PRE-CLAIM
CHHA PROTOCOLS
AGE-FRIENDLY WEBINAR
HCS REMINDERS
Though NY is not one of the demo states, CMS’s reboot of the pre-claim review process could extend beyond the demo region. New version of demo includes post-payment review option, as well as pre-payment.
HCA has reviewed a draft of revised CHHA audit protocols that OMIG expects to post soon. HCA seeks clarification, makes recommendations on some of the revisions.
June 20 webinar to discuss principles and initiatives to create ‘age-friendly’ health systems in NYS, as Cuomo Administration advances goal for 50% of the health system to be ‘age-friendly’ in 5 years.
HCA reminds providers to keep HCS contacts up-todate and routinely access the HCS, DOH’s primary vehicle for circulating alerts, rate changes, emergency response info, etc.
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COMING UP
Your Source for HOME CARE News, Policy and Advocacy
Vol. 3, Issue 24 | June 4, 2018
Virtual Integrated Care Management (ICM) Training
Assembly Action Joins Senate to Advance HCA Legislation
WEBEX Training Dates June 5: 1-3 p.m. June 12: 1-3 p.m. June 19: 1-3 p.m. June 26: 1-3 p.m.
The state Assembly joins the Senate this week in acting on HCA legislation that will promote home health and mental health provider collaboration, as well as the introduction of HCA bills on home care-public health interventions and HCA’s home care sepsis initiative.
Driving Decisions with Data: A Seminar for Clinical Managers June 6, 2018 Albany
Home Care-Mental Health Provider Collaboration Tomorrow, June 5, the Assembly Mental Health Committee has scheduled to take up an HCAwritten home care-mental health collaboration bill, A.10938, sponsored by Committee Chair Assemblywoman Aileen Gunther. See ACTION p. 2
Bootcamp: A Primer on the New LHCSA Regulatory Changes June 13, 2018 NYC
DOH Releases Proposed Advanced Aide Rule
Registration for these and other HCA programs are on our Education and Events page at: https://hca-nys.org/ events-education/ upcoming-events
As announced to members in an e-mail alert last week, the state Department of Health (DOH) has posted a proposed rule to implement the advanced home health aide (AHHA) law and several statutory changes related to criminal history record checks (CHRC). See AIDE p. 5
INSIDE Assembly Action Joins Senate to Advance HCA Legislation................................1 DOH Releases Proposed Advanced Aide Rule....................................................1 Bill Seeks EVV Delay.........................................................................................1 A Message from HCA Sponsor RBC Limited........................................................3 Member Hiring Announcement.......................................................................4 CMS Plans to Restart, Revise Pre-Claim Review Demo.......................................8 OMIG Plans CHHA Audit Protocols Revisions; HCA Reviews Draft.......................9
Bill Seeks EVV Delay Legislation has been introduced in Congress that would delay the implementation of the Electronic Visit Verification (EVV) requirement for personal care services for one year until January 1, 2020. See EVV p. 7
Hospice Provider Preview Reports Now Available....................................9 CMS to Host Star Ratings Algorithm Call on June 27.................................10 OIG Releases Semiannual Report to Congress........................................10 Important Upcoming Deadlines............................................................11 Age-Friendly Health Systems Webinar to be Held...................................12 A Reminder about HCS Requirements....................................................12 Webinar Scheduled on Alzheimer’s Voucher Program............................13 NGS Updates.......................................................................................13 Resources....................................................................................................................14
The Situation Report: the Home Care Association of New York State ACTION from p. 1 This legislation will promote collaborative models linking home care and mental health providers for integrated, coordinated care to support individuals with mental health and physical health conditions. The State Office of Mental Health (OMH) and HCA have been partnering for the past year to explore collaboration challenges and opportunities for home care and mental health, particularly in synch with OMH’s policy goal of promoting integrated care and aging-in-place capabilities for the state’s mental health population. This bill builds on the OMH Geriatric Mental Health Demonstration by incorporating the home care-mental health provider collaboration component. The Senate’s companion bill, S.8632, was voted last week from the Senate’s Mental Health Committee to the Senate Floor, where a full Senate vote for passage can take place as early as this week. HCA’s memorandum in support can be viewed at https://hca-nys.org/ wp-content/uploads/2018/06/HCA-Support-Memo-S8632-Ort_A10938Gunther.pdf. If you have not already done so, please immediately e-mail your support for A.10938 to Assemblywoman Aileen Gunther at GuntheA@nyassembly.gov and to Senator Robert Ortt at Ortt@nysenate.gov, thanking them for their sponsorship and urging full passage of the bill this session. Workforce Support Assemblywoman Donna Lupardo, Chair of the Assembly Committee on Aging, has introduced HCA legislation, A.10940, to institute a state Department of Labor examination of the competitive labor market for home care and hospice. Importantly, this examination would relate to the funding and reimbursement needed for home care and hospice to compete for, recruit, retain and sustain a workforce at levels to truly meet community needs in the state. The bill also would promote occupation and career interest in home care and hospice. The Senate version of this legislation, S.8559, has been introduced by Senate Committee on Aging Chair Susan Serino. Both bills are in the respective Health Committees of the Senate and Assembly. Assemblywoman Lupardo also introduced A.10818, sponsored in the Senate (S.8687) by Senator Serino, to create a new supplemental reimbursement from the HCRA pool for home care, hospice and MLTC 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 acardillo@hcanys.org Patrick Conole V ice President, Finance & Management pconole@hcanys.org Andrew Koski Vice President, Program, Policy & Services akoski@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 & Graphic Design jkerbein@hcanys.org Billi Wilson Manager, Meetings & Events bwilson@hcanys.org Teresa Brown Administrative Assistant tbrown@hcanys.org
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recruitment, training and retention of workforce in shortage areas and in shortage disciplines, including piloting of funds to be used for core personnel support, like transportation, child care, education and professional development, and more. Both bills are also in the Health Committee. Home Care Public Health Assemblyman John McDonald – a prominent member of the Assembly Health Committee and also, professionally, a Registered Pharmacist – has introduced HCA legislation to support and advance home care strategic roles in addressing areas of public health priority, such as sepsis, asthma, diabetes, cardiac health and health disparities. The HCA legislation consists of two bills: one, to integrate home care into state health policies and programs in primary care, public health and prevention, and a second bill that would further provide statewide support for the home care sepsis screening and intervention initiative launched by HCA. (The Assembly bills, awaiting bill number assignment as of publication time for The Situation Report, are both headed to the Assembly Health Committee.) The Assembly’s action follows introduction of these bills by Senate Health Committee Chair Kemp Hannon. The Senate version of the bill concerning sepsis intervention (S.8669) was successfully voted from the Health Committee to the Senate Finance Committee last week. HCA is next urging that the Finance Committee promptly advance the bill to the Senate Floor for a full Senate vote. The Senate’s version of HCA’s home care-public health bill (S.8620) is in the Health Committee and HCA is urging the Committee to also advance this measure to the Senate Floor. Continued on next page
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Continued from previous page Meanwhile, an additional HCA public health measure is also in the Senate and Assembly Health Committees. It was developed with the State Medical Society to support hospital-homecare-physician collaboration models to address health disparities (like hypertension, cancer, diabetes, sickle cell, and numerous other evidenced disparities in cultural, racial, geographic and other communities). The legislation, S.8656 by Senator Hannon and A.2925 by Assemblywoman Crystal Peoples-Stokes, targets a critical area of public health, and focuses on the unique and influential role that home care can play, in coordination with doctors and hospitals, to address these devastating and costly disparities in health. MLTC Nursing Home Flexibility Industry support has mounted for legislation pursued by HCA, in collaboration with LeadingAge New York, allowing MLTCs serving rural communities the option of retaining the long-term nursing home benefit for their MLTC enrollees. MLTCs in rural areas, with their nursing home network organizations, have been sending letters of support urging action on this bill that has been introduced by Senator Betty Little (S.8488) and Assemblyman Billy Jones (A.10688). The bills are each in Health Committee and seek to improve on the state budget provision which will impose a three-month care limit across-the-board – and pending federal approval – on the MLTC nursing home membership for those considered “permanent placement.” HCA will be launching guidance to hone and target member grassroots advocacy on this bill as we feel it will assist with the greatest impact given the narrow timeframe and limited number of session days remaining until the Legislative Session concludes. Please be on the lookout for a grassroots advocacy alert later this week on the various bills being advanced by HCA as two-house companion legislation now takes shape and is cued for advancement. For further information, contact Al Cardillo at acardillo@hcanys.org.
HIRING BRANCH DIRECTOR Able Health Care Services believes in quality care for our clients. Join us for an exciting career in Health Care. Currently, we are looking for a Branch Director to join our team. We offer competitive salary and benefits. Position Summary
Management and supervision of a team of professional, paraprofessional and clerical employees; accountable for providing competent care and achieving optimal patient/client outcomes for the Certified Agency. Supervises Inquiry/Intake referrals for home care services to individual patients/clients and their families. Provides nursing education and training as deemed necessary to increase the value of patient care as well as enhance the agency’s ability to offer new clinical initiatives.
The candidate for this position must be a NYS licensed Registered Nurse, bachelor’s prepared with:
A minimum of 5 years work experience in Licensed and Certified Home Care agencies. Strong Knowledge of Medicare/Medicaid/MLTC and managed care regulations. Excellent communication, human relations and organizational skills are needed. Self-motivator, assertiveness and independent decision-making skills are essential.
Please e-mail inquiries to Sandra Weintraub at SandraW@ablehealthcare.com. Able Health Care Services, Inc. is an Equal Opportunity Employer
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AIDE from p. 1
The proposed rule is on DOH’s website, accessible at https://tinyurl.com/yd4kfaqb, or in the May 30 State Register at https://docs.dos.ny.gov/info/register/2018/may30/rulemakings.pdf (page 15). There is a 60day period for public comments; HCA will be submitting comments and recommends that members also do so and/or send us your feedback for inclusion in our comments. The rule would define an AHHA, specify the supervisory requirements of AHHAs and authorize AHHAs to perform advanced tasks under the supervision of registered professional nurses employed by home care, hospice and enhanced assisted living residences (EALRs). It would also require reports by AHHAs to supervising nurses, in-service education for AHHAs at 18 hours annually, and more. New mandates are proposed, including: entry of AHHA training and testing information into the Home Care Worker Registry; the extension of CHRCs to hospice programs; inclusion of information on hospice workers in the Home Care Registry; and extension of CHRCs to adult homes, enriched housing programs, and residences for adults. Under the proposed rule, an AHHA must be directly supervised by a registered professional nurse who, among other responsibilities:
Provides training, guidance, direction and oversight, and evaluation;
Assigns advanced tasks to be performed by the AHHA after completing a nursing assessment to determine the patient’s current health status and care needs;
Provides case-specific training to the AHHA to verify and ensure the AHHA can safely and competently perform the advanced tasks for the patient;
Provides written, patient-specific instructions for performing advanced tasks, including the criteria for identifying, reporting, and responding to problems, errors or complications;
Conducts a comprehensive medication review, including evaluation of the patient’s current medication use and prescribed drug regimen, and identifies and resolves any discrepancies prior to assigning the AHHA to administer medications;
Determines direct supervision of the AHHA based on the complexity of advanced tasks, the skill and experience of the AHHA assigned to perform the advanced tasks, and the health status of the patient for whom the advanced tasks are being performed;
While on duty, is continuously available to communicate with the AHHA by phone or other means;
Conducts a home visit at least every two weeks (and more frequently, as determined by the registered professional nurse) to observe, evaluate, and oversee services provided by the AHHA. Continued on next page
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Continued from previous page Some other prominent features of the proposed rule are:
Patients have the right to refuse the provision of advanced tasks by an AHHA, in which case the CHHA, LTHHCP, LHCSA or hospice must ensure that such tasks are provided by a registered professional nurse.
A LHCSA must ensure that there is an order for AHHA services from the patient’s authorized practitioner.
Hospice services provided by an AHHA must be ordered by a physician, assigned by the supervising registered professional nurse, and included in the plan of care and consistent with training and advanced tasks permitted to be performed by AHHAs.
The state Education Department (SED) is also expected to release a proposed rule implementing Nurse Practice Act and related state education law provisions for AHHAs, at which time we will inform the membership. HCA was actively involved in preliminary and final discussions on legislation that would establish AHHAs. HCA advocated for numerous provisions to support prospective AHHAs, participating nurses, agencies and MLTCs. We also sought: greater flexibility; assurance of reimbursement coverage for MLTCs, agencies and workers; a stronger role for LHCSAs; and provisions facilitating alignment for MLTCs and provider agencies in AHHA authorization and use. These were regrettably not given due consideration by lawmakers in the original passage of the law and will remain areas for attention as the process moves to implementation. HCA will be working closely with DOH, SED and all parties to optimize the potential assistance of AHHAs in the MLTC, home care and hospice delivery structure. HCA hosted a presentation by DOH Home and Community Based Services Director Rebecca Fuller Gray and Deputy Director Margaret Willard on AHHAs at our annual conference earlier in May. We have also been requesting assistance for MLTCs and better synchronization of AHHA provisions between MLTCs and providers. HCA looks forward to working further in supporting the membership to maximize the application of AHHA services for patients and all concerned as this proposal heads toward finalization.
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EVV from p. 1 This initiative is separate and distinct from a similar requirement in New York State for verification organizations (VOs) to use EVV for pre-claim review, applicable to home health aide and personal care aide services by organizations with more than $15 million in Medicaid revenues. The federal legislation, S.2897, is sponsored by Senators Lisa Murkowski (R-Alaska) and Sherrod Brown (DOhio). In the House of Representatives, similar legislation, H.R. 5912, is being sponsored by Representatives James Langevin (D-Rhode Island) and Don Young (R-Alaska). The federal 21st Century CURES Act requires that states implement an EVV system for personal care services by January 1, 2019 and for home health services by January 1, 2023. Personal care services include any personal care provided to individuals in Medicaid fee-for-service (and Medicaid managed care); consumer directed services; and personal care provided in Nursing Home Transition and Diversion (NHTD), Traumatic Brain Injury (TBI), or any other waiver program. The EVV systems must verify the: type of services provided; individual receiving the service; date of the service; location of service delivery; individual providing the service; and time the service begins and ends. HCA has already met with the state Department of Health to discuss EVV implementation and intends to meet again soon to advocate on behalf of providers and consumers and discuss the state’s approach to implementing the federal requirements. HCA is surveying some members to determine if there is a need for a delay in EVV for personal care services to give providers and the state enough time to plan for implementation, particularly as the state has not provided any guidance yet. Stay tuned for more information on the proposed legislation. New York State’s requirements on verification organizations (again, applicable to organizations with more than $15 million in Medicaid revenues, including both fee-for-service and managed care) are at https:// omig.ny.gov/information/home-health-verification. As described in the May 21 edition of The Situation Report, the U.S. Centers for Medicare and Medicaid Services (CMS) in mid-May released an Informational Bulletin and frequently asked questions (FAQs) document covering the EVV requirements specified in the 21st Century CURES Act. The Bulletin and FAQs, along with webinar materials, are available at https://www.medicaid.gov/medicaid/hcbs/guidance/electronic-visit-verification/index.html. For more information, contact Andrew Koski at (518) 810-0662 or akoski@hcanys.org.
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CMS Plans to Restart, Revise Pre-Claim Review Demo New York Not Included in Updated Demonstration The U.S. Centers for Medicare and Medicaid Services (CMS) plans to restart an altered version of the preclaim review demonstration according to a May 29 information collection request. The previous demonstration was stopped at the end of March 2017 following concerns from HCA, the National Association for Home Care and Hospice (NAHC) and others that this cumbersome demo identified largely nominal errors, putting payments and services at risk while universally testing claims rather than scrutinizing those specific organizations exhibiting suspicious service or claims patterns. CMS proposes to run the latest demonstration first in Illinois, then in North Carolina and Ohio, and conclude in Florida and Texas. Illinois is the only state to have experienced the original demonstration before its suspension. Florida and Texas were states targeted for the original demo, but the demonstration was halted before it began there. North Carolina and Ohio are new states added to the list of possible targets. CMS holds open the possibility of expanding this newer version of the demo to other states beyond those named in the notice. The start date to begin in Illinois is no earlier than October 1, 2018. This newer version of the demo would compel providers in demonstration states to submit all claims for review either before or after payment has been made or undergo minimal post-payment review of a smaller portion of claims but with an accompanying 25-percent cut in payment. In addition, providers that do not submit claims could be subject to Recovery Audit Contractor (RAC) reviews. The previous version of the demo didn’t give providers the option of post-pay reviews. According to CMS’s notice, Certified Home Health Agencies (CHHAs) in demonstration states will continue to be subject to a review method until the agency reaches the target affirmation or claim approval rate. Once a CHHA reaches the target pre-claim review affirmation or post-payment review claim approval rate, it may choose to be relieved from claim reviews, except for an occasional spot check of their claims to ensure continued compliance. The CMS proposal, which was posted in the May 31 Federal Register (https://www.gpo.gov/fdsys/pkg/FR2018-05-31/pdf/2018-11492.pdf), follows a Government Accountability Office (GAO) recommendation calling on CMS to bring back the demonstration. The public has 60 days to comment on the CMS proposal, with the comment period ending on July 30, 2018. While CMS Administrator Seema Verma claims the new demonstration will offer providers more choice by including post-claim review, HCA and our colleagues at NAHC are not persuaded by that argument. No other health care sector is forced to submit every care claim for review or face a punishing 25 percent pay cut. While the post-payment review addition to the demonstration might ease some of the problems with cash flow caused by the original iteration of pre-claim review, it is very likely to lead to a substantial appeals backlog, as providers appeal denials by Medicare Administrative Contractors (MACs). In the original version of the demo, many denials were found to be based on simple and innocent paperwork errors. It is also important to remember that when the demo was halted originally, it did not find evidence of unnecessary care or services provided that were not meant to be covered. Instead, the demo merely found correctable documentation issues. HCA argued then, and will continue to do so, that CMS should
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concentrate its resources on pursuing outliers — those organizations with a claims or service pattern history indicative of potential fraud or abuse and not all providers in the demo region. While New York is currently not included in CMS’s proposed new demonstration, HCA will still be working with our colleagues at NAHC and other industry stakeholders to ensure that whatever emerges from the comment period is something that does not threaten access to care or home health agency viability. Late last week CMS posted some additional guidance on this new proposal which can be found at: https://www.cms.gov/Research-Statistics-Data-and-Systems/Monitoring-Programs/Medicare-FFS-CompliancePrograms/Review-Choice-Demonstration/Downloads/RCD-FAQs-for-the-Proposed-Collection-of-Information-0531-2018.pdf.
OMIG Plans CHHA Audit Protocols Revisions; HCA Reviews Draft The state Office of the Medicaid Inspector General (OMIG) intends to soon post revised audit protocols for Certified Home Health Agencies (CHHAs). OMIG shared a draft of the revised protocols with HCA and advised us that the revised version includes changes to the regulatory references and to protocol No. 4 (“Failed to Obtain Authorized Practitioner’s Signature Within Required Time Frame”) so that this protocol reflects revisions to the time frames for obtaining physician orders. After a comprehensive review, HCA has learned that protocol No. 19 (“Supervision Visit Not Performed Within Required Time Frame”) was revised to state that “if the patient is not authorized to receive skilled services, the RN must make a supervisory visit every 60 days and the visit must occur (bolded language is new) while the home health aide is providing patient care.” In addition, protocol No. 21 (“Failed to Maximize Third Party/Medicare Benefit”) was revised and HCA has requested clarification on the changes. Lastly, HCA has recommended to OMIG that Protocol No. 32 (“Missing Documentation of a PPD Skin Test or Follow-up”) be revised to allow for either tuberculin skin test or Food and Drug Administration (FDA) approved blood assay for the detection of latent tuberculosis infection (bolded language is new). Once finalized, the protocols will be posted at https://omig.ny.gov/audit/audit-protocols and HCA will notify members. For more information, contact Andrew Koski at (518) 810-0662 or akoski@hcanys.org.
Hospice Provider Preview Reports Now Available Hospice provider preview reports and Hospice Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey provider preview reports have been updated. These are now available in hospices’ Certification and Survey Provider Enhanced Reports (CASPER) non-validation reports folders. Hospice providers are encouraged to review their Hospice Item Set (HIS) quality measure results from Quarter 4, 2016 to Quarter 3, 2017 and their facility-level CAHPS survey results from Quarter 4, 2015 to Quarter 3, 2017. Providers
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have 30 days to review these results (June 1, 2018 through June 30, 2018). Providers may request CMS review if they believe the denominator or other HIS quality metric to be inaccurate, or if there are errors within the results from the CAHPS survey data. The CMS-required process is outlined on the webpages titled Public Reporting: HIS Preview Reports and Requests for CMS Review of HIS Data webpage and Public Reporting: CAHPS Preview Reports and Requests for CMS Review of CAHPS. See https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Hospice-QualityReporting/Hospice-Item-Set-HIS.html. For more information on how to access these reports, view the HIS Preview Report Access Instructions and the Hospice CAHPS Provider Preview Reports Access Instructions.
CMS to Host Quality of Patient Care Star Ratings Algorithm Call for Home Health Agencies: June 27 The U.S. Centers for Medicare and Medicaid Services (CMS) will be hosting a Quality of Patient Care Star Ratings Algorithm call for home health agencies on Wednesday, June 27 from 2 to 3 p.m. During this call, home health agencies can learn about proposed modifications to the way CMS calculates Home Health Quality of Patient Care Star Ratings, including:
Removal of the measure “Drug Education on All Medications Provided to Patient/Caregiver during All Episodes of Care.”
Addition of the measure “Improvement in Oral Medications.”
CMS will present the rationale, proposed timing, and impact of these changes. A question and answer session follows the presentation. Registration for the call is at https://blh.ier.intercall.com/.
OIG Releases Semiannual Report to Congress The federal Office of Inspector General (OIG) has posted its Semiannual Report to Congress that covers October 1, 2017 to March 31, 2018. It is at https://oig.hhs.gov/reports-and-publications/archives/semiannual/ 2018/sar-spring-2018.pdf. The report describes OIG’s work identifying significant risks, problems, abuses, deficiencies, remedies, and investigative outcomes relating to the administration of U.S. Department of Health and Human Services (HHS) programs and operations that were disclosed during the reporting period: October 1, 2017, through March 31, 2018. It includes actions taken against home health, home and community based services, hospice and other agencies; reports on state practices related to Medicaid and other programs; audits on cybersecurity protections; studies on the U.S. Centers for Medicare and Medicaid Services’ policies and procedures for various Medicare services; criminal and civil enforcement activities; oversight of state Medicaid Fraud Control Units; and more.
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The Situation Report: the Home Care Association of New York State
Upcoming Deadlines
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Requirement/Change
Effective/Due Date
More Information
Home Care, Fiscal Intermediaries and other providers who contract with Managed Care Organizations must be enrolled in Medicaid
Still being accepted, but providers are advised to submit now
https://www.emedny.org/info/ProviderEnrollment/ManagedCareNetw ork/index.aspx
Transition Period for Using Health Insurance Claim Number (HICN) or new Medicare Beneficiary Identifier (MBI)
April 1, 2018 to December 31, 2019
https://www.cms.gov/Medicare/NewͲMedicareͲCard/index.html
Written notice on NYC Paid Safe and Sick Leave Law must be given to existing employees
Due June 4, 2018
http://www1.nyc.gov/site/dca/businesses/paidͲsickͲleaveͲlawͲforͲ employers.page
Submission of Expression of Interest for the Medicare Low Volume Appeals Initiative
Due April 12 to June 8
https://www.cms.gov/Medicare/AppealsͲandͲ Grievances/OrgMedFFSAppeals/AppealsͲSettlementͲInitiatives/LowͲ VolumeͲAppealsͲInitiative.html
Long Term Care Planning Council Survey
Due June 18, 2018
https://www.surveymonkey.com/r/HM9DM97
Health Workforce Retraining Program RFA
Due June 22, 2018
https://www.health.ny.gov/funding/rfa/17842/index.htm
Rural Health Network Development Program RFA
Due June 28, 2018
https://hcaͲnys.org/wpͲcontent/uploads/2018/05/RuralͲHealthͲ NetworkͲDevelopmentͲProgramͲ_RFP_MayͲ2018.pdf
Managed care organizations will initiate termination of contracted providers who have not enrolled in Medicaid
July 1, 2018
2017 OSHA Form 300A (A Summary of WorkͲRelated Injuries and Illnesses)
Due July 1, 2018
https://www.osha.gov/injuryreporting/index.html
Hearing on state Department of Labor’s proposed rule to exclude compensable hours for meals and sleep time for all employees
July 11, 2018
www.labor.ny.gov
Certified Home Health Agency 2017 Medicaid Cost Report
Due July 16, 2018; HCA is seeking an extension
https://commerce.health.state.ny.us/public/hcs_login.html
Personal Care Provider 2017 Medicaid Cost Report
New Due Date: July 30, 2018
https://commerce.health.state.ny.us/public/hcs_login.html
https://www.emedny.org/info/ProviderEnrollment/ManagedCareNetw ork/index.aspx
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Age-Friendly Health Systems Webinar to be Held The state Department of Health (DOH), in collaboration with the John A. Hartford Foundation, will hold an Age-Friendly Health Systems webinar on Tuesday, June 20, 2018 from 3:30 to 4:30 p.m. Registration is at https://meetny.webex.com/meetny/k2/j.php?MTID=t78dc9d0b4f7ea118608b341607bb8cf1. This webinar will cover:
What an age-friendly health system is and its importance
The John A. Hartford Foundation and the Institute for Healthcare Improvement Age-Friendly Health Systems Initiative
How organizations can take steps to become age-friendly
Age-friendly health systems provide a specific set of evidence-based geriatric best practice interventions that:
Provide better health outcomes for older adults
Reduce waste associated with low-quality services
Increase utilization of cost-effective services for older adults
Improve reputation and market share
Governor Cuomo’s 2018 State of the State book includes a goal for New York to have 50 percent of its health systems age-friendly within the next five years. Questions can be directed to ALTCteam@health.ny.gov.
A Reminder about HCS Requirements HCA reminds members of how important it is to utilize the Health Commerce System (HCS) and to meet requirements related to the HCS. The HCS is the state Department of Health’s primary communication vehicle during emergencies, as well as for normal operational issues, including providing access to applications such as the Criminal History Record Check, the Home Care Worker Registry, and the Electronic Plan of Correction; collecting cost and statistical information from providers; and issuing guidance and communications such as Dear Administrator Letters (DALs). As announced to members in an e-mail alert , the state Department of Health (DOH) just last week sent out an important survey via the HCS for home care providers, due today (before press time for The Situation Report. Continued on next page
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Continued from previous page Regulations require that all Licensed Home Care Services Agencies, Certified Home Health Agencies, Long Term Home Health Care Programs and hospice providers maintain current HCS accounts, including provider contact information. Every home care and hospice provider is required to:
Obtain accounts for each licensed site it operates and ensure that staff are available to maintain and keep their accounts current.
Keep the agency’s HCS Communications Directory current and updated, reflecting changes in general information and staff roles as soon as they occur, and review it at least monthly.
Check the HCS daily, but more frequently during an emergency.
Assign staff to the following roles: Administrator; Director, Home Care Patient Services or Patient Services for hospices, Emergency Response Coordinator, and HPN Coordinator.
Establish HCS policies and procedures and review them at least annually.
Additional information is included in a state DOH DAL at https://hca-nys.org/wp-content/uploads/2018/06/ DAL_HCS_Requirements_020316.pdf.
Webinar Scheduled on Alzheimer’s Voucher Program The state Department of Health (DOH) will hold a webinar to discuss a newly enacted state budget provision that implements a voucher demonstration program targeted at those who are living with Alzheimer’s Disease and/or dementia in a Special Needs Assisted Living Residence (SNALR). The webinar will be held on June 11 from 2:30 to 3:30 p.m. and will provide program parameters and other important information. Registration is here: https://tinyurl.com/y9lu8qj2. The goal of the demonstration program is to provide financial assistance to help residents remain in the SNALR and delay or eliminate discharges to skilled nursing facilities.
NGS Updates National Government Services (NGS), New York’s Medicare Administrative Contractor (MAC), has provided the following important updates on its website.
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Changes to Termination Effective Date on All Provider Enrollment Applications. To ensure claims submitted for dates of service through the effective date of termination are paid, the U.S. Centers for Medicare and Medicaid Services (CMS) has directed MACs to ensure that the PECOS enrollment record
The Situation Report: the Home Care Association of New York State
Volume 3, No. 23 June 4, 2018
and corresponding documentation reflect a termination date of one day after the requested date on all CMS applications (855A, 855B, 855I, 855R, 855O and 20134). Therefore, if an application reflects an effective date of termination as May 31, 2018, the applicable Provider Transaction Access Number (PTAN) will be terminated effective June 1, 2018 and the finalization letter will also reflect June 1, 2018.
New Monthly EDI Bulletin Coming to Trading Partners. Starting in June, NGS’s Electronic Data Interchange (EDI) will deliver the EDI Monthly Bulletin as a PDF file to providers. The monthly bulletin will highlight an EDI topic, transaction or new feature that will help improve efficiencies and reduce costs.
July 2018 Release Dark Days for the Common Working File. In preparation for the July 2018 Release, the Common Working File (CWF) Hosts will not process claims beginning Friday, June 29, 2018 through Sunday, July 1. During this period, which is commonly referred to as “dark days,” the CWF Hosts will install the July 2018 Release, complete weekly/monthly/quarterly processing activities, and perform scheduled data center maintenance. These dark days will limit access to information provided by the Interactive Voice Response (IVR) system and NGSConnex. Providers may experience limited or no access to claims, eligibility, claim overlap, patient status, check inquiry, reopening/redetermination status, offset information, and financial claim information.
For further information, contact Patrick Conole at (518) 810-0661 or pconole@hcanys.org.
Resources
“Social Determinants Of Health: A Public Health Concept In Conflict,” Health Affairs Blog (May 30, 2018) https://tinyurl.com/yb4qocf7
“Expenditure Reductions Associated with a Social Service Referral Program,” Population Health Management https://www.liebertpub.com/doi/10.1089/pop.2017.0199
For more information, contact Andrew Koski at (518) 810-0662 or akoski@hcanys.org.
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