BUDGET
MLTC
MARKETING
EDUCATION
The State Budget is coming on Tuesday and HCA has a briefing for you on Jan. 20. Please also come to our Feb. 6 & 7 State Advocacy Program.
Gain the latest updates about the MLTC enrollment numbers and other MLTC developments.
Would your organization like to gain exposure by sponsoring or exhibiting? Read our 2017 Marketing Prospectus for details.
HCA has a bunch of forums, webinars, conferences and education programs coming up. Check out our latest round-up.
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COMING UP State Budget Conference Call Jan. 20, 2017 10 a.m. to noon Downstate LHCSA Forum in NYC Jan. 30, 2017 10 a.m. to 2 p.m. Selfhelp Family Home Care, Inc. 520 Eighth Avenue, 5th Floor New York, NY 10018 State Advocacy Day and PAC Reception Feb. 6-7, 2017 Albany, NY Feb. 6: PAC reception at HCA’s offices Feb. 7: HCA Board Meeting and appointments with legislators
Your Source for HOME CARE News, Policy and Advocacy
Vol. 2, Issue 3 | January 16, 2017
An Important Advocacy Message from HCA President Joanne Cunningham Governor’s state budget proposal next week, HCA state advocacy program (on Feb. 6 & 7), and industry survey all command attention On Tuesday, Governor Cuomo is releasing his 2017-18 executive budget. This process formally commences a busy time in Albany, with major uncertainty, possible risk, as well as opportunity for home care. We’ll be working throughout the week to prepare a written analysis of the budget, but we have already scheduled a free statewide conference call that we encourage you to attend and hear from HCA about the budget provisions that impact you. The call is on Friday, January 20, from 10 to 11 a.m. You can register for this members-only call at https://www.surveymonkey.com/r/2017StateBudget, and HCA will send you dial-in information next week.
INSIDE An Important Advocacy Message.............................................................…1 Update on 2015-16 QIVAPP Monies..........................................................…3 Important Deadlines and Due Dates........................................................…4 CMS Finalizes 2014 Rule Updating Home Health CoPs..............................…5 DOH Convenes MLTCs & Representatives for Policy Update......................…6
See ADVOCACY p. 2
NGS to Begin Round 2 of Probe-and-Educate Audit on Jan. 19….....................8 DSRIP Mid-Point Assessment Public Comment Day and PAOP Meeting….......9 Arguments Held on Andryeyeva Case….......................................................9 Market Your Brand, Services and Products with HCA in 2017.......................11 Take Advantage of Provider Forums, Education Sessions in Early 2017…....12 CMS Call Next Week on Home Health Grouping Model, Star Ratings….........15 Resources........................................................................................................…15
The Situation Report: the Home Care Association of New York State ADVOCACY from p. 1 In recent years, the state budget process has increasingly become a venue not only for financial decisions but also policy and programmatic ones. More so than in past cycles, the first few months of the year are a critical opportunity for HCA to get our priorities advanced while working vigorously to overcome a cascade of new challenges presented by the budget process, all within a very brief window of time. The budget deadline is April 1, but formative work to shape the outcome needs to be made as soon as possible. Aside from possible Medicaid payment changes, regulatory or programmatic challenges in the budget, providers and managed care payors are already distressed by the stilted minimum wage funding roll-out implemented by the state, even after a major push by HCA and other organizations to better define this process. We need to continue making the case for a more sensible distribution process going forward when it comes to expenses across all areas of home care and managed care operations, minimum wage included. This is a core part of our budget advocacy message in 2017. Home care also desperately needs support and flexibility to operate in new models of care. This includes operational safeguards to ensure that new models of care don’t incentivize other entities to step into home care service jurisdictional boundaries. Long-neglected needs for infrastructure investment, workforce support and home care information technology must additionally get addressed. With these needs in mind, HCA has begun the process of analyzing our Home Care Industry Survey to learn more about your experiences. Some of the preliminary findings related to claims-authorization, operating margins, managed care premium incomes and program experiences are concerning. If you have not completed this survey yet, it is absolutely vital that you do so. Please see the alert at http://conta.cc/ 2gLAFGO for instructions. This survey will culminate in a very important report to the Governor and Legislature that will help us advocate on your behalf in the budget, so it is absolutely critical that you complete it. Continued on next page Home Care Association of New York State (HCA) 388 Broadway, 4th Floor, Albany, NY 12207 Tele: 518-426-8764; Fax: 518-426-8788; Website www.hcanys.org
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The Situation Report is a weekly publication of the Home Care Association of New York State (HCA). Unless otherwise noted, all articles appearing in The Situation Report are the property of the Home Care Association of New York State. Reuse of any content within this newsletter requires permission from HCA. Joanne Cunningham HCA President jcunningham@hcanys.org Roger L. Noyes Director of Communications, Editor of The Situation Report rnoyes@hcanys.org Al Cardillo Executive V ice President, Policy & Programs acardillo@hcanys.org Patrick Conole Vice President, Finance & Management pconole@hcanys.org Andrew Koski Vice President, Program, Policy & 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 & Special Projects jkerbein@hcanys.org Billi Wilson Manager, Meetings & Events bwilson@hcanys.org Teresa Brown Administrative Assistant tbrown@hcanys.org
The Situation Report: the Home Care Association of New York State
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Continued from previous page Just as importantly, please also join us for our State Advocacy Program on February 6 and 7, starting with a PAC reception on the evening of February 6 and a full day of legislative meetings on February 7. We previously shared an agenda and registration form with you at http://hca-nys.org/wp-content/uploads/2016/ 12/2017-HCA-Advocacy-Day-Flyer.pdf. Please be sure to schedule appointments with your legislative representatives now for the afternoon of February 7 in Albany, following an important morning session where legislative and executive officials will address the HCA Board and members. (Note: If you are a member of HCA’s Board, we will be scheduling appointments for you.) All of the important information you need is in the flyer at the link above, so please open it, and complete the registration page to let us know you are coming to both the PAC reception and the Advocacy Day program. This is your opportunity to give voice to HCA’s message on behalf of home care during the critical budget negotiations, and to add muscle to our PAC initiatives in the political space. Don’t hesitate to reach any of the HCA staff if you have questions about advocacy logistics. I look forward to seeing you in Albany on February 6 and 7, and discussing the budget with you during next week’s statewide call.
Update on 2015-16 QIVAPP Monies The state Department of Health (DOH) informed HCA on January 6 that MLTC plans should get funding for the Quality Incentive Vital Access Provider Pool/QIVAPP (2015-16) in their payment cycle 2053 (January 11). Plans will then have 30 days to pass on the funds to their eligible home care contractors. Unlike the funding for 2014-15, which was in two payments, the state will be issuing one QIVAPP payment for 2015-16. As reported to members, DOH had earlier decided that the 2015-16 funding ($70 million) would be provided to those found QIVAPP-eligible for 2014-15 and to any additional home care agencies found eligible after submitting documentation. Last September, DOH announced that five additional agencies – which did not receive funding for the 2014-15 period – were qualified to receive QIVAPP for 2015-16. QIVAPP was initially intended to help home care agencies with the added labor costs to provide aide services in New York City that resulted from the state Wage Parity law. However, DOH added restrictive eligibility criteria that limited which agencies qualified during the 2014-15 period, a point that HCA has targeted in our advocacy as being contrary to the program’s intent. HCA has already contacted members eligible for 2015-16 QIVAPP and shared a list of the amounts they should receive from each plan. If you did not get it, please send an e-mail to Andrew Koski at akoski@hcanys.org. The state has not decided yet if there will be QIVAPP funding for 2016-17.
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Important Upcoming Deadlines Requirement Minimum wage increases to: $11 for New York City; $10 for Long Island and Westchester; and $9.70 for rest of the state
Use of OASIS-C2
Effective/ Due Date
More Information
Dec. 31, 2016
http://www.labor.ny.gov/legal/laws/pdf/minim um-wage/19a-amended-rule.pdf
Jan. 1, 2017
https://www.cms.gov/Medicare/QualityInitiatives-Patient-AssessmentInstruments/HomeHealthQualityInits/OASISData-Sets.html
Disenrollment is effective the first day of the month after the month the MA organization receives the disenrollment request.
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Medicare Advantage Disenrollment Period
Jan. 1 to Feb. 14, 2017
Home Care Worker Wage Parity certification forms for CHHAs, LTHHCPs and Managed Care Organizations (MCOs) that serve New York City, Long Island and Westchester
March 1, 2017 (for the period of March 1, 2017 to April 30, 2018)
https://www.health.ny.gov/health_care/medicai d/redesign/mrt_61.htm
Home Care Worker Wage Parity certification forms for LHCSAs that contract with CHHAs, LTHHCPs, or MCOs serving New York City, Long Island and Westchester
March 1, 2017 (for the period of March 1 to May 31, 2017)
https://www.health.ny.gov/health_care/medicai d/redesign/mrt_61.htm
Healthcare Personnel Influenza Vaccination Report for personnel employed from October 1, 2016 to March 31, 2017
May 1, 2017
http://hca-nys.org/wpcontent/uploads/2016/10/ctrlaccamstmpNotific ation_21226.pdf
Medicare home health revised Conditions of Participation
July 13, 2017
https://www.cms.gov/Medicare/Eligibility-andEnrollment/MedicareMangCareEligEnrol/Downl oads/CY_2017_MA_Enrollment_and_Disenroll ment_Guidance_8-25-2016.pdf
https://www.gpo.gov/fdsys/pkg/FR2017-01-13/pdf/2017-00283.pdf
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CMS Finalizes 2014 Rule Updating Home Health Conditions of Participation The U.S. Centers for Medicare and Medicaid Services (CMS) has finalized a rule updating the home health Conditions of Participation (CoPs), providing the most substantial changes since 1989. In October of 2014, CMS proposed the first set of changes to the CoPs. The proposed changes included sweeping new requirements related to patients’ rights, quality reporting and other areas affecting the operation of most home care agencies. Home health agencies must meet the CoPs in order to participate in the Medicare and Medicaid programs. The rule is effective July 13, 2017. According to a CMS press release, the final rule includes: Provisions that enumerate the rights of home health agency patients and the steps that must be taken to assure those rights. An expanded comprehensive patient assessment requirement. A requirement that patients and caregivers are provided written information about upcoming visits, medication instructions, treatments administered, instructions for care that the patient and caregivers perform, and the name and contact information of a home health agency clinical manager. A requirement for an integrated communication system. A requirement for a data-driven, agency-wide quality assessment and performance improvement (QAPI) program. A new infection prevention and control requirement that focuses on the use of standard infection control practices, and patient/caregiver education and teaching. New and revised requirements for the provision of home health aide services. A streamlined skilled professional services requirement. An expanded patient care coordination requirement that makes a licensed clinician responsible for all patient care services, such as coordinating referrals and assuring that plans of care meet each patient’s needs at all times. Revisions to simplify the organizational structure of home health agencies. New personnel qualifications for home health agency administrators and clinical managers. Continued on next page
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Continued from previous page
In our comments on the proposed rule, HCA voiced support for the goal of patient-centered, data-driven, outcome-oriented processes that promote high quality patient care. However, we expressed strong concerns that the proposed changes: Add new and unfunded costs at the very same time that CMS is implementing some of the most dramatic cuts in home health through rebasing; Are in steep conflict with CMS efforts and CMS-approved waivers to New York and other states to enroll Medicaid and dual Medicare-Medicaid patients into managed care; and Pose significant feasibility challenges and resource dislocation of agency staff, particularly given the fragile and already over-stretched status of many New York agencies. HCA policy staff have already reviewed the 300-plus-page rule and will provide the membership with a detailed summary of the rule’s provisions next week. HCA will also be conducting education sessions to assist the membership in understanding the full impact and preparing for these changes. Members can read our October 24, 2014 memo summarizing the proposed rule at http://hca-nys.org/wpcontent/uploads/2015/03/HomeHealthCoPsMemo102413.pdf, as well as our comments on the proposed rule at http://hca-nys.org/wp-content/uploads/2015/03/MedicareCoPsproposedcommentsDec2014.pdf. The final rule can be viewed at the Federal Register website at: https://www.federalregister.gov/publicinspection/current
DOH Convenes MLTCs and Representatives for Policy Update HCA participated in Thursday’s state Department of Health (DOH) Policy and Planning update for MLTCs and MLTC member associations. The updates included statistical, logistical and substantive information. Stats, transitions and stakeholder groups DOH provided updates on MLTC enrollment, as well as the schedule for expanded implementation of the Fully Integrated Dual Advantage (FIDA) program to Suffolk and Westchester, and announced upcoming stakeholder groups pertinent to FIDA, transition of the NHTD and TBI Waiver Programs to managed care, and implementation of the Community First Choice Option within managed care. Details on the latest enrollment numbers, as well as dates and logistics for related stakeholder meeting activity, can be seen in the Department’s meeting slide deck at http://hca-nys.org/wp-content/uploads/ 2017/01/011217policyandplanningmeetingMLTC.pdf. With regard to CFCO, DOH updated MLTCs on the joint MLTC-Mainstream CFCO Workgroup which met on January 5. HCA participated in that workgroup, contributing a good deal of input to the discussion and follow-up plans. (See HCA’s January 9 edition of The Situation Report.) DOH announced that it will be
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establishing an overall implementation steering committee as well as four sub-workgroups to examine provider management, benefit management, clinical management, and the Program of All-Inclusive Care for the Elderly (PACE). The federal government has reportedly given the state a tight, six-month window for implementation. PACE developments & plans DOH indicated keen interest in the Federal “PACE Innovation Act of 2015” and stated its intent to examine all possibilities the Act could give to PACE in New York. Links to further information about the Act and ways to offer comments are contained in the slide deck accessible on page 6 and an article in last week’s edition of The Situation Report. DSRIP & VBP DOH provided an update on the Delivery System Reform Incentive Payment (DSRIP) program. The update encompassed: the overall timeline and key benchmarks; the “Midpoint Assessment”; value based payment milestones; behavioral health integration; member attribution; and other details. Some findings of the Midpoint Assessment were noted by DOH: Governance – Many Performing Provider Systems (PPSs) have developed efficient and effective governance structures to implement the DSRIP initiative. Financial Sustainability and VBP – The Independent Assessor (IA) is recommending that over twothirds of the PPSs implement midpoint assessment action plans related to Financial Stability/ Sustainability and VBP for its provider network. Generally, the IA found that many PPSs have not focused on detailed arrangements for sustainability. Furthermore, the PPSs need to work to educate their partners on their role with VBP in New York Medicaid. Partner Engagement – Most PPSs need to focus their attention and funding to engage key partners. A majority of the PPSs are behind on their Partner Engagement goals at this point in DSRIP. Funds Flow – To date, the project management offices and hospitals have received over 70 percent of DSRIP funds across all PPSs. PPSs will need to fund their network partners at a meaningful level going forward. The PPSs must execute their plans for contracts with their downstream partners to ensure that they maximize engagement across the networks as soon as possible. Further details on the DSRIP midpoint findings, and on the DSRIP update overall, can be viewed at http:// hca-nys.org/wp-content/uploads/2017/01/011217DSRIPMCOupdates.pdf. State Medicaid Director Jason Helgerson emphasized the obligation under the state’s waiver to move 80 to 90 percent of Medicaid managed care payments to VBP, and the Department’s willingness to try to assist associations so that the plans and providers reach this milestone. Associations (such as HCA),
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which have been proactive in fostering education and technical assistance discussions on VBP, were cited by DOH, and all associations were encouraged to pursue and sustain these goals. Mr. Helgerson indicated that a follow-up meeting was in the works (similar to DOH’s December meeting), inviting all statewide associations to discuss ways DOH could assist providers and plans in their VBP efforts. During an open comment period, attendees again underscored the importance of DOH coordination with the state Office of the Medicaid Inspector General (OMIG) on the changing system, and the imperative that OMIG’s assessment and audit of payments and services under the system match with these changes. For further information, please contact Al Cardillo at acardillo@hcanys.org.
NGS to Begin Round 2 of Probe-and-Educate Audit on January 19 National Government Services (NGS), New York’s Medicare Administrative Contractor (MAC), has recently announced on its website that Round 2 of the Home Health “Probe-and-Educate” audit will begin on January 19, 2017. NGS says that all states are included except those actively involved in the Home Health Pre-Claim Review Demonstration. (New York is currently not in this Demonstration, so the exception does not apply to HCA members.) During the “Probe-and-Educate” audits, the appeals process remains the same. This means that providers should not wait for the results letter to appeal. Once a provider has received a denial, it should refer to the remittance advice to calculate the deadline for each claim. Also, the one-on-one education is not a forum for appeal. The Round 2 audits will continue for all states until such a point that the state becomes active in the PreClaim Review Demonstration, says NGS, but no such proposal exists for including New York in the demo. HCA members can find additional information on the “Probe-and-Educate” audits as well as information for responding to ADRs, appeals and other helpful job aids at NGS’s website: www.ngsmedicare.com. NGS Closed for Martin Luther King, Jr. Day NGS also announced that it will be closed Monday, January 16 for the Martin Luther King, Jr. holiday. This includes the Electronic Data Interchange (EDI) Help Desk, Provider Contact Center, Provider Enrollment Line, and Telephone Reopening Unit. Electronic claim files transmitted after 5 p.m. on Friday, January 13 will have a claim receipt date of Tuesday, January 17, 2017. EDI front-end acknowledgement transactions will be created as expected as EDI claim files are received. The Direct Data Entry (DDE) Provider Online System will be available on Friday, during regular hours. While DDE will be available, there will be no support available to respond to any issues. Providers will be able to access NGSConnex and use the Interactive Voice Response (IVR) system at 1-866275-3033. NGS will reopen on Tuesday, January 17 for normal business hours. For further information, contact Patrick Conole at (518) 810-0661 or pconole@hcanys.org.
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DSRIP Mid-Point Assessment Public Comment Day and PAOP Meeting The state Department of Health will hold a public comment day on the Delivery System Reform Incentive Payment (DSRIP) Program Mid-Point Assessment process and its findings on Tuesday, January 31, 2017. The public comment day will be held in Albany from 10:30 a.m. to 5 p.m. in the Swyer Room of The Egg. While no pre-registration is required, anyone wishing to speak needs to sign up at the registration desk by 3 p.m., and each speaker will have 5 minutes. Following this public comment day, the DSRIP Project Approval and Oversight Panel (PAOP) will meet with the DSRIP Performing Provider Systems (PPSs) in Albany at the Empire State Plaza from February 1 through the 3. This is open to the public, but there will be no public comment opportunity. All meetings will be webcast live and the link will be sent out when it becomes available. More information on the Mid-Point Assessment process, timelines, and reports can be found here: http:// www.health.ny.gov/health_care/medicaid/redesign/dsrip/mid-pt_assessment/index.htm.
Arguments Held on Andryeyeva Case Vital home care issues at stake This week, oral argument was held at the Appellate Division, Second Department in the Andryeyeva v. New York Health Care, Inc. case. This case, in which HCA had earlier submitted an amicus brief, will have major ramifications for the delivery of 24-hour/sleep-in home care cases if a lower court’s decision is upheld. In this case, a lower court judge had decided that home attendants working on 24-hour/sleep-in cases must be paid for each hour of the 24-hour shift, also ruling that sleep (eight hours) and meal periods (of up to three hours) cannot be deducted unless the attendant resides in the home of the person who is receiving care. As pointed out in the amicus brief, the lower court’s ruling conflicts with state Department of Labor (DOL) opinions that agencies have depended upon. Those opinions provide that third-party employers of 24-hour care attendants may pay their employees for 13 hours of a 24-hour shift, if the attendant gets eight hours of sleep, five of which are uninterrupted, and three uninterrupted hours for meals. The Littler law firm, who submitted HCA’s amicus brief, attended the oral argument at the Appellate Division. It was not able to argue as amicus curiae, but was able to observe the proceedings. The Littler law firm also provided material for this article. The court scheduled this week’s argument along with an appeal by the plaintiffs in Moreno v. Future Care Health Services, Inc. In that case, the lower court denied plaintiffs’ motion for class certification over plaintiffs’ objections. Both cases have similar issues. In Andryeyeva, the court certified a class action on the basis that the plaintiffs satisfied the requirement of a common policy allowing them to proceed as a class because the employer paid live-in aides only 13 hours of a 24-hour shift, which the court found to be an unlawful policy, making them similarly situated as class members. Continued on next page
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Continued from previous page To the contrary, in Moreno, although the plaintiffs made the same argument, the court denied the motion for class certification, finding that individual inquiries are necessary to determine whether the individual plaintiffs actually slept or took uninterrupted meal breaks and the courrt refused to grant conditional certification of a class based on the policy of paying 13 hours of a 24-hour shift for live-ins. At the heart of the issue is the New York Wage Order stating that “residential” employees (those that reside on the premises of their employer) can be paid 13 hours of a 24-hour shift. The state DOL found there to be no distinction between “residential” and “non-residential” (aides employed by third party agencies) because if an aide is sleeping or on meal break, they are not working and, thus, do not need to be paid for those breaks. The plaintiff’s argument is that the state DOL incorrectly interpreted the Wage Order while the defendants believe the interpretation is correct. The attorney for New York Health Care, Inc. argued various points which we also covered in our amicus brief, such as that the Court should give deference to the state DOL’s 2010 opinion letter and interpretation of the New York Wage Order in which it found that live-ins can be paid 13 hours of a 24-hour shift as long as they get the requisite sleep and meal breaks, regardless of whether they are “residential” or “non-residential.” This attorney explained how the Department of Health does not reimburse for 24-hours of a live-in shift. The presiding judge seemed to understand the argument. However, one judge on the panel did not seem to agree with the argument and asked a lot of questions. The attorney for the plaintiffs (aides) argued next. At one point, the presiding judge asked him whether or not the aide is residential or non-residential, and, if the aide is sleeping or taking a meal break, then isn’t it true that the aide is not working? The attorney argued that if the aide is residential and the aide’s home is on the premises, then the aides have more freedom than a nonresidential aide getting a meal or sleep break and, thus, the non-residential aides should be paid for every hour of a 24-hour shift. Next, the attorneys in the Moreno case made their arguments, which were similar to the Andryeyeva arguments. However, the plaintiffs’ attorney further argued that the agency had no records and, thus, could not dispute the allegations in the complaint that the aides worked through their meal and sleep periods. This, he said, is another reason the live-ins should have been paid for 24-hours of a 13-hour shift. The plaintiffs’ attorney argued that the burden is on the agency to disprove the plaintiff’s allegations and, without records, the agency cannot do that. Therefore, he claimed, the case should have been certified as a class action for that reason in addition to the agency’s policy of paying only 13-hours of a 24-hour shift. The parties were asked if this is an issue of first impression, meaning there is no binding legal precedent, which the parties stated that it is. The panel agreed to review the papers before issuing its decision. We expect a decision will be issued on or before June 2017 when the court goes into summer session. It is possible that the decision comes later. HCA’s annual survey of the home care membership asks questions about 24-hour /live-in cases and your responses would be helpful for our assessment of the impact this court proceeding could have on your operations. HCA will be sharing data from the survey – including on 24-hour/live-in cases – in the coming weeks. For more information, contact Andrew Koski at (518) 810-0662 or akoski@hcanys.org
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Market Your Brand, Services and Products with HCA in 2017 HCA's 2017 Marketing Prospectus is again offering home care vendors, partners, suppliers and consultants with great opportunities for exposure to home care audiences in 2017. If you've sponsored or exhibited with HCA in the past, or if you are looking for new marketing opportunities, please take a moment to browse our 2017 Marketing Prospectus, available online at http://hca-nys.org/ events-education/sponsors-exhibitors. This year, we are once again offering an expanded range of benefits in several sponsorship categories. You can sponsor at six bundled levels (Titanium, Platinum, Gold, Silver, Bronze and Friend). You can also choose from an exciting array of a-la-carte sponsorship options that include advertising, logo placements, opportunities to meet with HCA's Board of Directors, wi-fi sponsorships for providing Internet access at HCA events, and more. Whether you are a technology vendor, a home care business consultant, or a provider organization, we invite you to reinforce your vital partnerships with the home care community by sponsoring and exhibiting at our Annual Conference, other HCA signature events, and through our website, e-mail alerts and in our newsletter. HCA's educational programming is a vital component of HCA's core mission to support and advance New York's home care community. We invite you to play a critical and visible role in helping to make these events possible while garnering valuable exposure for your organization that helps build new and lasting business relationships. To further explore our 2017 marketing opportunities, please contact Billi Wilson, CMP, HCA's Meetings and Events Manager, at (518) 810-0666 or bwilson@hcanys.org.
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Take Advantage of These Provider Forums, Education Sessions, Webinars and Conferences in Early 2017 Registration for these upcoming programs is available on HCA’s website at http://hca-nys.org/eventseducation/upcoming-events. New programs are posted routinely and we have other announcements coming soon, so please be on the lookout for more information and updates.
State Budget Conference Call January 20 10 to 11 a.m. The Governor is releasing his executive state budget proposal on Tuesday and HCA has already scheduled a free member call to brief you on the provisions that impact your organization. This conference call is for members only, but you need to register in advance by completing the form at https://www.surveymonkey.com/r/ 2017StateBudget. HCA will send you the dial-in information next week.
Downstate LHCSA Forum January 30 10 a.m. to 2 p.m. Selfhelp Family Home Care, Inc. 520 Eighth Avenue, 5th Floor New York, NY 10018 HCA announces our Downstate LHCSA Forum which will be held on January 30 in New York City, from 10 a.m. to 2 p.m. All HCA-member LHCSAs are invited to attend this critical forum. Your team will not want to miss this opportunity for faceto-face discussion with the HCA policy team about the latest updates, next steps and exchange of experiences so that we can advocate on your behalf with decision-makers. Some of the vital items to be covered include: Minimum wage increase and funding; Fair Labor Standards Act (FLSA) and Quality Incentive/Vital Access Provider Pool (QIVAPP) monies; Regulatory issues and changes;
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Delivery System Reform Incentive Payment Program (DSRIP) and Value Based Payments; Additional issues or concerns This forum is for HCA members only and is an important benefit of your membership in HCA to gain updates specific to your organization. Please register at http://hca-nys.org/wpcontent/uploads/2017/01/HCA-DownstateLHCSA-Forum-January-30-2017-RegistrationForm.pdf.
HCA State Advocacy Day and PAC Reception February 6-7 Albany, NY The legislative stakes in 2017 are high, as state elected leaders face a possible multibillion-dollar budget shortfall, and as the home care industry confronts major new and ongoing challenges. To navigate this environment in support of home care, we urge you to attend HCA’s Advocacy Day Program and PAC Reception on February 6 and 7 in Albany when we’ll be pressing for payment reforms and program support in 2017. February 6 5-6:30 p.m.: Political Action Committee (PAC) reception at HCA’s offices. Continued on next page
The Situation Report: the Home Care Association of New York State Continued from previous page February 7 8 a.m. to noon: Key legislative committee and conference leaders to meet with HCA’s Board of Directors in the morning (all members are invited to attend) 12:30 to 4 p.m.: Appointments, which you should schedule in advance, to meet with legislators representing your district Download the flyer to register at: http://hca-nys.org/ wp-content/uploads/2016/12/2017-HCA-Advocacy-DayFlyer.pdf.
Hospice Billing: Three-part Webinar Series (Available individually or as a discounted series) January 26 (11:30 a.m. to 1 p.m.) February 7 (11:30 a.m. to 1 p.m.) February 28 (11:30 a.m. to 1 p.m.) Staying current on all hospice Medicare billing regulations can be a challenge. This webinar series will lay a concrete foundation for hospice billers and other hospice staff who need a more comprehensive understanding of the Medicare regulations. Part 1: January 26 Review the eligibility requirements for admitting patient to hospice under Medicare Benefit. Define benefit periods and certification requirements. Detail criteria for billing Hospice Notice of Election. Demonstrate claim requirements for Late Notice of Election. Part 2: February 7 Recap the distinct levels of care and specifics of billing them.
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Volume 2, No. 3 January 16, 2017
Detail criteria for line item billing hospice claims to Medicare, including physician billing. Review detail calculations for Routine Home Care and Service Intensity AddOn. Part 3: February 28 Detail the Face-to-Face requirements. Review hospice aggregate CAP selfreporting requirement. Discuss palliative care reimbursement. Recap HIS documentation impact on reimbursement Download the flyer and register at: http://hcanys.org/wp-content/uploads/2016/12/ Hospice-Billing-Webinar-Series-2017.pdf.
Successfully Acting as a Fiscal Intermediary in the Consumer Directed Personal Assistance Program (CDPAP) March 9, 2017 Mohawk Valley Health System Sogg’s Room (1650 Champlin Avenue) Utica, NY 9:30 a.m. to noon A statewide Medicaid program, CDPAP empowers consumers by giving them flexibility and freedom to choose who provides their care and how it is provided. LHCSAs can participate in this growth by becoming a Fiscal Intermediary (FI). At this morning session, you will get important information about CDPAP, including: consumer eligibility requirements and obligations; the process to become an FI; advantages and disadvantages of LHCSAs serving as FIs;
The Situation Report: the Home Care Association of New York State
requirements and obligations of the FI; policies and procedures; required contracts; wage and hour issues facing FIs; potential risk areas; and best practices of a successful program. This program will be presented by Michael Weiner, a partner in the law firm of Glaser & Weiner, LLP. For more than 20 years, Mr. Weiner has been a trusted advisor to his clients, providing them with practical legal counsel and business advice. LHCSAs are encouraged to participate in this CDPAP program and to stay for the noon Upstate LHCSA Forum (being held at the same location) for an exchange of valuable information, advocacy concerns and recommendations for action (see below). Download the flyer and register at: http://hca-nys.org/ wp-content/uploads/2017/01/HCA-Bootcamp-FiscalIntermediary-CDPAP-March-9-2017.pdf.
Upstate LHCSA Forum March 9, 2017 Mohawk Valley Health System Sogg’s Room (1650 Champlin Avenue) Utica, NY Noon to 3 p.m. On March 9, HCA is holding our Upstate LHCSA Forum for an exchange of valuable information, advocacy concerns and recommendations for action on: state budget developments; federal legislative issues; uniform billing codes; the minimum wage increase and state funding; the state’s offsite surveillance pilot program; CDPAP; the Delivery System Reform Incentive Payment Program (DSRIP) and value based payment; and issues in your region. This Forum follows a Bootcamp program on the Consumer Directed Personal Assistance Program that we encourage LHCSAs to also attend at the same location (see above). Download the flyer and register at: http://hca-nys.org/ wp-content/uploads/2017/01/HCA-Upstate-LHCSAForum-March-9-Registration-Form.pdf.
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Volume 2, No. 3 January 16, 2017
Blueprint for OASIS Accuracy OASIS C-2 Data Set April 19-20, Workshop, 8 a.m. to 4 p.m. April 21, COS-C Exam, 9 to 11:30 a.m. Doubletree by Hilton 100 Nott Terrace Schenectady, NY This two-day OASIS-C2 data collection workshop provides effective, up-to-theminute education targeted for field data collectors, their supervisors and those preparing for the COS-C Exam. Through guided, expert instruction, and participation in problem-solving discussions and application scenarios, participants will achieve mastery of the OASIS items, conventions, and the latest data collection rules. Rather than provide opinions, assumptions, or unfounded interpretations, the “Blueprint” presenters will model reliance on federal guidance documents and provide and demonstrate strategies for how to find defendable answers to your OASIS questions. Individuals may register for the workshop, the exam or both. Please note the exam fee is in addition to the twoday workshop fee. Download the flyer and register at: http://hca-nys.org/wp-content/uploads/ 2017/01/Blueprint-for-OASISSchenectady-Flyer-2017.pdf. Register online at: https:// www.eventville.com/Catalog/ EventRegistration1.asp?EventId=1012100.
The Situation Report: the Home Care Association of New York State
Volume 2, No. 3 January 16, 2017
CMS to Host Home Health Grouping Model Technical Report and Patient Care Star Rating Calls Next Week The U.S. Centers for Medicare and Medicaid Services (CMS) will be hosting the following two calls this week that may be of interest to the HCA membership. January 18: Home Health Groupings Model Technical Report Call In December 2016, CMS published the Medicare Home Health Prospective Payment System (HHPPS) Case-Mix Methodology Refinements technical report, including an overview of the Home Health Groupings Model (HHGM). This technical report can be downloaded at https://downloads.cms.gov/ files/hhgm%20technical%20report%20120516%20sxf.pdf. It describes efforts to reassess the current HHPPS and develop large-scale payment methodology changes. During this call, CMS experts will introduce the HHGM model. A question and answer session follows the presentation. The call is from 1:30 to 3 p.m. Registration is at: https://blh.ier.intercall.com/. January 19: Home Health Quality of Patient Care Star Rating Call During this call, CMS representatives will discuss proposed changes to the Home Health Quality of Patient Care star rating on Home Health Compare based on stakeholder and technical expert panel feedback as well as provide an overview of the current calculation algorithm, proposed changes, and potential roll-out plans. A question and answer session follows the presentation. The call is from 1:30 to 3 p.m. Registration is at: https://blh.ier.intercall.com/. For further information, contact the HCA Policy Staff.
Resources “Dear State Medicaid Director on Community First Choice State Plan Option,” by the U.S. Centers for Medicare and Medicaid Services https://www.medicaid.gov/federal-policy-guidance/downloads/smd16011.pdf “Remote Monitoring Technologies in Long-Term Care: Implications for Care Team Organization and Training,” by the UCSF Health Workforce Research Center on Long-Term Care http://healthworkforce.ucsf.edu/sites/healthworkforce.ucsf.edu/files/ REPORT_FINAL_RemoteMonitoring.pdf For more information, contact Andrew Koski at (518) 810-0662 or akoski@hcanys.org.
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