May 28, 2019 Edition of The Situation Report

FI PMPM

PDGM, LABOR LAW

PREPAREDNESS

DOH REG AGENDA

HCA seeks member input on state budget-required plan to establish per-member-permonth payments for fiscal intermediary services, at an impact of $150 million.

June is a busy month for HCA education, with programs on PDGM coding, five prominent labor law issues, and Blueprint for OASIS accuracy training.

Agencies should prepare now for required drill on 6/11-13 that will likely require survey responses re: patient census, other communications tests.

Newly posted Department of Health Regulatory Agenda keys up need-methodology, rate, CHRC and other changes.

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UPCOMING PROGRAMS PDGM Coding Essentials June 12 (Schenectady, NY)

PDGM Bootcamp For Clinical Managers and Quality Staff

Your Source for HOME CARE News, Policy and Advocacy

Vol. 4, Issue 21| May 28, 2019

HCA Rate & Benchmarking Bill Now in Both Legislative Houses: Use Online Action Center Today!

State Assembly Health Committee Chairman Richard Gottfried last week introduced HCA’s rate and benchmarking bill.

July 11 (Suffern, NY)

This follows introduction of the measure by Senate Health Chairman Gustavo Rivera in his chamber.

6 Legal Experts, 1 Day of Hot Topics in Labor Law

Sponsorship by both chairs in both houses (A.7798/S.5915) reflects a major, high-level recognition of the fiscal volatility in home care and the need to address it.

June 13 (NYC)

Blueprint for OASIS Accuracy – OASIS D Data Set June 17-18 (Workshop); June 19 (Optional COS-C Exam) in Webster, NY (near Rochester) September 23-24 (Workshop); September 25 (Optional COS-C Exam) in NYC

In an alert last week, HCA called upon members to help bolster this measure and the chairs’ support by doing two things: 

First, write to the Senate and Assembly Health Chairs thanking them for their sponsorship of this measure using HCA’s Legislative Action Center campaign at https://p2a.co/tSN6X2K.



Second, write to your own elected representatives urging them to cosponsor A.7798/ S.5915, along with Assemblyman Gottfried and Senator Rivera. You can do so by using a separate Legislative Action Center campaign at https://p2a.co/1EKgmbP.

INSIDE HCA Rate & Benchmarking Bill Now in Both Houses…............................................1 HCA Seeks Member Input on FI PMPM Issue…......................................................3 A Message from HCA Sponsor TSG Financial…......................................................3 June PDGM, Labor Law, OASIS Programs Across NYS…...........................................4 Prepare Now for June Emergency Response Drill…...............................................5 CMS Renews URAC for Managed Care Plans….......................................................6

See ACTION p. 2

DOH Regulatory Agenda Posted…................................................................6 Home Health Compare Data Updated….......................................................7 Meetings and Deadlines…...........................................................................8 HHCAHPS Survey Expiration Date Required for 2020…....................................9 Upcoming NGS Education Sessions….............................................................9 CMS Loads Hospice Compare Quarterly Refresh…........................................10 Health Resources…..................................................................................10

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

ACTION from p. 1 Note: if your elected representative is Chairman Gottfried or Rivera, do not send this second message, just the first one to the bill sponsors.

As previously reported, A.7798/S.5915 does two things: it provides a long-overdue 10-percent increase in the base episodic payment system (EPS) rates and fee-for-service rates (FFS) to Certified Home Health Agencies (CHHAs); and it establishes rate benchmarking standards for other home care payors to consider.

This latter provision offers a basis for rate adequacy outside the Medicaid FFS/EPS systems, given that FFS Medicaid home care rates are often used as a benchmark for Medicare Advantage, commercial insurers and other payors.

If you have any questions about these measures or how best to weigh in, do not hesitate to contact HCA’s Director for Public Policy & Advocacy Alyssa Lovelace at alovelace@hcanys.org.

In-service legislation approved by Senate Health Committee Thanks to HCA member grassroots advocacy – including over 400 messages sent through our Legislative Action Center – the Senate Health Committee unanimously approved HCA’s inservice training and tracking bill (S.5605/G. Rivera), which requires trainers to submit to the existing Home Care Registry a record of each in-service training and the hours completed by workers toward the fulfillment of annual in-service training requirements.

This bill supports compliance with in-service training regulations, which are vital to the integrity of patient care. It gives home care employers an efficient and reliable source for determining whether a new hire has fulfilled these requirements, eliminating the administrative burden of tracking down this information from a prior employer. It also avoids unnecessary duplication of administrative and oversight efforts when an aide works for more than one agency at a time.

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. 21 May 28, 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 Rebecca Fuller Gray Executive V ice President for Clinical and Program Affairs rgray@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. 21 May 28, 2019 

Continued from previous page At press time for the Situation Report, HCA learned that Assembly Health Committee Chairman Richard Gottfried has introduced an Assembly version of this measure (A.7854).

A table of other pending legislation developed and supported by HCA is added to the back of this week’s Situation Report or as a link at https://issuu.com/hcanys/docs/hca_bills_introduced_2019_state_leg?e=0.

The State Legislative Session ends on June 19, leaving just 13 scheduled session days to achieve passage of HCA’s priority bills in both houses. This is a critical time when all HCA members should be reaching their elected officials through our Legislative Action Center and other means. Please be on alert for new grassroots advocacy campaigns coming directly to your inbox soon – the time to act is now.

HCA Seeks Member Input on FI PMPM Issue HCA has been reaching out to members on a proposal in the final state budget agreement that establishes a per-memberper-month (PMPM) payment for Fiscal Intermediary (FI) administrative services.

This change, which is expected to reduce Medicaid funding by $150 million (state and federal shares), will have a major impact on FIs and managed long term care (MLTC) plans.

One of the proposals put forth by the state Department of Health (DOH) would provide different monthly administrative payment amounts for three different ranges of monthly hours of services. HCA has vetted the proposal with some of our FI and MLTC members and will use their feedback to inform our efforts.

Any member who did not, but wants to, receive information about the proposal should contact Andrew Koski at akoski@hcanys.org.

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

Volume 4, No. 21 May 28, 2019 

June PDGM, Labor Law, OASIS Programs Across NYS In just a few weeks, HCA is holding three important programs to: prepare your coders for the Patient-Driven Groupings Model (PDGM); cover the most prominent wage, hour and labor law issues that you struggle with; and get your assessment and clinical teams in shape for OASIS-D accuracy (which is especially important under PDGM).

Take a look and make sure a member of your team is at these sessions that are vital to your survival and performance in home care.

PDGM Coding Essentials (June 12 in Schenectady) Register at https://hca-nys.org/wp-content/uploads/2019/05/PDGM-Programs-HCA-2019.pdf 

Critical elements of PDGM, including diagnosis code updates.

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PDGM clinical groupings and sub-groups that impact case-mix.

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ICD-10-CM guidelines and clinic updates applied to complex case scenarios.

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Strategies for PDGM transition work plans.

Legal Experts, 1 Day of Hot Topics in Labor Law (June 13 in NYC) Register at https://hca-nys.org/wp-content/uploads/2019/04/HCA-Hot-Topics-in-Labor-Law-ProgramBrochure.pdf 

24-hour/live-in cases and the recent Court of Appeals Ruling.

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Paid Family and Sick Leave laws.

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State and City Sexual Harassment laws.

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Current developments in immigration law.

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Updates to the Fair Labor Standards Act “Regular Rate” of pay requirements for overtime.

Blueprint for OASIS Accuracy: OASIS-D Data Set & Optional COS-C Exam: June 16-19 (Webster, NY) Register at https://hca-nys.org/wp-content/uploads/2019/02/Blueprint-for-OASIS-Flyer-Rochester-June2019.pdf

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Master OASIS items, conventions, and data-collection rules.

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Achieve accuracy in OASIS data collection using CMS guidelines.

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COS-C exam readiness.

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

Volume 4, No. 21 May 28, 2019 

Agencies Should Prepare Now for June Emergency Response Drill HCA recommends that home care and hospice agencies prepare now for the June 11 to June 13 Emergency Response drill.

As mentioned in the May 13 edition of The Situation Report, the state Department of Health will hold such a drill that will: 

Allow providers to implement all aspects of their emergency preparedness plan; document activities conducted; evaluate their plan’s effectiveness; and, for federal providers, execute the required After-Action Report (a blank Report is at https://hca-nys.org/wp-content/uploads/2019/ 05/AAR-IP_Template-BLANK-for-CMS-EP-exercises.docx).



Test communication/plan systems with community partners. When doing so, the agency should clearly state that “this is an exercise.”

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Familiarize providers with the communication methods and information needed by DOH during and after an emergency event, which will help agencies develop systems to gather this information quickly.

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Familiarize providers with the revised survey tool used to collect information – the Health Electronic Response Data System (HERDS) Home Care Emergency Response Survey.

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Allow DOH to test the communication and data collection systems prior to a real emergency event.

The DOH drill announcement is in a Dear Administrator Letter (DAL) at https://www.health.ny.gov/ facilities/home_care/dal/docs/19-05.pdf. According to DOH, all CHHAs, LTHHCPs, LHCSAs and Hospices are required to participate in this drill. Failure to do so will result in a deficiency citation and possible enforcement action.

A similar drill was held in November 2017 which may provide some helpful hints on what to expect for the June drill. In the November 2017 drill, which involved a simulated earthquake, agencies were asked to complete information about: their agency and capacity, including patient census by county; patient classification levels (Levels 1, 2 and 3); transportation assistance levels; information on ventilator and electricity dependent patients; Office of Emergency Management partners; their ability to serve their current caseload; their capacity to serve additional patients; their ability to contact patients and staff; and more.

These components must all be kept updated as part of an agency’s emergency preparedness plan, as outlined in DOH’s December 1, 2016 DAL at https://www.health.ny.gov/facilities/home_care/dal/docs/ 16-11.pdf.

Questions about the drill can be sent to HCEmergency@health.ny.gov (please copy Andrew Koski at akoski@hcanys.org).

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

Volume 4, No. 21 May 28, 2019 

CMS Renews URAC for Managed Care Plans The U.S. Centers for Medicare and Medicaid Services (CMS) has renewed the Medicare Advantage ‘‘deeming authority’’ of the Utilization Review Accreditation Commission (URAC) for health maintenance organizations and preferred provider organizations for a term of six years.

The renewal is effective May 31, 2019 through June 2, 2025.

The notice is at https://www.govinfo.gov/content/pkg/FR-2019-05-21/pdf/2019-10586.pdf.

DOH Regulatory Agenda Posted The state Department of Health (DOH) has posted its regulatory actions under consideration for submission as a Notice of Proposed Rulemaking for January through December 2019.

It is at https://docs.dos.ny.gov/info/register/2019/may22/regulatoryagenda.pdf.

Some areas of interest include: 

Certified Home Health Agency (CHHA) rates – Amend the regulation to allow for minimum wage costs.



CHHA Determinations of Public Need – Amend the regulation to update the need methodology used to estimate the need for CHHAs.

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Approval of Licensed Home Care Services Agencies (LHCSAs) – Add a new section delineating a need methodology for LHCSAs.

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Determination of Public Need for Hospice – Amend the regulation to update the need methodology used to estimate the need for hospice care and services.

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Hospice Non-Residence Rates – Amend the regulation to include a description of the service intensity add-on for services provided by a registered nurse or social worker during the last seven days of a beneficiary’s life, as required by federal changes.

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Criminal History Record Check (CHRC) Program – Update the CHRC regulation to conform to recently enacted Public Health Law changes that include definitions and requirements for adult care facilities and hospice programs serving individuals at home.



Issuance of the Certificate of Authority – Add a provision requiring managed care organizations (MCOs) to maintain a complete file on each request for health care services or benefits and associated appeals pursuant to Article 49 of the Public Health Law and federal law and regulations.

Continued on next page

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

Volume 4, No. 21 May 28, 2019 

Continued from previous page 

Assisted Living Program (ALP) Billing for Assessment – Add regulations to provide for reimbursement of the cost of preadmission assessments conducted directly by ALPs.

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Adjustments to Rates of Payment – Amend the regulations to allow for rebasing of ALP provider rates.

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Adult Day Health Care – Amend the regulations to align with the federal Home and Community Based Services rule.

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Personal Emergency Response Services (PERS) – Amend the regulations to allow for annual authorizations and to delete the requirement that authorization of PERS be contingent upon a reduction/elimination of personal care aide/home health aide hours.

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Early Intervention Program – Amend the regulations, as needed, to comply with 34 CFR Parts 300 and 303. Contingent on approval by the U.S. Centers for Medicare and Medicaid Services of an amendment to the Medicaid State Plan, revise 10 NYCRR 69-4.30 to authorize the commissioner to establish a fixed payment methodology for service coordination services. Amendments also may be needed to ensure quality and consistency of EI service delivery.

Home Health Compare Data Updated Home Health Care Consumer Assessment of Healthcare Providers and Systems (HHCAHPS) Survey results based on services from October 2017 through September 2018 are now reported on Home Health Compare at http://www.Medicare.gov.

HHCAHPS Survey results are updated each calendar year quarter.

These data are also available on the HHCAHPS website through the “Archived Publicly Reported Data” link under the “General Information” tab. On this webpage, you can access: 

Home health agency-level data.

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State and national averages.

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Star ratings cut points.

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Patient mix adjustment coefficients for the linearized data used to construct the star ratings.

Information on how the star ratings were constructed is provided in technical notes at: https://homehealthcahps.org/Portals/0/HHCAHPS_Stars_Tech_Notes.pdf.

For more information about how the data were analyzed, go to https://homehealthcahps.org/Portals/0/PublicReporting/ PMAandHHCAHPSresults_AprPublicReporting2019.pdf.

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Volume 4, No. 21 May 28, 2019

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



MEETINGS & DEADLINES

8

Requirement/Change/Meeting

Effective/Due Date

More Information

NYC Health Care Coalition Leadership Council Meeting (emergency preparedness)

May 30, 2019

https://www.programinfosite.com/oepr/nychccͲ registration/

Electronic Visit Verification (EVV) Public Listening Session in Albany

May 30, 2019, 1 to 4 p.m.

https://www.eventbrite.com/e/albanyͲelectronicͲvisitͲ verificationͲevvͲregionalͲlisteningͲsessionͲregistrationͲ 61165457530

Quarterly Wage Parity Certification forms due from LHCSAs and Fiscal Intermediaries who operate in NYC, Long Island and Westchester

June 1, 2019

https://www.health.ny.gov/health_care/medicaid/rede sign/2016/2016Ͳ02Ͳ17_wage_parity_alert.htm

Electronic Visit Verification (EVV) Public Listening Session in Rochester

June 5, 2019, 9 a.m. to noon

https://www.eventbrite.com/e/rochesterͲelectronicͲ visitͲverificationͲevvͲregionalͲlisteningͲsessionͲ registrationͲ61172828577

Lower Hudson Valley Health Emergency Preparedness Coalition (HEPC) meeting

June 5, 2019, 9 a.m. to 12:30 p.m.

Gyongyi.McQueston@health.ny.gov

Long Island HEPC meeting

June 6, 2019, 9 a.m. to 12:30 p.m.

drew.fried@health.ny.gov

Emergency response drill for home care and hospice providers

June 11Ͳ13, 2019

https://www.health.ny.gov/facilities/home_care/dal/d ocs/19Ͳ05.pdf

Western Region HEPC All Partners meeting

June 12, 2019, 8:30 a.m. to 4:30 p.m.

https://tinyurl.com/yyk5vr3q

Electronic Visit Verification (EVV) Public Listening Session on Long Island

June 17, 2019, 1 to 4 p.m.

https://www.eventbrite.com/e/longͲislandͲelectronicͲ visitͲverificationͲevvͲregionalͲlisteningͲsessionͲ registrationͲ61173247831

Electronic Visit Verification (EVV) Public Listening Session in New York City

June 18, 2019, 1 to 4 p.m.

https://www.eventbrite.com/e/nycͲelectronicͲvisitͲ verificationͲevvͲregionalͲlisteningͲsessionͲregistrationͲ 61173885739

Fiscal Intermediary Workgroup meeting

June 19, 2019, 11 a.m. to 2 p.m.

akoski@hcanys.org

Electronic Visit Verification (EVV) Public Listening Session in Lake Placid

June 27, 2019, 1 to 4 p.m.

https://www.eventbrite.com/e/lakeͲplacidͲelectronicͲ visitͲverificationͲevvͲregionalͲlisteningͲsessionͲ registrationͲ61174344110

Revised Home Health Change of Care Notice (HHCCN)

July 1, 2019

https://www.cms.gov/Medicare/MedicareͲGeneralͲ Information/BNI/HHCCN.html

Fiscal Intermediary Workgroup meeting

July 10, 2019, 11 a.m. to 2 p.m.

akoski@hcanys.org

Fiscal Intermediary Workgroup meeting

August 7, 2019, 11 a.m. to 2 p.m.

akoski@hcanys.org

Emergency Preparedness Coalition of Manhattan (EPCOM) meeting

August 7, 2019, 12 to 1:30 p.m.

Caitlin.Flynn@nyulangone.org

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/NewͲMedicareͲ Card/index.html

Changes in MLTCͲLHCSA Contracting Limits

October 1, 2019

https://www.health.ny.gov/health_care/medicaid/rede sign/mrt90/mltc_policy/lhsca_contract_guidance.htm

Medicare will only accept claims submitted with the Medicare Beneficiary Identifier (MBI)

January 1, 2020

https://www.cms.gov/Medicare/NewͲMedicareͲ Card/index.html

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

Volume 4, No. 21 May 28, 2019 

HHCAHPS Survey Expiration Date Required for 2020 Effective January 1, 2020, the U.S. Centers for Medicare and Medicaid Services (CMS) is requiring the Office of Management and Budget (OMB) Expiration Date for the Home Health Care Consumer Assessment of Healthcare Providers and Systems (HHCAHPS) Survey to be printed on the first page of all HHCAHPS Survey questionnaires and as part of the OMB disclosure notice.

The questionnaires and OMB disclosure notices have been updated on the HHCAHPS website at https:// homehealthcahps.org/Survey-and-Protocols/Survey-Materials#catid2. Appendix J in the Protocols and Guidelines Manual has also been updated on the website.

The following phrase has been added to the cover of each HHCAHPS Survey questionnaire, just below the OMB number: “Expires January 31, 2021.”

The following sentence has been added to the OMB disclosure notices: “The expiration date for OMB control number 0938-1066 is January 31, 2021.”

Vendors should begin to incorporate these revisions as soon as possible and have them fully implemented no later than the January 2020 sample month for all approved translations.

Please contact the HHCAHPS Survey Coordination Team at hhcahps@rti.org or toll-free at (866) 354-0985 if you have any questions.

Upcoming NGS Education Sessions National Government Services (NGS), New York’s principal home health and hospice Medicare Administrative Contractor (MAC), is offering the following educational webinars in the coming weeks: 

Home Health Billing Basics: May 28 from 2:30 to 4 p.m. Registration is at: https://register.gotowebinar.com/register/3733209610422759171

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Hospice New Provider Training: May 30 from 2 to 3 p.m. Registration is at: https://register.gotowebinar.com/register/2204703731098897921

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Home Health Forms: May 30 from 2:30 to 3:30 p.m. Registration is at: https://register.gotowebinar.com/register/159049153859398658

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Virtual Conference on Updated Medicare Secondary Payer Questionnaire Requirements for Home Health and Hospice: June 4 from 3 to 3:50 p.m. Registration is at: https://register.gotowebinar.com/register/1522047747140176129

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Virtual Conference on Understanding the Levels of Appeals: June 4 from 4 to 4:50 p.m.

Registration is at: https://register.gotowebinar.com/register/3219452907379002115

NGS’s education or training events can be found in the events calendar on NGS’s website at www.NGSMedicare.com.

Continued on next page

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

Volume 4, No. 21 May 28, 2019 

Continued from previous page Providers should click the “HHH” home page link for the Home Health and Hospice portal and enter their state, then click “Accept” on the HCPCS/CPT code attestation page. Once in the Home Health and Hospice portal, click the education tab, then click the Webinar, Teleconference and Event tab.

CMS Loads Hospice Compare Quarterly Refresh The May 2019 quarterly Hospice Compare refresh of quality data is now available. It is based on Hospice Item Set (HIS) quality measure results from data collected in the third quarter of 2017 through the second quarter of 2018 and Hospice Consumer Assessment of Healthcare Providers and Systems (CAHPS) Survey results reported from the third quarter of 2016 through the second quarter of 2018.

Beginning with the May 2019 refresh, Hospice Compare will include additional information on hospice characteristics beyond the quality and patient experience metrics already available.

In addition, the U.S. Centers for Medicare and Medicaid Services (CMS) is updating the zip code database for the Hospice Compare search function, helping to ensure accurate search results.

For further information, see the “Hospice Compare May 2019 Refresh Fact Sheet” and the “Hospice Compare May 2019 Refresh Question & Answer” document in the Downloads section of the Public Reporting Background and Announcements webpage at: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HospiceQuality-Reporting/Public-Reporting-Background-and-Announcements.html.

HCA members can review their Hospice Compare data at: https://www.medicare.gov/hospicecompare/.

Health Resources

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“Using Health IT for Care Coordination: Insights From Six Medicare Accountable Care Organizations,” by the Office of Inspector General https://oig.hhs.gov/oei/reports/oei-01-16-00180.pdf



“Integrating Community Health Workers Into Health Care Teams Without Coopting Them,” Health Affairs Blog (May 10, 2019) https://tinyurl.com/yynthfaa

2019 State Legislative Session Priority Bills Introduced Â

Payment and Rate Stabilization What: A.7798/S.5915 does two things. First it would result in the development and posting of voluntary benchmark rates that payors (managed care plans, commercial insurance, etc.) would consider to help stabilize rate levels. Secondly, it would provide a 10% trend increase (like a COLA adjustment) to a minority portion of home care rates that are still directly set and reimbursed to providers by the state Medicaid program.

Home Care Rate & Benchmarking Bill

A.7798 (Richard Gottfried) S.5915 (Gustavo Rivera)

Why: Home care rate stabilization is critical at a time when the majority of agencies are operating at a loss, due to lagging reimbursement, with agencies reporting dramatic underpayments at 50% to 70% below costs in some payor categories. The voluntary benchmark rates developed and posted under A.7798/S.5915 would help stabilize, across payor sources, the rate levels for the majority of services that vulnerable New Yorkers rely upon.

This measure would also provide a long overdue trend increase to the portion of Medicaid payments for Certified Home Health Agencies (CHHAs) under the fee-for-service and episodic payment systems (EPS). CHHAs have not had a fee-for-service trend increase in over ten years. Such an increase will support EPS/FFS lines of service for medically intense care that is directly provided by CHHAs, as well as for CHHA care of pediatric patients under age 18.

Workforce

Home Health Aide and Personal Care Aide In-service Training and Tracking

A. 7854 (Richard Gottfried) S.5605 (Gustavo Rivera)

What: Requires trainers to submit to the existing Home Care Registry a record of each in-service training and the hours completed by workers toward the fulfillment of annual in-service training requirements.

Why: This bill, strongly recommended by HCA’s members, supports compliance with in-service training regulations, which are vital to the integrity of patient care. It gives home care employers an efficient and reliable source for determining whether a new hire has fulfilled these requirements, eliminating the administrative burden of tracking down this information from a prior employer. It also avoids unnecessary duplication of administrative and oversight efforts when an aide works for more than one agency at a time, as is often the case in home care.

2019 State Legislative Session Priority Bills Introduced

Home Care/Hospice Worker Shortage Areas and Disciplines

Labor and Market Study for Home Care/Hospice

What: Addresses major geographic and discipline shortages around the state that impact access to home care and hospice services; would allow providers to use funds to address key worker support needs.

A.6768 (Harry Bronson) S.1420 (Susan Serino)

A.6902 (Harry Bronson) S.1359 (Susan Serino)

Why: The urgent labor shortages in home care and hospice jeopardize access to care and are costly to a system where patients need cost-effective home care alternatives to institutions (such as hospitals or ER use) but face delays in admission or start of care because the workforce supply is lacking. Indeed, 38.95 percent of a provider’s case admissions, on average, are delayed or hindered by aide and nurse shortages, with wide variation across the state – a gap that this bill would help address.

What: Authorizes the state Commissioner of Labor to conduct a competitive labor market study assessing and making recommendations for home care and hospice capability to compete in the labor market for recruitment and retention of direct-care staff to meet patient and health system needs. The bill also establishes an interagency state task force to promote the value of home care and hospice occupations and strategies to encourage entrance into the field.

Why: We know anecdotally, as well as from our own polling/surveys, that home care shortages are acute; however, a comprehensive, statistical analysis is crucial for better understanding the labor and shortage patterns that exist in the various regions of the state, as well as the solutions needed to address those shortages, both in terms of wage and non-wage supports.

Promotion of Public Health Improvement, Savings & Reinvestment Home Care Integration in NY's Public Health Prevention Strategies

What: Supports the incorporation of home care in the state's public health, prevention and primary care strategies.

A.3836 (John McDonald) S.1816 (Gustavo Rivera)

Why: This legislation supports home care’s role and promising outcomes as part of the state’s planning and investment in core public health priority areas like asthma, diabetes and cardiac health. In line with state policy goals, the legislation would help position home care more strongly in term of its roles and partnerships, yielding system savings for reinvestment in workforce and infrastructure needs.

2019 State Legislative Session Priority Bills Introduced

What: Creates a new Article 36 section devoted to home care sepsis intervention that would authorize the state Department of Health to provide support for statewide home care sepsis efforts in numerous ways.

Sepsis Prevention

A.3839 (John McDonald) S.1817 (Gustavo Rivera)

Why: This legislation enables home care providers to draw upon existing strengths and assets for battling sepsis, a life-threatening condition which is the cause of a hospitalization every 20 seconds and a top cause of hospital readmissions. New York’s home care system has already pioneered a voluntary sepsis screening tool and algorithm that is now being used by home care nurses in nearly every county of New York State. It is saving lives and health care costs, but more can be done at the state level to foster this program and help support integration of protocols, data and screening encounters.

What: Amends the Geriatric Demonstration Program. Enables Commissioners of OMH and DOH to waive rules and regulations in order to address barriers to collaboration between mental health providers and providers of home care services under the Program.

Mental Health/Home Care Collaboration

A.6566-A (Aileen Gunther) S.3872-A (David Carlucci)

Why: Beyond its medical, therapeutic and community-based support role, home care is especially equipped to address the psychosocial needs of the elder care population by collaborating with mental health providers, combining individual areas of expertise and practice for patients through the geriatric program model that already exists under OMH. HCA has been working closely with OMH on this promising initiative that builds on a series of other collaboration statutes already in motion to strengthen our care for patients struggling not only with medical and supportive needs, but also the critical mental health supports necessary for successful outcomes across all disciplines of care.

What: Addresses health care disparities under the Hospital-Home Care-Physician Collaborative Program.

Health Care Disparities

A.6772 (Crystal PeoplesStokes) S.4742 (James Sanders)

Why: This proposal promotes health, and can save untold health care dollars. Disparities in health are a multibillion-dollar problem, and a condition that the late Rev. Martin Luther King described as “the greatest injustice.”

As a community-based field of practice, home care has unparalleled reach to provide vital medical, social, therapeutic and assistive supports to patients who may not otherwise access the health care system, have unmet needs, receive fragmented or uneven care, or who find themselves accessing the health care system in times of crisis or emergency. Many of the systematic disparities in treatment of hypertension, cancer care, diabetes and numerous other chronic conditions are rooted in cultural, racial, geographic and other demographic factors that home care providers are uniquely equipped to overcome, given their routine access to patients at home and their knowledge of the environmental or social conditions that directly influence care outcomes in the home and neighborhood-level settings.