BUDGET MEMO
DSRIP TESTIMONY
HIT $
SEPSIS
Learn all the details about the proposed state budget and its home care, MLTC and hospice impact in our latest memo.
HCA testifies at DSRIP Project Advisory and Oversight Panel meeting about challenges, obstacles for home care’s participation in DSRIP.
Webinar provides details of $10K funding opportunity for provider HIT connections. Repeat webinar is on Feb. 7.
Join HCA and partners this week for fourth webinar to prepare you for use of the sepsis screening tool in home care.
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COMING UP 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 Free HCA Member Webinar on New Home Health CoP Changes Prepare Now for Implementation of the New Home Health Conditions of Participation (CoPs) Feb. 14, 2017 11 a.m. to 12 p.m. Registration for these and other events is at http://hca-nys.org/ events-education/ upcoming-events.
Your Source for HOME CARE News, Policy and Advocacy
Vol. 2, Issue 6 | February 6, 2017
Bringing Home Care’s Message to Legislators this Week This week begins HCA’s first major grassroots advocacy drive to press for home care and Managed Long Term Care priorities in the state budget. Tonight, HCA is holding a Political Action Committee reception at our offices, and then gearing up for tomorrow’s HCA State Advocacy Day program, where the HCA Board and other member leaders will meet with state officials and legislators representing their districts. See ADVOCACY p. 2
QIVAPP Monies Distributed HCA has confirmed with the state Department of Health (DOH) that MLTC plans received funding for the Quality Incentive Vital Access Provider Pool (QIVAPP) in their payment cycle 2053 on January 11, 2017. See QIVAPP p. 4
INSIDE Bringing Home Care’s Message to Legislators this Week...................................1 QIVAPP Monies Distributed..............................................................................1 Trump Administration Directives Aim for 75% Cut In Regs...................................1 HCA Budget Memo Summarizes Provisions......................................................3 HCA Testifies to DSRIP Panel.............................................................................4 Criteria for Data Exchange Incentive Program Presented in Webinar................4 Member Hiring Announcement.......................................................................5 HCA and DOH Discuss Home Care, Hospice Developments...............................6 Payment Increase Proposed for Medicare Advantage Plans............................7 Emergency Preparedness Workgroup Reinvigorated.................................7
Trump Administration Directives Aim for 75% Cut In Regulations Impact on health care unclear, as HCA redoubles efforts for relief from mandates in meetings with Congress last week The Trump administration has directed federal agencies to temporarily freeze any pending regulations that were initiated during the Obama administration, including a 60-day delay for all regulations that have been published. See REGS p. 3 Study: MA Beneficiaries Use Less Home Care than FFS Beneficiaries..........8 This Week: Webinar IV on Home Care Sepsis Screening Tool......................9 Public Reporting Results Refreshed on Home Health Compare................10 MSSNY Reaches out to Physicians on Home Care Probe-and-Educate.......10 Two Upcoming HCA Member Forums for LHCSAs and HCC Members.........11 Home Care Reach-Out for February National Heart Health Month...........12 Upcoming Member Education on CoP Changes, CDPAP & Compliance........13 Webinar on Pressure Ulcer Quality and Cost Performance: Feb. 8.............15 Issuance of IRS Form 1099......................................................................15 Clinicians Participate in Population Care Coordination Program..............16 NGS Updates..........................................................................................16 Resources...............................................................................................17
The Situation Report: the Home Care Association of New York State ADVOCACY from p. 1 HCA has already shared with you three documents to support your advocacy this week and throughout the process. One of these documents provides instructions for members, guiding their outreach with the Legislature. The other two documents were prepared with the legislature and Governor’s office in mind as our audience. These two reports, shared with all members of the Legislature on Friday, outline: 1) the findings of our financial condition analysis for the state’s home care and MLTC sectors, along with 2) our requests for payment adequacy, infrastructure investment, regulatory relief and workforce support. These latter two documents work as companion pieces, with the financial condition report offering a basis for the relief measures sought in our advocacy “asks.” All three documents are posted to our website at http://hcanys.org/advocacy-pac/state. As reported to members, this year’s proposed budget offers some risk as well as potential opportunity areas that require amendment, further tailoring and/or stronger funding commitments. If you haven’t done so already, please see our just-issued memo on the proposed state budget for a summary of its provisions. The memo is at: http://hca-nys.org/wp-content/uploads/2017/02/ Proposed2017018BudgetAnalysisFeb2017.pdf. Tomorrow’s State Advocacy program will begin with a meeting of our Board of Directors and invited state officials where we’ll be discussing HCA’s legislative proposals for inclusion in the budget and relying on the voice of our Board to convey the need for relief measures. In the afternoon, the Board and other HCA member leaders in attendance will fan out to the offices of key committee chairmen, legislative leaders, and district representatives to further spread our advocacy message and enlist legislative or Executive support. HCA will report next week on any significant developments culminating from our State Advocacy Day program, along with further opportunities for member grassroots advocacy as budget negotiations, legislative hearings and other milestones occur in the process. 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
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REGS from p. 1 This coincides with an Executive Order calling for major cancellations in business regulations. The President’s January 30 executive order says that for every new regulation introduced, two must be eliminated. It calls for a 75-percent cut in regulations, directing any new regulatory burdens to be offset by other deregulatory policies so there are no new regulatory dollars spent during the remainder of fiscal year 2017. Some sectors, like the military, are exempted under the order. It is unclear how these actions – the regulatory freeze and the executive order – will affect home care-related regulations, including sweeping new revisions to the home health Conditions of Participation (CoPs), which were finalized just before the change in administrations in December. HCA President Joanne Cunningham was in Washington late last week where she met with the offices of New York’s Congressional Delegation to redouble HCA’s efforts on home care regulatory relief, including HCA’s call for a one-year delay in the effective date for the new CoPs. (A briefing paper on the CoP delay request is at http://hca-nys.org/wp-content/uploads/2017/ 01/OneYearDelayCoPs2017.pdf.) HCA is also continuing to take aim at four other regulations, including: the Medicare face-to-face requirement; prohibitions on non-physician practitioners to order home health services;
unfunded federal overtime pay requirements; and the pre-claim review demonstration requirement. Our positions on these regulations are summarized in a separate briefing paper being shared with Congress and available on our website at http://hca-nys.org/wp-content/ uploads/2017/01/ HomeCareRegulationsandMandates.pdf. The President’s executive order also instructs the director of the Office of Management and Budget to develop a way for standardizing how regulatory costs are measured, stating: “Such guidance shall address, among other things, processes for standardizing the measurement and estimation of regulatory costs; standards for determining what qualifies as new and offsetting regulations; standards for determining the costs of existing regulations that are considered for elimination; processes for accounting for costs in different fiscal years; methods to oversee the issuance of rules with costs offset by savings at different times or different agencies; and emergencies and other circumstances that might justify individual waivers of the requirements of this section.” HCA is reviewing the Executive Order carefully and will consult with our federal government affairs representative, Brett Heimov of Envision Strategy, to determine any precedent or place-setting language in these directives that would provide a pathway for mandate relief in home care.
HCA Budget Memo Summarizes Provisions HCA last week circulated a memo summarizing the major provisions in Governor Cuomo’s Executive State Budget proposal. You can download the memo at http://hca-nys.org/wp-content/uploads/2017/02/ Proposed2017018BudgetAnalysisFeb2017.pdf. As reported to members, this year’s proposed budget offers some risk as well as potential opportunity areas that require amendment, further tailoring and/or stronger funding commitments. If you haven’t done so already, please see our just-issued memo on the proposed state budget for a summary of its provisions. While HCA has been reporting to you about core budget elements in recent editions of The Situation Report, our memo provides HCA’s most comprehensive summary on the overall fiscal plan, the impact of non-healthcare provisions on negotiated decisions affecting health care, overall Medicaid funding levels and the specific items affecting home care, MLTC and hospice.
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The Situation Report: the Home Care Association of New York State
QIVAPP from p. 1
HCA Testifies to DSRIP Panel
The monies, issued in one payment, are for certain home care agencies in New York City and were intended to help them with increased labor costs related to providing aide services subject to the state Wage Parity law. The funds cover the 2015-16 period.
On Tuesday, HCA testified to the Delivery System Reform Incentive Payment (DSRIP) program’s Project Advisory and Oversight Panel (PAOP) during a public comment day related to the recent DSRIP Mid-point Assessment and Recommendations conducted by the state’s Independent Assessor (IA), Public Consulting Group (PCG).
Plans have 30 days to pass on the funds to their eligible home care contractors. HCA has been told by some LHCSA members that they have started to receive the funds. HCA previously provided eligible members with a personalized list of the monies they should receive from each MLTC plan. If you did not obtain this list, please email Andrew Koski at akoski@hcanys.org. The state has not yet decided if there will be QIVAPP funding for 2016-17.
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The PAOP is comprised of health care industry stakeholders from around the state who are not part of the DSRIP process, but play an important role in oversight. Following the public comment day, held in Albany, the PAOP met with every PPS from around the state regarding their Mid-point Assessment, recommendations, and presumably any other concerns of the PAOP members. HCA submitted written comments in response to the IA’s assessment and recommendations at the end of 2016, but took the opportunity to echo those comments in person to the PAOP last week. We stressed concern about the duplication of existing services and crossing over into Article 36 jurisdiction by PPS leads and other entities for purposes of DSRIP, as well as funding concerns, the expense of time and resources required for participation, and the apparent lack of recognition and awareness of home care services and their innate ability to assist in meeting DSRIP goals. Many of these experiences are detailed in our recent financial condition report of the home care and MLTC sectors, available at http://hca-nys.org/wp-content/uploads/2017/01/ NYSHomeCareProgramandFinancialTrends2017.pdf. For more information, please contact Alex Fitz Blais at (518) 8100658 or ablais@hcanys.org.
Criteria for Data Exchange Incentive Program Presented in Webinar The New York E-Collaborative (NYeC) held a webinar on Thursday, February 2, related to the new Data Exchange Incentive Program (DEIP) established by the state Department of Health (DOH) in partnership with the U.S. Centers for Medicare and Medicaid Services. There will be a repeat webinar on this topic offered on February 7. The DEIP is intended to increase Health Information Exchange (HIE) adoption by Medicaid providers in New York State by helping to cover the costs of connection to their local Qualified Entity (QE),
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which was formerly known as a Regional Health Information Organization (RHIO). The incentive funds available are $10,000 per organization on a first-come, first-served basis, and the program is open to a variety of Medicaid participating organizations and providers including long-term care providers such as Article 36 home care agencies and hospices. In order to participate and receive these funds, organizations must:
Have an Electronic Health Record (EHR) that is certified by the federal Office of the National Coordinator for, at a minimum, Privacy and Security criteria. If you are unsure whether your EHR system is certified, consult this site: https://chpl.healthit.gov/#/search
Accept Medicaid (Fee-for-Service or Medicaid Managed Care)
Not already be connected and contributing data to a QE/ RHIO
The organizations that receive funds through the DEIP will be required to subsequently contribute a predefined set of data elements to their local QE once connected. Those data elements are defined in the set of slides from the webinar that are linked below. HCA encourages members who are interested in this funding opportunity to participate in the next webinar on February 7, or consult the webinar slides below. Registration for the webinar on February 7 is located here: http:// www.nyehealth.org/services/hieadoption/. Slides from Thursday’s webinar can be found here: http:// www.nyehealth.org/nyec16/wpcontent/uploads/2016/04/DEIPWebinar_February2017.pdf. Please direct any related questions to Alex Fitz Blais ablais@hcanys.org or Andrew Koski akoski@hcanys.org.
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HCA and DOH Discuss Home Care, Hospice Developments HCA and state Department of Health (DOH) officials met to discuss various home care and hospice developments and recommended steps in support of the home care community. Issues discussed included:
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The continued prevalence of providers who are non-article 36 and 40 licensed home care/ hospice providers crossing over into providing services sanctioned under law and regulation only to licensed home care/hospice agencies. HCA has been providing DOH with examples of such crossover for well over a year, and urging DOH to produce and provide to all sectors a clear advisory on articles 36 and 40 jurisdiction and notice of statutory and regulatory enforcement. DOH is developing its response. Meanwhile regulatory flexibility in the context of stepped up control for article 36/40 adherence is a core HCA message during this week’s HCA State Advocacy Day. (See related p. 1 story.)
Regulatory Flexibility Proposals. HCA has presented distinct regulatory flexibility proposals for home care including a proposal to facilitate and further empower home care’s capabilities to partner and bring cost and clinical benefits to the new and evolving models of care and payment (e.g., DSRIP, VBP, ACOs, advanced primary care, managed care, etc.). We also discussed the Governor’s current budget proposal to establish an MRT-like Health Care Regulation Modernization Team to recommend overhaul of state regulations and statues, with an emphasis on home and community based care flexibility. (See HCA’s advocacy materials for further details on this issue).
Community Paramedicine. HCA, hospital association partners, and EMS representatives had drafted and provided DOH with a collaborative model legislative proposal for community paramedicine which would bring hospital, physician, home care and EMS partners together for a mutually planned approach to community paramedicine. Prior legislative proposals have stalled and were opposed by HCA and others because they lacked clear guides and parameters. The HCA proposal brings all sides together in a common approach, coordinated across all parties and health licensure jurisdictions. “Community Paramedicine” has been encompassed by the Governor’s Regulatory Modernization Team proposal, discussed above.
Conditions of Participation (CoPs). HCA staff discussed timing of compliance with the new federal CoPs for home care, currently set to become effective in July, and the emergency preparedness components set to be effective for home care and hospice later, in November. HCA reiterated the need for a lengthier period before these sweeping COP changes take effect (HCA has been advocating in Washington for at least a one-year postponement of the effective date), and asked the Department’s support in this request. HCA also stressed that the new and added cost implications must be taken into consideration by the Department in setting adequate premiums for MLTCs and rates for providers. DOH has no new information at this time as to whether the CoPs will be held or delayed under President Trump’s regulatory freeze directive to federal agencies. (See related p. 1 story.)
Home Care Capacity and Workforce Needs. HCA discussed the continued pressing need for home care working capital, addressing home care capacity and workforce shortages, and the need for comprehensive support in these areas. HCA has submitted legislative and budget proposals to the
The Situation Report: the Home Care Association of New York State Administration and Legislature to address this need in comprehensive ways. (See HCA Advocacy Day materials). HCA will keep the membership carefully apprised of our progress in pursuing these issues with the Department, and in the budget, and we underscore the importance of HCA member participation in our state advocacy efforts on these issues. For further information, please contact Al Cardillo at acardillo@hcanys.org.
Payment Increase Proposed for MA Plans On February 1, the U.S. Centers for Medicare and Medicaid Services (CMS) proposed a 0.25 percent increase in Medicare Advantage (MA) managed care plan rates for calendar year 2018. The increase was included in CMS’s document, Advance Notice of Methodological Changes for Calendar Year (CY) 2018 for Medicare Advantage (MA) Capitation Rates, Part C and Part D Payment Policies and 2018 Call Letter. The Call Letter is at https://tinyurl.com/zgohjts. Insurers have 30 days to respond to the proposed payment rates and other changes included in the Call Letter and CMS will announce the final increase amount on April 3. Last year, CMS proposed an increase of about 1.35 percent but later trimmed that back. In the Call Letter, CMS is maintaining the amount of the Maximum Out-of-Pocket (MOOP) limit for all Medicare Part A and Part B covered services, after which plans need to cover all Part A and Part B covered services at 100 percent. Most MA plans have selected the Mandatory MOOP limit – the highest
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Emergency Preparedness Workgroup Reinvigorated On Wednesday, as part of our monthly meeting with the state Department of Health’s Office of Health Emergency Preparedness (OHEP), HCA along with the New York State Association of Health Care Providers (HCP) participated in a call with the Home Care Emergency Preparedness Workgroup comprised of providers across the state, including several HCA members. The workgroup has been called upon to offer provider input into the development of a Planning for Emergencies Toolkit geared toward patients and their families. The concept for this toolkit has been in the works for over a year, and is now even further apropos given the new Emergency Preparedness Conditions of Participation (CoPs) issued by the U.S. Centers for Medicare and Medicaid Services (CMS) which take effect in November of 2017. A requirement of these CoPs is that home health agencies institute an emergency plan for each individual patient. A central goal of the workgroup’s effort will be ensuring that the final product is widely applicable as a comprehensive agency and patient resource for implementing personal emergency plans. On Wednesday’s call, the group agreed that a survey of workgroup members would be conducted as a next step to identify important elements for inclusion, gather existing useful resources, and collect general recommendations in advance of a first draft. HCA welcomes any additional input from members related to the development of a patient/family toolkit for Emergency Preparedness. Please forward any comments or questions about this to Alex Fitz Blais at ablais@hcanys.org. Additionally, this workgroup will be examining solutions related to the evacuation transport of home care and hospice patients during emergencies in regions across the state, including discussion of the particular issues surrounding the New York City Homebound Evacuation Operation (HEO). For further information about emergency preparednessrelated concerns, please contact Al Cardillo at acardillo@hcanys.org or Alex Fitz Blais at ablais@hcanys.org.
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allowed by CMS – of $6,700 in 2017 (and proposed to remain the same in 2018). These plans cannot charge a copayment for home health services. However, if the plan has a lower voluntary limit of up to $3,400 in 2017 (the same amount proposed for 2018), then CMS allows the plan greater flexibility in its cost-sharing design, and the plan can charge up to 20 percent, or $35, for home health care. Enrollment in MA plans grew by about 7 percent last year to account for about one-third of Medicare beneficiaries nationwide. In New York State, about 40 percent of all beneficiaries are enrolled in MA plans. In some counties, enrollment is at 60 percent. It is not clear if the new Trump Administration will make any broad changes to the Medicare Advantage program, but HCA will be watching this closely as many home care providers contract with Advantage plans for services.
Study Shows That Medicare Advantage Beneficiaries Use Less Home Care than FFS Beneficiaries A recent study by the American Journal of Managed Care revealed that the trend of home health agencies expanding their patient revenue share to Medicare Advantage (MA) plans is increasing. However, the study also noted that MA beneficiaries are using less home health care than Medicare beneficiaries receiving traditional fee-for-service (FFS) home health services. The study used data from 30,837,130 FFS beneficiaries and 10,594,658 MA beneficiaries, but did not include dual-eligible patients. Regarding functional outcomes, or measurable goals that help patients perform specific daily activities, the data was similar for patients using FFS and MA plans, but length of episodes in home care were 33 percent longer in FFS scenarios. The study also showed that FFS beneficiaries who used home health were enrolled for an average of 75.8 days, compared to MA beneficiaries who were enrolled for an average of 56.3 days. Of the patients enrolled in FFS, 6.3 percent had at least one home health episode compared with 3.9 percent of patients enrolled in MA plans. The study concluded that “The MA versus FFS comparison of home health utilization across regions is of interest because MA plans, which are paid a capitated rate to cover all needed services, have a direct incentive to minimize financial costs, whereas there is no real equivalent incentive for FFS.” Contrary to this assertion, HCA points out, however, that the episodic nature of the Home Health Prospective Payment System (HHPPS) does, in fact, provide a direct incentive to not only minimize financial costs but control utilization under FFS Medicare home health. The full study can be found here: http://www.ajmc.com/journals/issue/2016/2016-vol22-n11/doesmedicare-advantage-enrollment-affect-home-healthcare-use. For further information, contact Patrick Conole at (518) 810-0661 or pconole@hcanys.org.
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This Week: Webinar IV on Home Care Sepsis Screening Tool HCA, partners from IPRO and others are gearing up for the fourth in a series of webinars to guide home care agencies on use of the home care sepsis screening and intervention tool. The next webinar is this week, on February 9, from 10:30 a.m. to noon. Please note that agencies are required to access all of the webinars in this series to obtain a user agreement (to be issued soon after the final webinar) for employing this tool in the future. Archived recordings of the first three webinars in the series (held September 30, October 20 and January 19) are posted at http:// atlanticquality.org/initiatives/sepsis-initiative/educational-eventswebinars/. As emphasized in this series, sepsis is the number one all-cause of Medicare thirty-day hospital readmissions in New York State, and second only to schizophrenia in its impact on New York Medicaid. Home care providers, using this firstof-its-kind screening tool, can play a powerful role in identifying and acting on this public health crisis. Registration information for this week’s webinar is below. Sepsis Webinar IV: Thursday, February 9 10:30 a.m. to noon Train-the-Trainer and Introduction of Screening Tool Protocol To join the online event, visit http://tinyurl.com/zdgtdn7, click “Register” and complete the online form. If assistance is required, contact QNet WebEx Support at qnet_webex_support@hcqis.org or (571) 598-1988. Questions on the home care sepsis initiative can be directed to HCA at acardillo@hcanys.org or to IPRO at Sara.Butterfield@areaI.hcqis.org or Eve.Bankert@areaI.hcqis.org.
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Public Reporting Results Refreshed on Home Health Compare The latest Home Health Care Consumer Assessment of Healthcare Providers and Systems (HHCAHPS) Survey results are now reported on the Home Health Compare link at www.medicare.gov. They are based on responses from patients who received home health care from Medicare-certified home health agencies (HHAs) during the period of July 2015 through June 2016. HHCAHPS Survey results are updated each calendar year quarter. These data are also available on the HHCAHPS website (https://www.homehealthcahps.org/GeneralInformation/Announcements/tabid/311/ EntryId/376/Public-Reporting-Results-Refreshed-on-Home-Health-Compare-Archived-Publicly-ReportedData-Available-on-HHCAHPS-Website.aspx) through the “Archived Publicly Reported Data” link under the “General Information” tab. On this webpage, you can access:
HHA-level data; State and national averages; Star Ratings cut points; and Patient mix adjustment coefficients for the linearized data used to construct the Star Ratings.
The Technical Notes provide information on how the Star Ratings were constructed. (See https:// www.homehealthcahps.org/Portals/0/HHCAHPS_Stars_Tech_Notes.pdf.) The following link provides more information on the data analysis used to statistically adjust the results for public reporting on Home Health Compare: https://www.homehealthcahps.org/Portals/0/ PublicReporting/PMAandHHCAHPSresults_JanPublicReporting2017.pdf.
State Medical Society Reaches out to Physicians on Home Care Probe-andEducate The Medical Society of the State of New York (MSSNY) published a statewide newsletter advisory to physicians about the recent phase II startup of “Probe-and-Educate” audits being systematically conducted on all New York home care providers by the U.S. Centers for Medicare and Medicaid Services (CMS). The MSSNY outreach, fashioned in partnership with HCA, was sent to all its member physicians. It provides up-to-date information on Probe-and-Educate, with the goal of reinforcing close physician collaboration with home care in certifying both the Face-to-Face documentation and core home care medical eligibility requirements for Medicare home care coverage. HCA greatly appreciates MSSNY support and active work in this effort. HCA and MSSNY have been working in close partnership on physician-homecare efforts in the delivery and management of patient care. Together, HCA and MSSNY have fashioned joint proposals, shared joint information among our physician-homecare/MLTC/hospice memberships, and participated in one another’s committees. In particular, over the past year, HCA and MSSNY have formed a joint physician-home care task force to create recommendations for elimination of obstacles and regulatory burdens in the partnership between
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providers. The task force has been meeting frequently to analyze issues and shape proposals for action. Substantial focus has been devoted to advocacy planning to mitigate Face-to-Face regulatory compliance burdens, and to improve physician-homecare provider communication capabilities. HCA will keep all members informed of developments as the task force progress, as well as additional related work with MSSNY in our overall health care improvement goals. For further information, contact Al Cardillo at acardillo@hcanys.org.
Two Upcoming HCA Member Forums for LHCSAs and HCC Members Register today for these upcoming member forums in March. Registration links are below each session summary. These registration forms contain location information and other details. Home Care Council of HCA Member Forum: March 6 in New York City Please join the HCA staff and member colleagues for the next Home Care Council (HCC) of HCA Member Forum. The HCC of HCA members include personal care providers who formerly were members of the Home Care Council of New York City. Participation in HCA Member Forums gives you an opportunity to interact with HCA staff and members, and exchange valuable information with your colleagues. Some of the vital issues to be covered include:
Update on HRA contracts and other important topics; State Budget proposals that impact home care; Funding for minimum wage increase; Minimum wage survey; QIVAPP final awards; Spread of hours requirements; Uniform billing codes; Other policy changes; and Future education programs.
For more information, contact Andrew Koski at (518) 810-0662 or at akoski@hcanys.org. Download the registration form: http://hca-nys.org/wp-content/uploads/2015/01/HCC-Forum-3-6-17Registration-Form.pdf. Upstate LHCSA Forum: March 9 in Utica On March 9, HCA is holding our Upstate LHCSA Forum for an exchange of valuable information, advocacy concerns and recommendations for action, including: state budget developments; federal legislative issues; uniform billing codes; the minimum wage increase and state funding; the Consumer Directed Personal Assistance Program (CDPAP); the Delivery System Reform Incentive Payment (DSRIP) program; value based payment; and regional issues. Continued on next page
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Continued from previous page This Forum follows a Bootcamp program on CDPAP opportunities for home care that we encourage LHCSAs to also attend at the same location. (See related p. 13 story.) Download the registration form: http://hca-nys.org/wp-content/uploads/2017/01/HCA-Upstate-LHCSAForum-March-9-Registration-Form.pdf.
Home Care Reach-Out for February National Heart Health Month HCA and home care providers around the country are active participants and promoters of the national Health Care Quality Improvement (HHQI) campaign for home care cardiovascular health initiatives. HCA is a state coordinator under HHQI, participating in national home care cardiovascular health discussions with HHQI and partner associations around the country. HCA has featured HHQI and the home care cardiovascular health initiative in our Quality Symposium sessions, Quality Committee work and educational programing. We’ve also echoed the HHQI precepts in HCA-written legislation sponsored by Senator Hannon and Assemblyman Gottfried. This legislation was submitted as part of our state budget funding and policy proposals. February is National Heart Health Month, and home care providers are encouraged to engage in heart health promotion and advancement activities. This includes promoting the visible work that you do in home care to support prevention and management efforts in cardiovascular disease. The HHQI home page has links to the Million Hearts campaign, as well as other helpful resources, toolkits and educational material, provided below:
http://www.homehealthquality.org/Cardiovascular-Health/CardioLAN.aspx
https://millionhearts.hhs.gov/
In New York State, IPRO, the Quality Improvement Organization is coordinating participation of home care agencies in the home health cardiovascular initiative. IPRO also offers assistance to agencies in their cardiovascular health efforts. Agencies interested in exploring this initiative can contact Veronica Pryor VPryor@ipro.org or Susan Hollander SHollander@ipro.org at IPRO. Cardiovascular disease prevention, management and health promotion are among the major focal points in current state health reforms to payment and service delivery models. Home care leaders are encouraged to consider and pursue the clinical and system value-adds of the heart health initiative amid these new system models and priorities. For further information, please contact Al Cardillo at acardillo@hcanys.org or IPRO at the above listed addresses.
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The Situation Report: the Home Care Association of New York State
Volume 2, No. 6 February 6, 2017 ď Žď€
Upcoming HCA Member Education Programs on CoP Changes, CDPAP and Compliance In February and March, HCA is offering three special programs to assist providers in: understanding new changes to the Medicare Home Health Conditions of Participation (CoPs); determining whether to become a fiscal intermediary under the Consumer Directed Personal Assistance Program (CDPAP); and developing and maintaining an effective compliance program. Information and registration for all three programs are below. Please download the registration forms for further details. Free HCA Member Webinar on New Home Health CoP Changes: February 14 HCA is offering a webinar, free of charge for HCA members ($79 for non-members), which will provide you with a deeper understanding and implementation plan for the newly finalized Home Health CoPs, which include sweeping changes affecting virtually all aspects of home care operation. The program, presented by home care clinician and operational expert Trish Tulloch, provides vital information for executive, clinical, compliance and operational team members across your entire organization. Participants will be able to: detail all required final CoP updates; list provider actions to address and implement each CoP update; discuss operational and clinical practice refinements to meet the new CoPs; and access tips to comply with the new CoPs. This webinar is targeted for home care CEOs, CFOs, COOs, Administrators, Clinical Supervisors, Directors, Educators, Performance Improvement Staff and those responsible for the oversight and delivery of care and services in the certified home health care setting. Download the registration form: http://hca-nys.org/wp-content/uploads/2017/01/HCA-Conditions-ofParticipation-Webinar-Registration-Form.pdf. Successfully Acting as a Fiscal Intermediary in CDPAP: March 9 in Utica 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; 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. Continued on next page
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The Situation Report: the Home Care Association of New York State
Volume 2, No. 6 February 6, 2017
Continued from previous page LHCSAs are encouraged to participate in this CDPAP program and to stay for the afternoon Upstate LHCSA Forum (being held at the same location), and directly following, for an exchange of valuable information, advocacy concerns and recommendations for action (see related p. 11 story). Download the registration form: http://hca-nys.org/wp-content/uploads/2017/01/HCA-Bootcamp-FiscalIntermediary-CDPAP-March-9-2017.pdf. HCA Bootcamp: Establishing and Maintaining an Effective Compliance Program: March 23 in New York City HCA is holding a Bootcamp session on March 23 in New York City (from 9:30 a.m. to noon) to help providers establish and maintain an effective compliance program – a topic that is all the more important during a time of heightened compliance scrutiny and multiple audits by state and federal agencies. This program, presented by compliance expert Rachel Hold-Weiss of the Arent Fox Health Care Group, will convey:
Why a compliance program is needed.
An overview of state and federal requirements for compliance programs.
Components of an effective compliance program, including the eight required elements and seven areas a compliance program must cover.
Which staff need to be trained and how training should be conducted.
Recent state Office of the Medicaid Inspector General (OMIG) compliance guidance and OMIG audit protocols.
Testing the effectiveness of a compliance program, including auditing the compliance program and self-assessment.
State and Federal False Claims Acts.
Compliance findings and remedial actions.
OMIG (and OIG) voluntary disclosures.
Annual compliance (and federal) certifications.
Download the registration form: http://hca-nys.org/wp-content/uploads/2015/01/HCA-Bootcamp-Establishingand-Maintaining-an-Effective-Compliance-Program.pdf.
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The Situation Report: the Home Care Association of New York State
Volume 2, No. 6 February 6, 2017
Webinar on Pressure Ulcer Quality and Cost Performance: Feb. 8 HCA Executive Vice President Al Cardillo, LMSW is among the featured speakers for an important February 8 (11 a.m. to noon) statewide webinar on pressure ulcer quality and cost performance. Registration is at http://tinyurl.com/jltokfn. This educational webinar will examine the Gold STAMP Program (see http://www.albany.edu/sph/cphce/ goldstamp.shtml) and highlight resources available to home care and other providers through this program. Pressure ulcers can cause pain, increase the risk for infection, and may slow recovery from another illness or surgical procedure. Home care’s role in pressure-ulcer identification and treatment is vital, especially with the advent of new models, like the Delivery System Reform Incentive Payment (DSRIP) program, which provide opportunities for home care providers to tackle clinical issues and meet outcomes measures. Other speakers include: Nancy Leveille, RN, MS, Sr. Director of Center for Wound Healing Research of the New York State Health Facilities Association; and Laura E. Edsberg, Ph.D., Director of Center for Wound Healing Research and Associate Professor in the Natural Sciences Department at Daemen College.
Issuance of IRS Form 1099 CSRA, the eMedNY contractor for the state Department of Health (DOH), issues IRS (Internal Revenue Service) Form 1099 to providers at the beginning of each year for the previous year’s Medicaid payments. The 1099s are issued with the individual provider’s social security number, or, for businesses, with the Federal Employer Identification Number (FEIN) registered with NY Medicaid. As with previous years, the IRS 1099 amount is not based on the date of the checks/electronic funds transfer (EFT); rather, it is based on the date the checks/EFTs were released to providers. Subsequently, due to the two-week check lag between the date of the check/EFT and the date the check/EFT is issued, the IRS 1099 amount will not correspond to the sum of all checks/EFTs issued for your provider identification number during the calendar year. The IRS 1099 that will be issued for the tax year 2016 will include the following: Check/EFT, dated 12/21/15 (Cycle 2000) and released on 01/06/2016, through Check/EFT dated 12/12/16 (Cycle 2051) and released 12/ 28/16. DOH advises providers to keep their addresses current. An incorrect address will impact the provider’s ability to receive his or her 1099 form in a timely manner. 1099s are not issued to providers whose yearly payments are less than $600. IRS 1099s for the year 2016 were mailed prior to January 31, 2017. Any questions should be directed to the eMedNY Call Center at: (800) 343-9000.
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The Situation Report: the Home Care Association of New York State
Volume 2, No. 6 February 6, 2017
Home Care Clinicians Participate in Population Care Coordination Certification Program Faculty from Duke University conducted onsite training in New York City last week for home care clinicians under its Population Care Coordinator Program (PCCP). The program, a semester-long blend of online and onsite training, was hosted by the Visiting Nurse Service (VNS) of New York for its clinicians. Ordinarily, the onsite component of PCCP is conducted at Duke University, in North Carolina, but is periodically brought onsite to New York under an arrangement between Duke and VNS, and a supportive grant received for the training. HCA Executive President Al Cardillo participates with the Duke faculty as part of the New York onsite training faculty. The program incorporates population, organizational and clinical analytics and practices for advanced training of clinicians (predominately RNs, but likewise open to PTs, MSWs, physicians and other clinicians) in this era emphasizing evidence-based, interdisciplinary, patient-centered and population health based practice. The training leads to certification in skills and insights that sync to virtually all of the contemporary drivers of health trends and changes. PCCP training has been recommended for inclusion under the soon-to-be implemented $245 million “Workforce Center of Excellence” education and training initiative for MLTC/home-care, funded under the state’s federal waiver and being finalized by the state Department of Health. HCA has provided extensive information to providers about this coming training program. Final details keep changing as the Department and U.S. Centers for Medicare and Medicaid Services (CMS) negotiate the terms of the program. Providers interested in learning more about PCCP for their agencies and clinical staff can view the Duke PCCP homepage at http://pccp.nursing.duke.edu/.
NGS Updates National Government Services (NGS), New York’s Medicare Administrative Contractor (MAC), has recently posted the following information to its website.
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Meet Performant Recovery, the New National Recovery Audit Contractor (RAC) for Home Health and Hospice Services – On Thursday, February 16, from 3 to 5 p.m., NGS will host a webinar for Performant Recovery, the new National RAC for Region 5, which includes home health and hospice providers in Jurisdiction 6 (J6) and JK (New York is in J6). The webinar will introduce Performant’s team; explain the characteristics of the new RAC contracts and their scope; highlight key timeframes and processes; review resources; and answer questions from home health and hospice providers. Registration is at: https://attendee.gotowebinar.com/register/4223497221445225987.
New YouTube Video on The Usage of an Advance Beneficiary Notice of Noncoverage – NGS has recently released a new YouTube video titled, The Usage of an Advance Beneficiary Notice of Noncoverage. This five-minute video, which explains how to properly use an ABN, can be accessed at: https://www.youtube.com/watch?v=xfsxZymS1Mk.
Hospice Aggregate Cap Submission Deadline is March 31 – The Self-Determined Hospice Cap (SDHC) form completed by hospice providers and submitted to NGS is due on March 31, 2017. This is the
The Situation Report: the Home Care Association of New York State
Volume 2, No. 6 February 6, 2017
latest that hospices may file their aggregate cap calculations for the 2016 cap year (November 1, 2015 to October 31, 2016). If the form is not submitted, a past due letter will be issued and payments will be suspended. For further information, contact Patrick Conole at (518) 810-0661 or pconole@hcanys.org.
Resources
“Medicaid State Fact Sheets,” by the Kaiser Family Foundation http://kff.org/interactive/medicaid-state-fact-sheets
“5 Key Questions: Medicaid Block Grants & Per Capita Caps,” by the Kaiser Family Foundation http://files.kff.org/attachment/Issue-Brief-5-Key-Questions-Medicaid-Block-Grants-&-Per-CapitaCaps
“10 Essential Facts About Medicare’s Financial Outlook,” by the Kaiser Family Foundation http://files.kff.org/attachment/Issue-Brief-10-Essential-Facts-About-Medicares-Financial-Outlook
For more information, contact Andrew Koski at (518) 810-0662 or akoski@hcanys.org.
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