February 25, 2019 Edition of The Situation Report

WAGE PARITY

SEPSIS BILL

SURGE TEST

EDUCATION

Quarterly and annual certification forms are due from providers and/or plans by March 1. Quarterly forms are due to contract partners while annual forms are due to DOH.

HCA’s sepsis bill is scheduled to be taken up by the state Senate Health Committee this week.

Central New York drill tests providers’ ability to place 900 patients from three hospitals into other settings, including home care.

March education programs include webinar on CASPER reports, LHCSA Forum, certification for hospice/ palliative care RNs, and HCA Finance Summit.

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Your Source for HOME CARE News, Policy and Advocacy

UPCOMING PROGRAMS WEBINAR: Understanding How to Run and Interpret CASPER Reports March 6, 2019 Downstate LHCSA Forum March 6, 2019 (NYC) Senior and Financial Managers Summit March 19, 2019 (Troy) Hospice and Palliative Nurse Certification March 25-26, 2019 (Holyoke, MA) March 28-29, 2019 (Lawrence, MA) WEBINAR: Clinical Documentation Improvement (CDI) April 11, 2019

Vol. 4, Issue 8| February 25, 2019

HCA Presses Amendments to Executive Budget Proposals; Urges Members to Engage in Grassroots Advocacy Initiatives As March approaches and budget negotiations intensify in advance of the state’s April 1 budget deadline, HCA continues to meet with lawmakers, legislative and fiscal staff, and state agency representatives to address the Association’s budgetary priorities.

Throughout the last week, public policy staff have met with Senate and Assembly central staff to discuss these priorities, including: 

Amending the Executive proposal to provide long-overdue rate increases under the Certified Home Health Agency (CHHA) Episodic Payment System and individual fee-forservice rates to authorize cost-increase adjustments to the rate methodology for CHHAs;

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Requiring the state to provide transparency and to secure actuarial soundness and adequacy of rates to Managed Long Term Care (MLTC) plans and network providers, and to mitigate unfunded mandates on MLTCs and providers;

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Opposing the Executive’s proposal that would establish a National Provider Identifier (NPI) number for home health aides and personal care aides; See AMENDMENTS p. 2

INSIDE HCA Presses Amendments to Executive Budget Proposals............................1 Wage Parity Certification Forms Due March 1..............................................2 Guidance Issued on MLTC Retro Disenrollment Reason Codes.....................3 Member Hiring Announcements................................................................4 HCA Sepsis Bill on Senate Health Committee Calendar Wednesday...............5 Hospice Compare Quarterly Refresh Now Available......................................5 Coalition Surge Test Exercises Held in Central NY..........................................6

March Education & Events..........................................................................8 OHSA Form 300A Must be Submitted by March 2...........................................9 CMS Releases Projections of National Health Expenditures.......................10 Upcoming Deadlines and Due Dates.........................................................11 CMS Posts Draft Revisions to HHCCN for Additional Comments...................12 CMS Reissues Survey for Monitoring State Compliance with EVV.................12 Health Resources.....................................................................................13

The Situation Report: the Home Care Association of New York State AMENDMENTS from p. 1 

Rejecting the repeal and replace of the Consumer Directed Personal Assistance Program;

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Requesting the use of funding pools, such as Fidelis/ Centene monies, for home care and community-based organizations within the Statewide Healthcare Facility Transformation Program;

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Supporting numerous HCA-driven proposals that address workforce development; and Promoting home care and hospice in ways and policies that can improve public health and achieve savings for the health system.

To assist us with these budgetary priorities, we are kicking off a series of grassroots advocacy campaigns later this week. Once notified of the online campaigns, simply click the link, insert your address and press “submit” – the process is simple and easy, and will require no more than a few minutes of your time.

This week, we will also continue to meet with Senate and Assembly legislative staff to continue to advocate for the Association’s priorities, and will engage the membership through a series of Action Alerts as the budget deadline approaches.

For questions or concerns about the advocacy initiatives listed above, or to learn how to connect with your lawmakers, please contact Alyssa Lovelace at alovelace@hcanys.org or call (518) 810-0658.

Wage Parity Certification Forms Due March 1 The state-required Home Care Worker Wage Parity Law certification forms are due March 1 for Certified Home Health Agencies (CHHAs), Long Term Home Health Care Programs (LTHHCPs), Managed Care Organizations (MCOs), and Licensed Home Care Services Agencies (LHCSAs) who provide or arrange for aide services in New York City (NYC), Long Island and Westchester and for Fiscal Intermediaries (FIs) under consumer directed services in these parts of the state.

Continued on next page Home Care Association of New York State (HCA) 388 Broadway, 4th Floor, Albany, NY 12207 Tele: 518-426-8764; Fax: 518-426-8788; Website www.hcanys.org

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Volume 4, No. 8 February 25, 2019 

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. Al Cardillo President and CEO acardillo@hcanys.org Roger L. Noyes Director of Communications, Editor of The Situation Report rnoyes@hcanys.org Patrick Conole Vice President, Finance & Management pconole@hcanys.org Andrew Koski Vice President, Program, Policy & Services akoski@hcanys.org Alyssa Lovelace Director for Policy and Advocacy alovelace@hcanys.org Lauren Ford Director of Program Research, Development and Policy lford@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 4, No. 8 February 25, 2019 

Continued from previous page The Wage Parity law and related certification do not apply to areas outside of NYC, Long Island and Westchester.

CHHAs, LTHHCPs and MCOs must certify prospectively to DOH, on an annual basis, their compliance with the Wage Parity Law. These certification forms, due March 1, 2019, are for the March 1, 2019 to February 29, 2020 period; the forms are sent to HCWorkerParity@health.ny.gov.

Meanwhile, CHHAs, LTHHCPs and MCOs are required to obtain a written certification on a quarterly basis from their contracted LHCSAs or FIs which attests to the LHCSAs/FIs’ compliance with the state’s Home Care Worker Wage Parity Law for defined certification periods and on a prospective basis.

This form, also due March 1, 2019, covers the period March 1, 2019 to May 31, 2019, and is sent to the CHHA, LTHHCP or MCO, not to DOH. DOH is expected to post the 2019 certification forms soon at https://www.health.ny.gov/health_care/ medicaid/redesign/mrt_61.htm. That site also includes the wage parity levels, frequently asked questions and other documents.

For more information, contact Andrew Koski at (518) 810-0662 or akoski@hcanys.org.

Guidance Issued on Retroactive Disenrollment Reason Codes for MLTC Plans The state Department of Health (DOH) has issued a General Information System (GIS) notice on new Managed Long Term Care (MLTC) retroactive disenrollment reason codes.

The GIS is at https://www.health.ny.gov/health_care/medicaid/publications/docs/gis/19ma05.pdf.

Most disenrollments from MLTC plans are prospective, not retroactive, except in certain circumstances.

Included in the MLTC Partial Capitation, Medicaid Advantage Plus, and Programs for All-Inclusive Care for the Elderly (PACE) contract is language concerning these retroactive disenrollment reasons and the Department’s right to recover capitation payments paid to the contractor for enrollees listed on the monthly roster who are later determined, for the entire applicable payment month, to be ineligible for the applicable program.

Local Departments of Social Services or the Human Resources Administration (HRA) are responsible for notifying MLTC plans and the state Office of the Medicaid Inspector General (OMIG) of an enrollee’s retroactive disenrollment and the effective date of the disenrollment.

The retroactive disenrollment codes for mainstream Medicaid Managed Care plans (i.e., plans subject to the Medicaid Managed Care or Family Health Plus Special Needs Plan model contract) may apply to enrollees of MLTC plans.

Questions regarding MLTC policy may be submitted to mltcretrodisputes@health.ny.gov.

Questions regarding the retroactive disenrollment notification process may be submitted to retrodata@omig.ny.gov.

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HIRING Director of Patient Services Lourdes Home Care Description: Lourdes is looking for a Director of Patient Services for our home health and hospice (home care) program. The director will work with a robust team of experienced clinical managers to guide the strategic direction and growth of the home care program. Focus will include collaboration with the Lourdes Palliative Medicine Program and with other community based programs offered at Lourdes and in the community at large. The director will be responsible for the achievement of clinical/quality and financial goals, as well as maintaining a culture of safety and accountability. Both programs are growing, and we attribute that to low turnover and effective leadership. We are looking for a leader who will embrace shared governance and the principles of servant leadership.

The ideal candidate is a registered professional nurse, with a minimum of 5 years’ experience in home care and at least two years of experience in leadership/management. A Master’s degree or combination of Bachelor’s degree and experience preferred.

President of Home Care & Hospice The Position: Head strategic Home Care and Hospice operations for the health system, including growing specialty programs. Pave the way for clinical and technological innovation in both the home care and hospice programs including a heart failure readmission reduction program, implementation of a new EMR, growing the current telehealth program, expansion of community and facility based palliative care programs, and support for value based purchasing (VBP) initiatives. Must possess prior CHHA executive experience, financial/budgetary experience, and a familiarity with Population Health strategies and initiatives. RN and/or Nurse Practitioner with Master’s degree required.

The Organization: Lourdes Home Care is a Certified Home Health Agency and Hospice that provides mission-based care to patients across Broome, Tioga, Chenango, and Delaware counties. Lourdes continues our 90+ year legacy of serving individuals in our community as part of Ascension, the largest nonprofit health system in the U.S and world’s largest Catholic health system. As a part of this system, Lourdes is able to access resources, tools, and best-practices from Ascension ministries across the country.

The Organization: Catholic Health Services of Long Island includes six hospitals, three skilled nursing facilities, a regional home care service, a certified hospice and a community-based agency for persons with special needs. The 1,928-bed system prides itself on the values of Integrity and Compassion. CHS serves hundreds of thousands of Long Islanders each year, providing care that extends from the beginning of life to helping individuals live their final years in comfort, grace, and dignity. At Catholic Health Services, there are 358,805 annual home care visits and 125,636 annual hospice days-of-care.

If you’d like additional information, please contact Ann Fattarusso, our Lourdes Ascension Recruiter: ann.fattarusso@ascension.org; m: (607)206-5839.

To apply, please visit our website at: https:// www.besmith.com/job-details/farmingdale-new-yorkhome-health-1256636/.

RN Director of Patient Services Fort Hudson Health Systems is looking for a Director of Patient Services for our Certified Home Health Agency. The Director will be responsible for the clinical direction and supervision of patient care services. The DPS will be a professional member of the health care team that provides oversight for the patient services provided by the agency and assures compliance with regulations.

Requirements: Bachelor’s degree, with at least 2 years of supervising community health experience, or 2 years of home care nursing experience plus a Master’s degree in a health-related field. Position may also serve as Administrator with additional experience.

Fort Hudson CHHA is an affiliate of Fort Hudson Health System, a not-for-profit multilevel health care and housing provider located in the Glens Falls region of New York. Fort Hudson provides a full range of services including skilled nursing, rehabilitation, adult day care, licensed home care, care management, senior housing and certified home health. For nearly five decades, Fort Hudson has maintained its reputation as an innovative, high quality, and compassionate provider of senior services. Our strength, stability and tradition within the community places Fort Hudson Health System at the forefront of healthcare providers throughout the entire region.

To apply, contact Elizabeth Parsons, Director of Human Resources, at eparsons@forthudson.com or 518-747-2811, ext. 264.

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Volume 4, No. 8 February 25, 2019 

HCA Sepsis Bill on Senate Health Committee Calendar Wednesday The state Senate Health Committee is poised to take up HCA’s Sepsis bill (S.1817) this Wednesday, sponsored by the Committee Chairman Senator Gustavo Rivera. It is also sponsored in the Assembly by Assemblyman John McDonald (A.3839).

HCA has garnered a strong memo of support for the bill from our partners at Sepsis Alliance who say the bill would “support a state and nationally groundbreaking sepsis initiative of the Home Care Association of New York State to screen, prevent, mitigate and educate about sepsis through the home care system,” adding that “NYS and HCA are first nationally to break the ground of utilizing the home care system to address sepsis.”

This legislation would specifically create a new article 36 section devoted to home care sepsis intervention that would authorize the state Department of Health to provide support in numerous ways.

The scope would include support for prevention, screening, intervention and education. Specific areas include: provider/clinician training; integration with electronic health records and vital information exchange; collaboration of key clinical partners; public education; and more. The bill would also authorize provider support in the form of grants or rate supplementation to assist in the program’s sepsis goals.

Support in the Senate Health Committee would be a critical step for this bill to move forward as HCA is simultaneously seeking inclusion of this legislation into the state budget.

To learn more about HCA’s sepsis initiative, please visit our Stop Sepsis at Home website at http://stopsepsisathomeny.org/.

Hospice Compare Quarterly Refresh Now Available The U.S. Centers for Medicare and Medicaid Services (CMS) recently announced that the February 2019 quarterly Hospice Compare refresh of quality data is now available.

The updated data is based on Hospice Item Set (HIS) quality measure results from data collected during the second quarter of 2017 through the first quarter of 2018 as well as Hospice Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey results reported from the second quarter of 2016 through the first quarter of 2018.

CMS encourages hospice providers to review the updated data on Hospice Compare at https:// www.medicare.gov/hospicecompare/.

Additional information is on CMS’s Hospice Quality Public Reporting website at: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Hospice-QualityReporting/Public-Reporting-Background-and-Announcements.html.

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The Situation Report: the Home Care Association of New York State

Volume 4, No. 8 February 25, 2019 ď Žď€

Coalition Surge Test Exercises Held in Central NY Similar exercises to be held in other regions Last week, the state Department of Health (DOH) held a Coalition Surge Test (CST) in Central New York.

DOH plans to hold similar exercises in other regions outside of New York City.

The simulated scenario involved severe weather conditions and critical infrastructure failures that resulted in the evacuation of patients at three hospitals in Central New York. These hospitals had to determine which patients could be: transferred to other hospitals; discharged to nursing homes; sent home without services; and/or sent home with home care.

The drill started with an e-mailed Integrated Health Alerting and Notification System (IHANS) message at about 7:50 a.m. on February 21 regarding the exercise and another notification about the need to complete a brief Health Electronic Response Data System (HERDS) survey by 8:30 a.m. The survey asked hospitals, long term care facilities and home care providers for a contact person at the agency, whether the provider could receive additional patients, and the number of patients in Patient Classification Levels 1, 2 and 3 that could be accommodated.

DOH regional office staff sent these notifications to certain staff roles in the Health Commerce System (HCS) Communications Directory, so it is vital to keep your HCS directory listings up-to-date.

At 8 a.m., DOH held a conference call briefing that outlined the exercise scenario, activities and goals.

The actual exercise lasted three hours during which three hospitals had to transfer over 900 patients in total.

Home care providers, along with other sectors, were asked to complete another survey at the end of the exercise. The survey asked if the agency received any requests to take patients; the Patient Classification Levels of patients accepted; and the number of any patients in each Level that were accepted.

HCA, HCA members and non-member home care providers participated in the exercise. In addition, HCA was part of the Facilitated Discussion/Hot Wash webinar that followed the exercise and asked questions about home care agency participation in the exercise as well as referrals from hospitals to home care. All three hospitals that had to transfer patients identified some patients who could be sent home with home care but did not contact any home care providers due to time constraints. HCA suggested that follow up with home care agencies be incorporated into future drills as this is such an essential component of any real emergency.

As the exercise started before 8 a.m., which may be before agencies officially open, home care providers are reminded that they are required to have procedures in place to respond to events like exercises that occur outside of their normal business hours.

Home care and hospice involvement in these drills/exercises can count toward meeting one of the federal and/or state emergency preparedness requirements. Those who do participate must also complete an After Action Report (AAR) for the CST drill in order to meet the requirements. The AAR is retained by the agency for three years and not sent to DOH, but must be available for review by DOH surveyors.

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Continued from previous page A blank AAR is at https://hca-nys.org/wp-content/uploads/2019/01/AAR-IP_Template-IOC-Drill-SAMPLE.doc.

A sample completed AAR is at https://hca-nys.org/wp-content/uploads/2019/02/AARIP_Template-IOC-DrillSAMPLE.pdf.

Additional CST drills will be held during the following timeframes in the regions below.    

April 1 to 12: Western NY (Buffalo and Finger Lakes) April 1 to 12: Capital District April 15 to 26: Long Island April 29 to May 10: Lower Hudson Valley

MCM/IOC DOH will also begin holding Medical Countermeasure (MCM) and Interoperable Communications (IOC) drills for agencies outside of New York City.

The MCM drill is for local health departments (not home care and hospice providers) and involves an anthrax outbreak. Home care, hospice and other providers can participate in an IOC drill held in conjunction with the MCM. For this drill, DOH regional offices will send agencies an IHANS message regarding an anthrax outbreak. The drill alert will be sent to certain individuals in the HCS Communications Directory, not by e-mail directly to agencies.

Agencies will be asked to click on a link in the IHANS message to access the HERDS survey. The IHANS notice will go out 90 minutes prior to the drill, and providers will have 60 to 90 minutes to complete the survey.

The IOC drill is intended to demonstrate the ability to use a primary and back-up communications system (internet, including Voice over Internet Protocol/VOIP, radio, cellular and satellite phone) to communicate with coalition partners (local health departments, hospitals, police, fire, EMS, local emergency management officials, and others).

The MCM/IOC drills are scheduled for the following dates:     

Feb. 27: Central NY April 4: Western NY (Buffalo and Finger Lakes) April 11: Capital District April 18: Long Island May 9: Lower Hudson Valley

DOH Meeting Last week, HCA met with state Department of Health (DOH) officials from the Office of Health Emergency Preparedness (OHEP) and the Office of Primary Care and Health Systems Management (OPCHSM) as part of a monthly meeting with HCA and the New York State Association of Health Care Providers (HCP) – who

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Volume 4, No. 8 February 25, 2019 

receive funding to work with all home care and hospice providers to support their roles in emergency preparedness.

The group discussed the utility of Health Emergency Preparedness Coalitions (HEPCs) holding meetings via webinar and/or conference calls in addition to or instead of in-person and which HEPCs are able to do so.

HEPCs are coalitions of health care providers, local and state emergency management and local public health preparedness officials that develop and coordinate emergency preparedness across the continuum, including readiness among individual health sectors, holding exercises and ‘hot washes,’ conducting hazard and vulnerability assessments and other important activities. HCA and HCP are responsible for participating in HEPC meetings across the state.

We also discussed the upcoming CST, MCM and IOC drills and the role of home care and hospice providers; issues in navigating the Health Commerce System; and additional deliverables under HCA and HCP’s contract with the state, including further collaboration with local offices of emergency management and local health department preparedness officials, as well as participation with HEPCs. For more information, contact Andrew Koski at (518) 810-0662 or akoski@hcanys.org; or Alyssa Lovelace at (518) 810-0658 or alovelace@hcanys.org.

March Education & Events: CASPER Reporting, LHCSA Forum, Finance Summit and Palliative Care Nursing HCA is offering several education programs and events in the coming month for various staff roles at your organization, from CASPER data to hospice and palliative care nursing in support of your organization’s outcomes, as well as big operational updates at our Downstate LHCSA Forum and Senior Financial Managers Summit. Summaries are below with links to registration or more information.

Webinar: Understanding How to Run and Interpret CASPER Reports: March 6, 2019 CASPER reports are the foundation for Home Health Compare and other reported measures that can help with your outcomes and self-auditing. This webinar will identify 2 to 3 of the different reports available in the CASPER system, saving you time on the hunt for data. It will show you how to interpret risk-adjusted and potentially avoidable events and describe how the reports can be used to enhance quality initiatives.

Register at: https://hca-nys.org/wp-content/uploads/2019/02/Casper-webinar-March-6-2019.pdf.

Downstate LHCSA Member Forum: March 6, 2019 (New York City) HCA’s Forums, led by our Policy team of experts, provide a venue for focused attention on issues specific to certain segments of the home and community-based sector in certain regions of the state. In addition to a state budget update, this Downstate LHCSA Forum will exchange information with LHCSA members on several pressing issues, including:   

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Minimum Wage and Other Statutory Wage Mandates 24-Hour/Live-In Cases DOH’s Guidance on Advanced Home Health Aides

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Volume 4, No. 8 February 25, 2019 

Continued from previous page  

Medicare Conditions of Participation that Impact Home Health Aides Other Regulatory Changes, Issues or Concerns

This is an important opportunity to learn more about the above issues in the budget and elsewhere in regulations, as well as how these issues impact you, and what HCA is doing about them.

Register at https://hca-nys.org/wp-content/uploads/2019/02/March-6-Downstate-LHCSA-and-HCC-ForumRegistration-Form.pdf.

Senior Financial Managers Summit: March 19, 2019 (Troy, NY) Payment systems, their funding, and the regulations that condition them are the drivers that determine your agency’s performance. Meanwhile, big reforms, like the Patient-Driven Groupings Model (PDGM), mean you’ll be working with entirely new machinery in 2020. As a CFO, finance manager, controller, or executive with finance oversight, you have enormous responsibility over all of these factors, which is why HCA’s popular Senior Financial Managers Summit on March 19 in Troy (near Albany) brings you the policymakers who directly influence home care, hospice and MLTC finance, as well as experts who have deftly analyzed it.

Register here: https://hca-nys.org/wp-content/uploads/2019/01/HCA-CFO-Forum-Registration-Form2019.pdf.

Hospice and Palliative Nurse Certification: March 25-26, 2019 (Holyoke, MA) and March 28-29, 2019 (Lawrence, MA) In partnership with our Massachusetts state association colleagues, HCA is cosponsoring a course designed for nurses to take the hospice and palliative care certification exam at the member rate.

Nurses already certified can use this class as part of your continuing education requirements.

The two-day course is delivered via multi-media tools, handouts and lectures, as well as individual and group exercises to reinforce the information. The goal is to promote and review the special knowledge of hospice nursing care as well as disease progression and regulatory aspects of the Medicare benefit.

Register here: https://hca-nys.org/wp-content/uploads/2019/02/Hospice-Certification-RegistrationForm.pdf.

OHSA Form 300A Must be Submitted by March 2 March 2 is the deadline for electronically reporting the Occupational Safety and Health Administration (OSHA) Form 300A (Summary of Work-Related Injuries and Illnesses) data for calendar year 2018.

OSHA published a Final Rule to amend its recordkeeping regulation, removing the requirement to electronically submit information from the OSHA Form 300 (Log of Work-Related Injuries and Illnesses) and OSHA Form 301 (Injury and Illness Incident Report) for establishments with 250 or more employees that are required to routinely keep injury and illness records. Covered establishments are only required to

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electronically submit to OSHA information from the OSHA Form 300A. The final rule did not alter an employer’s duty to keep and maintain OSHA Forms 300, 300A, and 301 onsite for five years.

Not all establishments are covered by the requirement to submit Form 300A. To review which establishments need to provide their data, go to https://www.osha.gov/injuryreporting/index.html#clickhere.

OSHA forms are at https://www.osha.gov/recordkeeping/RKforms.html.

CMS Office Releases 2018-2027 Projections of National Health Expenditures According to the U.S. Centers for Medicaid and Medicaid Services (CMS), national health expenditures are projected to grow at an average annual rate of 5.5 percent for 2018-27, representing 19.4 percent of gross domestic product (GDP) and reaching nearly $6.0 trillion by 2027. Prices for health care goods and services are projected to grow on average 2.5 percent per year for the same period and will account for almost half of the projected health care spending growth.

Federal, state and local governments are projected to finance 47 percent of national health spending by 2027, increasing from 45 percent in 2017.

The increased growth of national health spending is expected to be driven primarily by long-observed demographic and economic factors essential within the health sector, which include: continued growth in income and employment, and demographic factors, such as the baby-boom generation continuing to age from private insurance into Medicare, and increases in prices for medical goods and services.

Medicare spending growth is expected to accelerate and be the fastest growing among the major payers. In 2018, Medicare spending increased to 5.9 percent in 2018 from 4.2 percent in 2017. Contributing to this acceleration are faster per-enrollee growth and higher spending growth for prescription drugs and hospital care. Medicare spending is projected to grow again to 7.1 percent in 2019 due to higher fee-for-service payment rates. From 2020 to 2027, Medicare spending is expected to grow by 7.6 percent per year on average. There will also be considerable growth in the use and intensity of Medicare services similar to rates of the program’s long-term history, largely due to the enrollment shift of the baby-boomer generation into Medicare programs.

Medicaid spending is projected to have grown more slowly in 2018, at 2.2 percent from 2.9 percent in 2017.

This deceleration in growth has been caused by lower enrollment rates, as Medicaid enrollment is projected to have grown just 1.1 percent in 2018 compared to 2.0 percent in 2017.

However, Medicaid spending is projected to accelerate to 4.8 percent in 2019, largely due to a 1.3 percentage point increase in enrollment growth to 2.4 percent. This enrollment acceleration reflects the effects of Medicaid expansion in five states, which includes: Idaho, Maine, Nebraska, Utah, and Virginia.

From 2020-2027, Medicaid spending growth is projected to average 6.0 percent per year by 2027, influenced by faster per-enrollee spending growth.

The Office of the Actuary’s report is available at: http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/ NationalHealthExpendData/NationalHealthAccountsProjected.html.

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Upcoming Due Dates and Deadlines

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Requirement/Change/ Meeting

Effective/Due Date More Information

Posting of OSHA Form 300A: Summary of WorkͲRelated Injuries and Illnesses

February 1 to April 30, 2019

https://www.osha.gov/recordkeeping/RKforms.html

Interoperable Communications/Medical Countermeasures (IOC/MCM) exercise – Syracuse

February 27, 2019

megan.kash@health.ny.gov

Annual Wage Parity certification forms due to state Department of Health from CHHAs, LTHHCPs and Managed Care Organizations

March 1, 2019 for period of March 1, 2019 to February 29, 2020

https://www.health.ny.gov/health_care/medicaid/redesign/2016/2 016Ͳ02Ͳ17_wage_parity_alert.htm

Quarterly Wage Parity certification forms due from LHCSAs and CDPAP FIs to contracted CHHAs, LTHHCPs and Managed Care Organizations

March 1, 2019 for period of March 1, 2019 to May 31, 2019

https://www.health.ny.gov/health_care/medicaid/redesign/2016/2 016Ͳ02Ͳ17_wage_parity_alert.htm

Downstate LHCSA Forum

March 6, 2019

https://hcaͲnys.org/wpͲcontent/uploads/2019/02/MarchͲ6Ͳ DownstateͲLHCSAͲandͲHCCͲForumͲRegistrationͲForm.pdf

Lower Hudson Valley Health Emergency Preparedness Coalition (HEPC) meeting

March 6, 2019, 9 a.m. to noon

https://www.nylearnsph.com/Public/default.aspx (registration)

Long Island Health Emergency March 7, 2019 Preparedness Coalition (HEPC) 9:30 a.m. to noon meeting

https://www.nylearnsph.com/Public/default.aspx (registration)

Interoperable Communications/Medical April 4, 2019 Counter Measures (IOC/MCM) exercise – Western NY

Shaun.sharp@health.ny.gov

IOC/MCM exercise – Capital District

April 11, 2019

Maureen.casaleͲreidt@health.ny.gov

IOC/MCM exercise – Long Island

April 18, 2019

Drew.Fried@health.ny.gov

IOC/MCM exercise – Lower Hudson Valley

May 9, 2019

gyongyi.mcqueston@health.ny.gov

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CMS Posts Draft Revisions to HHCCN for Additional Comments On February 14, the U.S. Centers for Medicare and Medicaid Services (CMS) posted proposed changes to the Home Health Change of Care Notice (HHCCN) that would change the expiration date (to June 2021) and no longer reference a discontinued document (i.e. the Home Health Advance Beneficiary Notice of Non-coverage) in the HHCN instructions. Comments are accepted within 30 days.

The posting is at https://www.cms.gov/Regulations-and-Guidance/Legislation/ PaperworkReductionActof1995/PRA-Listing-Items/CMS10280.html?DLPage=1&DLEntries=10&DLSort=1&DLSortDir=descending.

This follows a similar posting on November 27, 2018 when CMS announced it would accept comments for 60 days.

Home health agencies (HHAs) are required to provide the HHCCN – they do an estimated 13.6 million annually – whenever they reduce or terminate a beneficiary’s home health services due to physician/ provider orders or limitations of the HHA in providing the specific service.

The current HHCCN should be used until CMS reviews any comments. It is at https://www.cms.gov/Medicare/Medicare-General-Information/BNI/HHCCN.html.

For more information, contact Andrew Koski at akoski@hcanys.org or (518) 810-0662.

CMS Reissues Survey for Monitoring State Compliance with EVV The U.S. Centers for Medicare and Medicaid Services (CMS) is again seeking public comments on its plans to require that states report, via a survey, their progress in implementing electronic visit verification (EVV) for personal care services, which is required by January 1, 2020.

The notice documents are at https://www.cms.gov/Regulations-and-Guidance/Legislation/ PaperworkReductionActof1995/PRA-Listing-Items/CMS10680.html?DLPage=1&DLEntries=10&DLSort=1&DLSortDir=descending.

The survey was originally posted last October and had to be posted again for 30 days of public comments after CMS made revisions based on earlier comments.

The survey would be distributed to all state Medicaid agencies in November. CMS will use the survey data to assess states’ compliance with the EVV requirements and to levy Federal Medical Assistance Percentage (FMAP) reductions where necessary.

The federal legislation that delayed the implementation of EVV for personal care services from January 1, 2019 to January 1, 2020 also included a resolution for CMS to obtain stakeholder input. To implement this last provision, CMS is asking states to report on how they took into account a stakeholder process for input in designing their EVV system.

HCA will alert members when New York establishes any stakeholder process.

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The Situation Report: the Home Care Association of New York State

Volume 4, No. 8 February 25, 2019 

Continued from previous page Additional information on the federal EVV requirement is at https://www.medicaid.gov/medicaid/hcbs/guidance/electronic-visit-verification/index.html.

Any questions can be directed to Andrew Koski at akoski@hcanys.org or (518) 810-0662.

Health Resources 

“What New Home Health Agencies (HHAs) Need to Know About Being Placed in a Provisional Period of Enhanced Oversight,” by the U.S. Centers for Medicare and Medicaid Services https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/ downloads/SE19005.pdf

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“Expansion of Telehealth,” Medicaid Update (February 2019) https://www.health.ny.gov/health_care/ medicaid/program/update/2019/feb19_mu_speced.pdf

For more information, contact Andrew Koski at akoski@hcanys.org or (518) 810-0662.

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