QIVAPP
SEPSIS
SCHEDULING-PAY RULE POSTED
CONTRACTING COMPLIANCE
QIVAPP funds released soon to MLTC plans for pass-through to eligible New York City providers.
HCA is excited to announce the first series of crosssector collaborative training programs as part of our “Stop Sepsis at Home” initiative. . PAGE 3
The state Department of Labor has posted its proposed rule regarding pay for “call-in” and other scheduling situations. Join us for Dec. 6 call to discuss the rule.
HCA offers a brand new webinar for members to explore vital issue of home care-managed care contracting compliance. Join us on December 14.
PAGE 5
PAGE 8
PAGE 2
COMING UP
Your Source for HOME CARE News, Policy and Advocacy
Bootcamp: How LHCSAs Can Survive and Thrive in a VBP World Upstate Edition (Syracuse): Dec. 4, 2017
CMS Confirms 1-Year Delay on CoP Civil Monetary Penalties
The Second Annual Women in Health Care Leadership Summit Dec. 7 & 8, 2017 Saratoga Springs Webinar: Contracting Compliance Challenges in a Managed Care Environment Dec. 14, 2017 Northeast Home Health Leadership Summit Jan. 16-18, 2018 Boston
Vol. 2, Issue 43 | November 27, 2017
Our national partners at ElevatingHome have confirmed that the U.S. Centers for Medicare and Medicaid Services (CMS) will instruct its Regional Offices to delay imposing Civil Monetary Penalties (CMPs) on home health agencies (HHAs) for one year related to the new home health Conditions of Participation (CoPs). The one-year delay would begin on the effective date of the new CoPs, currently scheduled for January 13, 2018. This agreement was made by CMS to acknowledge and address provider concerns with having CMPs imposed while they are still familiarizing themselves with the new CoPs. The exception to this hiatus will be where Immediate Jeopardy situations are identified on survey. During the hiatus, surveyors will still cite agencies for noncompliance with the revised CoPs. If the agency does not make the necessary corrections to regain compliance, the agency may be terminated or an alternative sanction may be imposed temporarily in lieu of immediate termination (limit 6 months). This hiatus will not apply to emergency preparedness compliance, which began on November 15, 2017, or for the quality improvement section of the CoPs, which does not start until July 13, 2018.
Women’s Leadership Summit Next Week! Time is Running Out! Time is running out to register for our Women in Healthcare Leadership Summit next week in Saratoga Springs (December 7 and 8). Don’t miss out on this final HCA Signature program of 2017, and a chance to network with powerhouse women leaders in home care and health care, See SUMMIT p. 2
INSIDE CMS Confirms 1-Year Delay on CoP Civil Monetary Penalties...................................1 Women’s Leadership Summit Next Week! Time is Running Out!.............................1 2016-17 QIVAPP Funding Finalized for NYC Providers.............................................2 HCA “Stop Sepsis at Home” Training Sessions Begin in December: Register Today!........3 Emergency Preparedness Series Starts Thursday for Upstate Providers.................4 DOL Posts Proposed Rule on Scheduling, “Call-in” Pay...........................................5 LHCSA-VBP Program Coming Up in One Week for Upstate Providers.......................6 Appeals Process to Change for Medicaid Managed Care Enrollees.........................6
Important Upcoming Deadlines and Due Dates...................................................7 CMS Announces Subunit Changes.......................................................................8 Reminder: 12/14 Webinar on Home Care-Managed Care Contract Compliance....8 DOH Issues DAL on CMS’s Updated OASIS-C2 Guidance Manual.............................8 DOH Convenes New Workgroup on LTC Need Methodologies.................................10 HCA Comments on DOH’s Draft MLTC Model Contract Revision............................10 State’s Medicaid Cap Report Shows $25M Variance from Projections ................11 eMedNY Training Schedule Announced.............................................................12 Resources...........................................................................................................................12
The Situation Report: the Home Care Association of New York State SUMMIT from p. 1 plus some exceptional leadership sessions to support you. Please remember that we are also offering a special mentor/ mentee rate for additional savings. Mentors and sponsors play a vital role in supporting women leaders on the rise. If you are a C-level executive, please consider taking this sentiment to heart by actively working to support a colleague’s advancement in healthcare at our upcoming conference. We have several exceptional consultants, business leaders and women entrepreneurs on hand to give you tools, insights and information to excel. More information about the program is in the brochure at the back of this week’s newsletter. You can register online at https://www.eventville.com/catalog/ eventregistration1.asp?eventid=1012182.
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 Vice President acardillo@hcanys.org Patrick Conole Vice President, Finance & Management pconole@hcanys.org
2016-17 QIVAPP Funding Finalized for NYC Providers The state Department of Health (DOH) has informed HCA of the funding that will be given to managed long term care (MLTC) plans and then passed on to their eligible home care contractors in New York City for the Quality Incentive Vital Access Provider Pool (QIVAPP) program (for the period from April 1, 2016 through March 31, 2017). MLTC plans were e-mailed information about the QIVAPP amounts last week. The funding will be distributed by lump-sum payment in cycle 2101 to the plans with a check release date of December 13, 2017. DOH is requiring that all funding be passed through to providers by January 16, 2018. DOH advised HCA recently that the final QIVAPP amounts should not differ from the initial amounts announced in September and which HCA shared with members, but HCA has not reviewed the final amounts yet to confirm this. 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
2
Volume 2, No. 43 November 27, 2017
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
The Situation Report: the Home Care Association of New York State
Volume 2, No. 43 November 27, 2017
Continued from previous page QIVAPP has been available since the 2014-15 state fiscal year for New York City home care providers who contract with MLTCs and meet certain criteria. The eligibility criteria include:
Home care agencies receive at least $18.50 per hour from MLTC plans.
The home care agency maintains or participates in a specialty training program for home health aides (HHAs) and personal care aides (PCAs) that exceeds DOH’s training requirements (the standard 75 hours of training for HHAs or 40 hours for PCAs and/or the annually required in-service training of 12 hours for HHAs and 6 hours for PCAs).
The agency has a written, implemented and currently active quality assurance program.
The agency participates in a health benefit fund for its HHAs and/or PCAs and/or provides comprehensive health insurance coverage to its employees that meets certain requirements outlined by DOH.
At least 30 percent of the agency’s total New York City workforce is enrolled in the health benefits coverage.
More information on QIVAPP for past years is at https://www.health.ny.gov/health_care/medicaid/redesign/ mrt_61.htm.
HCA “Stop Sepsis at Home” Training Sessions Begin Dec. 15 Through March: Register Today! Registration is now open for home care providers and system partners (including hospitals, nursing homes, physician practices, EMS and managed care plans) to participate in eight upcoming regional training sessions as part of HCA’s NYSHealth-funded “Stop Sepsis at Home” initiative. Find a session near you and register online free of charge at https://www.surveymonkey.com/r/SepsisRegionalTrainings. Learn more and read the program agenda for each session by downloading the flyer at https://hca-nys.org/wp-content/uploads/2017/11/Regional-Sepsis-Training-andCross-Sector-Session-Brochure.pdf. With 80 to 90 percent of sepsis cases originating in the community, among other compelling data, the New York State Health Foundation (NYSHealth) has awarded HCA a major grant to support home care’s statewide adoption and use of HCA’s sepsis screening and intervention tool, which was developed and piloted in conjunction with partner organizations over the past two years. Continued on next page
3
The Situation Report: the Home Care Association of New York State
Volume 2, No. 43 November 27, 2017
Continued from previous page While this effort is home care-driven, it is absolutely vital that system partners also engage on the mutual benefits of this first-of-its-kind community-based sepsis prevention effort by attending one of our upcoming training programs. HCA and sepsis leaders (including IPRO, national Sepsis Alliance, Rory Staunton Foundation for Sepsis Prevention, and others) are holding eight in-depth training sessions across New York State for all home care and applicable providers on sepsis, steps for provider adoption and clinical application of the sepsis screening tool, clinical case application, integration into agency procedures and records, and more. Who should attend? Home care agencies, hospitals, physician practices, EMS, health plans and other community partners.
Emergency Preparedness Sessions Begin This Thursday and Friday for Providers in String of Upstate Counties HCA and the New York State Association of Health Care Providers (HCP) are holding a series of local emergency preparedness sessions for all home care agencies and hospices serving patients in the Central New York and lower Hudson Valley areas. The sessions are the most recent in a series of emergency preparedness networking sessions that HCA and HCP have been conducting progressively across the state since 2016, reaching 24 counties to date. The sessions are supported by a federal/state-administered grant. Each session pairs county emergency managers and county public health department health preparedness representatives with home care and hospice representatives to discuss needs, challenges, best practices and recommendations. Session dates are below for each of the following regions and counties. See the online registration form for specific locations at https://www.surveymonkey.com/r/EPTrngs.
4
November 30, 2017: Jefferson, Lewis, St. Lawrence Counties (10 a.m. to noon); Cayuga, Cortland, Onondaga, Oswego Counties (2 to 4 p.m.)
December 1, 2017: Broome, Chenango, Tioga, Tompkins Counties (10 a.m. to noon); Herkimer, Madison, Oneida Counties (2 to 4 p.m.)
December 7, 2017: Ulster, Sullivan, Orange, Rockland Counties (10 a.m. to noon); Dutchess, Putnam, Westchester Counties (2 to 4 p.m.)
The Situation Report: the Home Care Association of New York State
Volume 2, No. 43 November 27, 2017
DOL Posts Proposed Rule on Scheduling, “Call-in” Pay HCA solicits member comments and will hold December 6 program to review the rule On November 22, the state Department of Labor (DOL) published in the State Register its proposed rule that will require home care agencies to pay additional wages for employees affected by certain employer scheduling practices, including “call-in pay” situations. The November 22 publication of the rule starts the clock on a 45-day comment period that ends January 8, 2018. HCA asks members to review this important rule and send us any concerns or feedback so that we can incorporate them into our comments for submission to state DOL. While the announcement states that the rule “does not impose any mandatory costs on the regulated community,” nor “an adverse economic impact upon small businesses,” HCA disagrees and looks to our members to provide support for our response. The State Register notice is at https://docs.dos.ny.gov/info/register/2017/nov22/toc.html (page 8). The newly proposed DOL rule would impose the following requirements on employers (with certain exceptions): 1. An employee who reports to work for a shift not scheduled 14 days in advance must be paid an additional two hours of call-in pay. 2. An employee whose shift is canceled within 72 hours of the scheduled start time must be paid at least four hours of call-in pay. 3. An employee who is required to be available to report to work (“on-call”) must be paid at least four hours of call-in pay (current practice). 4. An employee who is required to contact the employer and confirm whether to report to work within 72 hours of the shift start time must be paid at least four hours of call-in pay. Members-Only Call HCA will hold a members-only call on this proposed rule on Wednesday, December 6, at 10 a.m. Registration for this free member call is at https://www.surveymonkey.com/r/Dec6HCACall. Just fill out the form and HCA will send you dial-in information in advance of the call. The program will be led by Joseph Dougherty, a member of Hinman Straub’s Labor and Employment and Litigation departments. He represents a wide variety of clients in addressing issues that arise in and out of the workplace and in litigation matters. For more information, contact Andrew Koski at (518) 810-0662 or akoski@hcanys.org.
5
The Situation Report: the Home Care Association of New York State
Volume 2, No. 43 November 27, 2017
LHCSA-VBP Program Coming Up in One Week for Upstate Providers The upstate version of our program How LHCSAs Can Survive and Thrive in a VBP World is coming up one week from today, on December 4 in Syracuse. The timing of this program is especially important as the state is requiring all MLTC contracts to include Value Based Payment (VBP) provisions by December 31, 2017, which is little more than a month away. Home care agencies need to get ready for this imminent requirement as soon as possible. The program will examine your agency’s role as a “VBP contractor” and focus on successfully working with MLTC partners in navigating the path to the VBP world. Please note that both of our previously announced New York City sessions for this program (on November 30) have officially sold out. Information about our upstate session, in Syracuse, is below. Register here today: https://hca-nys.org/wp-content/uploads/2017/11/HCA-Bootcamp-How-LHCSAsCan-Survive-and-Thrive-in-a-VBP-Dec-4-2017-Registration-Form.pdf.
Appeals Process to Change for Medicaid Managed Care Enrollees Due to federal Medicaid regulations that affect managed care plans, plan enrollees will soon have to request an internal appeal with their plan and the plan must deny that appeal before the enrollee can request a fair hearing. According to the New York Legal Assistance Group, while the change is effective in New York on April 1, 2018, the state Department of Health (DOH) intends to put it in effect on March 1, 2018. Under this change, if a Medicaid mainstream managed care or managed long term care plan sends a notice that it intends to reduce hours of home care services, or reduce or stop any other service, the member will now have to request an internal plan appeal within the 10-day window needed to secure “aid continuing” — continuation of services at the original current amount, without the proposed reduction going into effect. To prepare for implementation of this change, DOH has convened a workgroup comprised of both plan and consumer representatives, and has solicited comments on draft model notices. HCA will provide more information once it becomes available. An article on this issue is at www.wnylc.com/health/news/80.
6
The Situation Report: the Home Care Association of New York State
Volume 2, No. 43 November 27, 2017
Important Upcoming Deadlines Requirement/Change
Effective/ Due Date
Fiscal Intermediary (FI) Authorization Application Dec. 1, 2017 due from Existing FIs
7
More Information https://www.health.ny.gov/health_care/medicaid/redesign/mrt_10003.htm https://www.health.ny.gov/health_care/medicaid/program/update/2017/2017Ͳ 10.htm#consumer
Wage Parity Certification Forms due from LHCSAs and Fiscal Intermediaries for December 1, 2017 to February 28, 2018
Dec. 1, 2017
https://www.health.ny.gov/health_care/medicaid/redesign/mrt_61.htm
Medicare Open Enrollment Period
Oct. 15 to Dec. 7, 2017
www.medicare.gov
2016 Adult Care Facility Financial Report
Dec. 22, 2017
https://commerce.health.state.ny.us/public/hcs_login.html
2016 CHHA/LTHHCP Statistical Report
Dec. 29, 2017
https://commerce.health.state.ny.us/public/hcs_login.html (HERDS application)
2016 Hospice Cost and Utilization Report
Dec. 29, 2017
https://commerce.health.state.ny.us/public/hcs_login.html (HERDS application)
2018 State Worker Wage Parity Levels
Dec. 31, 2017
https://www.health.ny.gov/health_care/medicaid/redesign/mrt_61.htm
2018 State Minimum Wage Levels
Dec. 31, 2017
https://www.labor.ny.gov/workerprotection/laborstandards/workprot/minwage.shtm
State Compliance Program Certification Form Submission
Dec. 31, 2017
https://omig.ny.gov/sslͲcertification
Federal Deficit Reduction Act Compliance Certification Form Submission
Dec. 31, 2017
https://omig.ny.gov/draͲcertification
Implementation of Universal Billing Codes for Home and Jan. 1, 2018 CommunityͲBased Long Term Care Services under Managed Care
https://www.health.ny.gov/facilities/long_term_care/reimbursement/letters/dal_201 7Ͳ09Ͳ22_billing_codes.htm
Revised Medicare Home Health Conditions of Participation in Effect
Jan. 13, 2018
https://www.gpo.gov/fdsys/pkg/FRͲ2017Ͳ01Ͳ13/pdf/2017Ͳ00283.pdf
Start of Transition Period for Using Health Insurance Claim Number (HICN) or Medicare Beneficiary Identifier (MBI)
April 1, 2018
https://www.cms.gov/Medicare/NewͲMedicareͲCard/index.html
The Situation Report: the Home Care Association of New York State
Volume 2, No. 43 November 27, 2017
CMS Announces Subunit Changes The U.S. Centers for Medicare and Medicaid Services (CMS) has announced a change in the treatment of home health agency (HHA) subunits. Under the newly revised Conditions of Participation (CoPs), effective January 13, 2018, the definition for “subunit” has been eliminated. Existing subunits will become freestanding HHAs unless they notify the State Survey Agency (SA) and the Medicare Administrative Contractor (MAC) that they wish to become a branch office of the parent organization. Information on HHAs’ options and the actions that existing subunits must take are in a CMS Survey and Certification Memo at https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/ SurveyCertificationGenInfo/Downloads/Survey-and-Cert-Letter-18-03.pdf.
Reminder: Dec. 14 Webinar on Contracting Compliance Challenges in Home CareManaged Care Compliance and program integrity are pressing concerns for all home care agencies and managed care plans functioning in today’s competitive marketplace. Join HCA for a new December 14 webinar on this important topic (from 10 to 11:30 a.m.) by completing the registration form at the link below. You’ll hear from one of the state’s preeminent compliance experts, at Arent Fox, about common pitfalls and trouble spots that, if not handled properly, can result in violations of federal and state law, as well as recoupments or sanctions during federal and state audits. Webinars offer you a convenient, cost effective way to access critical information. There’s no travel expense, nor time away from the office, and you can invite as many colleagues as you’d like to listen-in through a single registered site connection. Register using the form at https://hca-nys.org/wp-content/uploads/2017/11/Contracting-ComplianceChallenges-in-a-Managed-Care-Environment.pdf.
DOH Issues DAL on CMS’s Updated OASIS-C2 Guidance Manual The state Department of Health (DOH) issued a Dear Administrator Letter (DAL) last week to notify Certified Home Health Agencies (CHHAs) and Long Term Home Health Care Programs (LTHHCPs) that the updated U.S. Centers for Medicare and Medicaid Services (CMS) Outcome and Assessment Information Set (OASIS) C2 guidance manual is available and will be effective January 1, 2018. The OASIS Data Sets have not changed. DOH’s DAL is at: https://hca-nys.org/wp-content/uploads/2017/11/DAL_OASIS-2_112117.pdf. The OASIS C2 Guidance Manual replaces the previous version in its entirety. The updated manual corrects any minor
8
The Situation Report: the Home Care Association of New York State
Volume 2, No. 43 November 27, 2017
errors from the previous version and contains clarifications about the “One Clinician Rule,” as explained below. HCA members can download the manual at: https://www.cms.gov/Medicare/Quality-Initiatives-PatientAssessment-Instruments/HomeHealthQualityInits/HHQIOASISUserManual.html. Agencies are encouraged to print out the manual and share with appropriate agency staff and clinicians. Chapter 1 of the guidance manual contains clarifications about the “One Clinician Rule.” Although one clinician must take responsibility for accurate completion of the comprehensive assessment, a clinician and/or other agency staff are permitted to collaborate with the patient, caregivers, and other health care personnel (including the physician or pharmacist) for assistance with completion of OASIS items, effective January 1, 2018. When collaboration is utilized, the assessing clinician is responsible for considering available input from these other sources and selecting the appropriate OASIS item response(s) within the appropriate timeframe and consistent with CMS guidance. For items requiring patient assessment, the collaborating health care providers must have had direct contact with the patient. If collaboration with other health care professionals and/or agency staff is utilized, the agency is responsible for establishing policies and practices related to collaborative efforts, including how assessment information from multiple clinicians will be documented within the clinical record, ensuring compliance with applicable requirements, and accepted standards of practice. OASIS data should be collected at each time point based on a unique patient assessment, not simply carried over from a previous assessment. Comprehensive assessment data form the basis of the physician-ordered plan of care. Thus, the documentation of comprehensive assessment findings and the plan of care should be congruent. The plan of care should be updated to reflect revised care orders and current diagnoses throughout the period the patient is receiving home health services. Agencies may continue to limit the OASIS to only data directly assessed and collected by the single assessing clinician. HCA members can find additional information pertaining to the “One Clinician Rule” at the following CMS OASIS Resources:
OASIS Data Sets: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-AssessmentInstruments/HomeHealthQualityInits/OASIS-Data-Sets.html
OASIS Guidance Manual: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-AssessmentInstruments/HomeHealthQualityInits/HHQIOASISUserManual.html
CMS OASIS Quarterly Q&As: https://www.qtso.com/hhatrain.html
Questions on this DAL or the OASIS-C2 guidance manual can be e-mailed to DOH at: oasis@health.ny.gov.
9
The Situation Report: the Home Care Association of New York State
Volume 2, No. 43 November 27, 2017
DOH Convenes New Workgroup on LTC Need Methodologies The state Department of Health has convened a new/additional regulatory modernization workgroup to analyze and make recommendations on “long term care need methodologies and innovative models.” The workgroup met last Monday for the first of what may be two or three meetings total, exploring issues in certificate of need (CON), service capacity, quality considerations and related methodological and policy issues. The workgroup charge is to examine these issues pertinent to home care, hospice, nursing homes, and assisted living. A major portion of the initial meeting was devoted to broader background, including a presentation of quality measures currently required and collected in long term care, and the Administration’s “Age-Friendly and Health Across All Policies” goals. HCA discussed the intent and provisions of the state’s laws related to home care CON, commented on developments in home care quality measures (in particular those which are unfolding for agencies under the state’s value based payment initiative), and underscored the need to ensure home care capacity in ways beyond just the approval of “numbers of agencies” – providing support to agencies for a home care infrastructure that meets the significant and dramatically increasing statewide and regional needs for care. The home care discussion will continue at the next meeting, which is also anticipated to focus on hospice and nursing homes. The workgroup membership includes HCA, several individual HCA provider and MLTC members selected by DOH, along with state and regional long term care and hospital association representatives. A DOH background paper prepared for the workgroup, including discussion questions posed, can be viewed at https://hca-nys.org/wp-content/uploads/2017/11/Long-Term-Care-Need-Methodologies-and-Innovative-ModelsBackground-Paper-110217.pdf. HCA will be developing formal comments and recommendations in response to the DOH background paper and questions. HCA invites the direct input of the membership, including CHHA, LHCSA, MLTC, hospice, CDPAP and fiscal intermediary members. Please direct your input to HCA Executive Vice President Al Cardillo acardillo@hcanys.org, or HCA Vice President Andrew Koski at akoski@hcanys.org.
HCA Comments on DOH’s Draft MLTC Model Contract Revisions DOH invited HCA and other associations representative of MLTC members to comment on draft revisions to the state’s model contact for MLTC partial capitation. In response, HCA last week presented comments and suggestions on this draft, which encompassed many technical changes as well as substantive ones. HCA focused our comments on areas of potential operational and fiscal impact to plans and, in turn, to network providers and enrollees (e.g., case manager-to-enrollee ratios, CDPAP provisions, new emergency preparedness provisions, discharge planning, among others). As the dialogue with colleagues and DOH continues, HCA will be advocating that agreed-to changes be accommodating and workable (particularly given the vast activity associated with MLTC movement to value based payment contracts, and the host of additional requirements and mandates continuing to be layered upon MLTCs), and that fiscal impacts be factored into appropriate premium/funding adjustments for plans. HCA will keep the membership apprised of the developments.
10
The Situation Report: the Home Care Association of New York State
Volume 2, No. 43 November 27, 2017
State’s Medicaid Cap Report Shows $25M Variance from Projections In April through August The state’s latest Medicaid Global Cap Spending Report (for the current fiscal year through August 2017) finds that overall spending was $25 million above the global cap projections, across all sectors, a difference of $9.010 billion in actual spending versus $8.985 billion in estimated spending for the period. The fiscal year (FY) begins on April 1 and ends on March 31. Nearly all of the provider and plan categories were above the cap projections. “Other Long Term Care” (which includes home care) was $19 million above projections. DOH notes that there were 1,220 more personal care recipients during this period, driving the costs. Managed Long Term Managed Care was $35 million over projections due to there being 2,925 more recipients than anticipated during the report period. In other report highlights:
The Accounts Receivable (A/R) ending balance for FY 2017 was $204 million. The state is expected to recoup $135 million by the end of FY 2018, resulting in a projected A/R balance of $69 million by March 2018. Through the end of August, retroactive rates owed to the state were $165 million. This reflects net recoveries of $39 million since March 2017.
Total Medicaid enrollment reached 6,089,989 at the end of August 2017. This reflects a net decrease of 23,578 enrollees since March 2017.
The report contains multiple other data, including tables or summaries of: Vital Access Provider program award amounts; Inventory of Medicaid Rate Packages, Regional Medicaid spending, enrollment estimates; and more. These reports, particularly the semi-annual and annual reports, are important given the superpowers allowing executive actions to cut rates in the event that spending exceeds the cap. As Washington continues to debate a health care overhaul, with billions of dollars in Medicaid funding and expansion dollars at stake, HCA will advocate for a funding mechanism that sustains vital services and accurately accounts for reasonable cost factors, such as enrollment changes and wages and related labor costs, in a flexible interpretation of provider performance relative to the cap. The full report is at: https://www.health.ny.gov/health_care/medicaid/regulations/global_cap/monthly/ sfy_2017-2018/docs/aug_2017_report.pdf. For further information, contact Patrick Conole at (518) 810-0661 or pconole@hcanys.org.
11
The Situation Report: the Home Care Association of New York State
Volume 2, No. 43 November 27, 2017
eMedNY Training Schedule Announced The eMedNY Training Schedule for November and December is available, and open to registrations for seminars and webinars. Some of the topics offered include:
ePACES for Dental, DME, Free Standing and Hospital Based Clinics, Institutional, Professional (RealTime), Physician, Private Duty Nursing, and Transportation
Medicaid Eligibility Verification System (MEVS)
eMedNY Website Review
New Provider/ New Biller
The schedule is at https://www.emedny.org/training/index.aspx.
Resources
“From Katrina To Wildfires: Leveraging Technology In Disaster Response,” Health Affairs Blog (November 17, 2017) http://www.healthaffairs.org/do/10.1377/hblog20171113.545312/full/
“Quarterly Update of HCPCS Codes Used for Home Health Consolidated Billing Enforcement,” by the U.S. Centers for Medicare and Medicaid Services https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017-Transmittals-Items/ R3923CP.html?DLPage=1&DLEntries=10&DLSort=1&DLSortDir=descending
“Home Health Agency Subunits,” by the U.S. Centers for Medicare and Medicaid Services https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/ Downloads/Survey-and-Cert-Letter-18-03.pdf
For more information, contact Andrew Koski at (518) 810-0662 or akoski@hcanys.org.
12
December 7 & 8, 2017 Excelsior Springs at the Courtyard Marriott 47 Excelsior Avenue Saratoga Springs, NY 12866
The Second Annual
Own Your Voice: Leading with Strength, Certainty & Style
The Second Annual
December 7 & 8, 2017 Excelsior Springs at the Courtyard Marriott 47 Excelsior Avenue Saratoga Springs, NY 12866
Own Your Voice: Leading with Strength, Certainty & Style Building on the success of last year’s inaugural program, HCA is excited to present the second annual Women in Healthcare Leadership Summit on December 7-8 to help women leaders from across the health care spectrum cultivate their unique talents and strengths as leaders. Hear from women executives, leadership consultants and other engaging presenters who will help you leverage tools and insights for professional advancement, enhance your potential for leadership growth, and further develop your talents as women leaders in health care.
Courtyard by Marriott Saratoga Springs 11 Excelsior Avenue Saratoga Springs, NY 12866 Phone: (866) 210-9325 HCA has reserved a limited block of rooms at the Courtyard by Marriott Saratoga Springs for the night of Thursday, December 7th at a discounted rate of $129 per night. To receive this special rate, please call (866) 210-9325 prior to November 7th and ask for the Home Care Association of NYS group rate.
$129/night
The new state-of-the-art lobby at Courtyard by Marriott Saratoga Springs provides greater flexibility and choices for their guests, including spaces to work or relax in, free Wi-Fi throughout and easy access to the latest news, weather and airport conditions via the GoBoard. The highlight of the new lobby experience is The Bistro - Eat. Drink. Connect. which provides guests with healthy food and beverage offerings in the morning and evening dinner service with cocktails. The hotel is just a few minutes walk to downtown Saratoga. The hotel offers complimentary local shuttle service, a well equipped fitness center, indoor pool and whirlpool. A 24-hour business center and boarding pass printing service are also available and train access is nearby.
The Second Annual
Thursday, December 7, 2017 Excelsior Springs Foyer (Located at 47 Excelsior Avenue) 5:00 – 7:00 PM
Tell Me About It: Networking & Cocktail Reception Mix and mingle with like-minded power-house women in the healthcare industry while you enjoy hors d'oeuvres, a cocktail (or two) and peruse items from Stella & Dot, LuLa Roe, Madame Pirie and more!
Inspiring & Indulgent Door Prizes We will be hosting pop-up prize drawings throughout the event starting with our networking reception giving you the opportunity to win one of our inspiring and indulgent door prizes, but you must be present to win!
Thanks to our summit sponsors:
The Second Annual
Friday, December 8 Programming will be held in the Excelsior Springs Building located at 47 Excelsior Avenue. 8:00-9:00AM
Women of Influence Networking Breakfast 9:00 – 9:15 AM
HCA President’s Welcome 9:15-10:45AM
Women Who Grow: Lessons on Entrepreneurship from the Cannabis Industry Panelists: Kristin L. Jordan, Chair, Newman Ferrara, LLP- Cannabis Practice Group Tanya Osborne, NYC Market Leader, Women Grow Hillary Peckham, Chief Operations Officer, Etain, LLC Panel Moderator: Bernie Lee, MD, Associate Chief Medical Officer, MJHS Hospice and Palliative Care With the evolution of legalized recreational (8 states + DC) and medical marijuana (29 states) in states across the U.S., including New York, women have emerged as a driving force in the advocacy for and development of the cannabis industry. Panelists will provide insights, strategies and lessons learned that will enlighten and equip you to engage your own entrepreneurial spirit. 10:45-11:00AM
Break 11:00-Noon
DIY Leadership Edition: Use Existing Skills & Resources to Customize Your Own Leadership Experience Katherine Detwiler, Strategic Alliances Manager, Relias Learning; Founder & Co-Chair, Relias Women’s Leadership Initiative; President, NC Triangle Chapter of Ellevate In an ongoing study by leadership consultancy Zenger Folkman, women are consistently rated by their peers, bosses, direct reports and other associates as better overall leaders than their male counterparts. Further, two of the measures on which women outscore men to the highest degree — taking initiative and driving for results — have long been thought of as particularly male strengths. While the lack of gender diversity in leadership remains one of the biggest challenges for organizations, our opportunities to lead don’t have to depend solely on corporate structure or title changes! In this interactive session, find out how to uncover leadership opportunities where you are right now, leverage existing resources at work and in your community, and create your own path to becoming the leader you are meant to be. Noon-1:30PM
Networking Luncheon & Leadership Roundtables Enjoy a sumptuous lunch with your colleagues as you explore a leadership topic of your choice such as managing work/life balance, the rewards of joining a board, negotiating compensation, engaging men in the advancement of women leaders, and more.
As, NYC’s Market Leader for Women Grow, a national professional organization dedicated to connecting, educating, empowering and inspiring women entrepreneurs in the cannabis industry, Tanya Osborne curates and hosts monthly meetings aimed at encouraging women to learn about and participate in the industry. Ms. Osborne started her career as an assistant in the music industry and soon after, formed a publishing company for the primary purpose of licensing her father’s music. Most recently Ms. Osborne has honed her coaching and professional development skills and has provided financial empowerment education to families and individuals for over twenty years. Hillary Peckham co-founded Etain, LLC, the only women-owned business to receive one of the original five competitive medical marijuana licenses in NYS. At only 24 years old, Hillary was the youngest person to ever receive a marijuana license in the Unites States. Peckham and the Etain team built an application and operations strategy founded on small-scale, deliverable plans with room to grow and a commitment to economic development as well as quality of life for patients in NYS. Etain opened its dispensaries to patients within five months of being awarded a license, and is the second company to open all four of its allocated dispensing locations around the state. In addition to her role as owner, Hillary is the Chief Operating Officer and oversees all operations for Etain, LLC at their manufacturing facility and four dispensing locations. She is the acting spokeswoman for the company as well as liaison between Etain, LLC and the NYS Department of Health. Kristin Jordan is an attorney, activist and entrepreneur with over with over 20 years of legal experience in real estate, state licensing, and governmental regulatory experience. In addition to serving as the Chair of the Cannabis Practice Group at the NYC law firm, Newman Ferrara, Ms. Jordan is also a Co-founder and former Executive Director of the Cannabis Cultural Association, a non-profit organization dedicated to helping marginalized communities in the cannabis industry, Co-Founder of Sea Sweet Collective, a corporate event and professional networking company, and serves as Chief Administrative Officer of Harvest 360, a Denverbased full-service consulting and management firm that provides sustainable business development solutions to the cannabis industry. Ms. Jordan previously served as counsel to NYC’s hospitality industry, represented owners, developers and tenants in litigation matters and commercial transactions, and served as a Real Estate Director for several global corporate and retail real estate departments where she managed portfolios and led sophisticated transactions. As the Associate Chief Medical Officer at New York’s largest palliative care agency, Metropolitan Jewish Hospice and Palliative Care, Dr. Bernie Lee leads the daily clinical operations, ensures quality and ethical standards, maintains regulatory compliance, develops new business and strategic plans, and educates professional staff. In addition, he also serves as an Assistant Clinical Professor at the Albert Einstein College of Medicine, where he educates medical students, physicians in training, attending physicians and other healthcare professionals. Dr. Lee is a strong physician advocate of medical marijuana and is leading the charge to educate physicians on its safe and effective use in order help alleviate the suffering of patients with chronic and terminal illness.
Katherine Detwiler is passionate about the transformative power of lifelong learning and committed to the holistic and patient-centered missions of home care and hospice. Raised on several continents including Africa and Europe, her professional background includes a degree in education as well as 10 years of home care experience with multiple software companies, in a variety of roles ranging from support to process improvement and business development. As Strategic Alliances Manager at Relias Learning, Ms. Detwiler leverages her passions for education and the home care / hospice industry by building relationships that make meaningful education readily accessible to all learners. Ms. Detwiler also serves as President of the NC Triangle Chapter of Ellevate: a global professional women's network dedicated to helping women advance in the workplace, both for themselves and the greater good.
The Second Annual
Friday, December 8 – continued 1:30-3:30PM
DO less and BE More— Courageous Leadership Corey Jamison, President & CEO, Corey Jamison Consulting Courageous leadership calls us to a higher level of competence and commitment to serve people and organizations. It calls us to do less, and BE more. It calls us to be COURAGEOUS as women, leaders, team members and human beings, in good and challenging times. With the pressure of external forces on healthcare we are all facing, a Transformational Leader mindset is essential to positioning the right people, to do the right work at the right time in our organizations. Transactional Leaders manage process, Transformational Leaders focus on effectively leading, engaging and inspiring human beings at all levels so that they can sustain momentum, change and evolve to serve our clients with the highest level of care. Join us for this thought provoking, interactive (and FUN!) session where we will explore our own courage to live and model the 3 Key Practices of Transformational Leaders.
3:30-4:00PM
LaughterRechargesUs – Plus, Chicksare Funny! Professional women today are juggling their careers along with the needs of loved ones, personal commitments and community responsibilities. With so many serious responsibilities, we all need to laugh with each other to unwind, recharge and refresh. Comedienne Erin Harkes will round out the Women’s Leadership Summit with some humor we can all relate to, keeping you laughing on your drive home.
4:00PM
Closing Remarks and Adjournment
Corey Jamison brings more than 25 years of experience partnering with executives and teams around the globe to drive dramatic, sustainable organizational transformation. She has worked with leaders at all levels of some of the largest brands, and offers a level of experience, acumen, partnership, and courage that inspires leaders and teams toward the hard work of taking it to the next level. Corey is a world-class facilitator who can turn even the most challenging teams toward shared accountability and new levels of productivity. She is a dynamic and sought-after speaker and appears frequently at professional conferences and seminars. In addition, Corey has been interviewed and quoted by National Public Radio, Good Morning America, and the New York Times. Corey received a bachelor’s degree from Vassar College and a master’s degree in education from Fitchburg State College. She is a doctoral candidate in psychology at Walden University.
The Second Annual
December 7 & 8, 2017
Excelsior Springs at the Courtyard Marriott - 47 Excelsior Avenue - Saratoga Springs, NY 12866
REGISTRANT INFORMATION – Please register by November 21. Name: __________________________________________________________________________ Title:____________________________________________________________________________ Agency:_________________________________________________________________________ Address:_________________________________________________________________________ City/State/Zip:____________________________________________________________________ Phone:________________________________ Ext._________ Fax: _________________________ Email: ___________________________________________________________________________ (Required)
HCA REGISTRATION FEE HCA encourages participants with advanced level leadership experience to serve as a ‘mentor’ for a colleague who is a high-potential leader and invite them to join you at the summit at a discounted ‘mentee’ rate. Each mentor may sponsor up to 5 mentees at the discounted rate.
HCA Cancellation Policy
□ HCA Member/Mentor $279 per person $___________ □ HCA Member/Mentee $229 per person $___________ Mentee Name(s):_______________________________________
HCA registration cancellations received by November 22 are refundable less a 25% administrative fee. No refunds will be issued after this date.
□ Non-Member/Mentor $379 per person $___________ □ Non-Member/Mentee $329 per person $___________ Mentee Name(s):_______________________________________
Cancellations must be received in writing at info@hcanys.org. Substitutions are permitted.
PAYMENT – By check or credit card
Please note Courtyard Marriott’s cancellation policy when making your reservation.
Paying by check: Make check payable to “HCA Education and Research” and mail to 388 Broadway, 4th Floor, Albany, NY 12207. Checks must be received by November 21.
Special Needs __________________________________________________________________________________________ Card Number ____________________________________________ _____________________________________________ Expiration Date Security Code __________________________________________________________________________________________ Mailing Address of Card Holder __________________________________________________________________________________________ City, State, Zip __________________________________________________________________________________________ Name on Card __________________________________________________________________________________________ Authorized Signature
In accordance with the Americans with Disabilities Act, or special dietary needs, please let us know how we can accommodate you:
_______________________ _______________________ _______________________ _______________________ _______________________ _______________________ _______________________
Register online at www.eventville.com/hcanys or FAX completed form to HCA at (518) 426-8788
TO: 388 BROADWAY FOURTH FLOOR ALBANY, NEW YORK 12207
The Second Annual December 7 & 8, 2017 Excelsior Springs at the Courtyard Marriott Saratoga Springs, NY 12866
Own Your Voice: Leading with Strength, Certainty & Style