court decision related to further education.
IMPACT Act Forum and Provider Call Scheduled The U.S. Centers for Medicare and Medicaid Services (CMS) will hold a Special Open Door Forum on “The IMPACT Act and Improving Care Coordination” on September 15 from 2 to 3 p.m., and a National Provider Call on October 13, 2016, from 1:30 to 3 p.m. Open Door Forum Details The September 15 Forum will provide information and solicit feedback pertaining to the Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act). As previously reported, the IMPACT Act mandates the standardization of patient assessment data across post-acute care settings including skilled nursing facilities, home health agencies, inpatient rehabilitation facilities, and long term care hospitals in order to improve quality of care and quality of life. This Forum will offer discussion on the goals of the IMPACT Act, the expected outcomes of the Act, and potential roles post-acute care providers can play in improving coordinated care. Question, comments, and ideas can be submitted to: PACQualityInitiative@cms.hhs.gov. Click here for the presentation: http://tinyurl.com/hgc7cbw. The participant dial-in number is 1-800-837-1935; the Conference ID no. is 74951666. Continued on next page 16
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Continued from previous page A transcript and audio recording will be posted to the Special Open Door Forum website at http:// www.cms.gov/OpenDoorForums/05_ODF_SpecialODF.asp (under the “downloads” section) as well as on the IMPACT Act Downloads and Videos webpage: http://tinyurl.com/hn6mqmn. National Provider Call CMS’s National Provider Call for home health agencies and other post-acute care providers will discuss the IMPACT Act and how data elements fit within measure development, how information from assessment instruments is used to calculate quality measures, and examples of the process using the Pressure Ulcer measure. To register or for more information, visit https://blh.ier.intercall.com/details/ b745cb4472bb40018189a1da9077eeee.
September eMedNY Trainings eMedNY has announced its September training programs. Some of the topics include:
ePACES for Dental, DME, Institutional, Professional (Real-Time), Physicians, Private Duty Nursing, and Transportation
ePACES COB Billing for Professional and Clinics
New Provider/ New Biller
Medicaid Eligibility Verification Systems (MEVS)
eMedNY training seminars are being held at the following locations:
Binghamton
Canandaigua
Hauppauge
Plattsburgh
New York City
Poughkeepsie
Rensselaer
eMedNY also offers webinars; information for all programs is at https://www.emedny.org/training/index.aspx.
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NGS Updates New York’s Medicare Administrative Contractor (MAC), National Government Services (NGS), has posted the following news to its website:
Update to IVR System – NGS’s Interactive Voice Response (IVR) system now provides the National Provider Identifier (NPI) of the home health or hospice if there is an overlapping home health episode or hospice election for the date of service in question. Providers no longer need to speak with a live customer care representative to obtain this information. This information is available within the Eligibility feature by just saying “Eligibility” or pressing 1 and authenticating one’s provider information and the beneficiary information.
Reminder When Billing Third Party Liability Demand Claims – Home health agencies are reminded that all requests for anticipated payment (RAPs) and claims, including those billed under Third Party Liability (TPL) guidelines, must be submitted to Medicare within one calendar year of the episode end date. Any RAP billed past the timely filing limit will reject as untimely in the claims processing system. Untimely RAP billing may cause an issue with the TPL demand claim processing; therefore, both the RAP and the claim for the TPL demand episode must be in the system as a clean claim submission within one calendar year of the episode end date.
Additional CERT Information Now Available – The Comprehensive Error Rate Testing (CERT) Documentation office recently published documentation reference lists based on provider and billing types. The provider and billing types are listed alphabetically. Providers can view and print the documentation listing(s). The documentation listings will be updated when changes are approved. If printing, providers should refer to the CERT Provider Website to confirm the current listing. The documents are available in both English and Spanish. The lists also include medical record documentation that may be needed to support services billed to Medicare. Providers submitting documentation via CD should send the password to CERTMAIL@livanta.com; use the CID number in the subject line of your e-mail. The available lists can be found on the CERT Provider website at: https://www.certprovider.com/ ProviderDocumentationRequestListing.aspx.
For further information, contact Patrick Conole at (518) 810-0661 or pconole@hcanys.org.
Publications
“Caring for America’s Seniors: The Value of Home Care,” by the Home Care Association of America and the Global Coalition on Aging https://www.homewatchcaregivers.com/docs/default-source/default-document-library/valueof-home-care-report-4-17-2016—hcaoa.pdf?sfvrsn=2
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“Medicaid Eligibility Verification System (MEVS) and Dispensing Validation System (DVS) Provider Manual (August 2016),” by eMedNY https://www.emedny.org/ProviderManuals/5010/MEVS/ MEVS_DVS_Provider_Manual_(5010).pdf
“Realizing the potential of telehealth: Federal and state policy is evolving to support telehealth in value-based care models,” by the Deloitte Center for Health Solutions and the Deloitte Center for Regulatory Strategy http://www2.deloitte.com/us/en/pages/life-sciences-and-health-care/articles/telehealth-policybrief.html?id=us:2em:3na:chs3327:awa:chs:081716
For more information, contact Andrew Koski at (518) 810-0662 or akoski@hcanys.org.
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