TRANSFORMATION FUNDS
PUBLIC CHARGE RULE
To clear up confusion about the funding dates, HCA has confirmed that SHCFTP Phase II funds have not yet been announced. Expect more news soon.
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CONTRACT LIMIT, VBP UPDATES FROM MMCARP
OVERTIME PAY THRESHOLD CHANGES
A new federal proposed rule would deny entry/permanent legal status for immigrants who use new thresholds of public assistance. HCA comments on the rule, which has implications for home care patients, staff.
Recent MMCARP meeting details MLTC-LHCSA contract limit exception requests and other process items.
We remind members that new pay thresholds kick in for 2019 when it comes to exemptions of white-collar staff from overtime pay requirements.
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Your Source for HOME CARE News, Policy and Advocacy
UPCOMING PROGRAMS Two-Part Webinar Series on OASIS D Dec. 11 and Dec. 13 Free Members-Only Webinar on NYS DOL Revised "Call-in Pay" Regulations: Dec. 18
Vol. 3, Issue 48| December 10, 2018
HCA Participates in Newly Launched LTC Financing Study Group A newly formed Long Term Care (LTC) Financing Study group has been launched “to bring together the best ideas from the fields of health care, senior advocacy, law, housing, insurance and finance.” The group met Friday for its first meeting, jointly hosted by AARP and the Pierro, Connor, & Strauss Law Firm.
2019 Northeast Home Health Leadership Summit Jan. 22-24, 2019 (Boston)
The initiative has a stated goal of “analyzing the funding shortfalls of existing LTC programs and ultimately making recommendations to policymakers for needed reforms.” See GROUP p. 3
WCEI 5-Day Onsite Skin and Wound Management Course March 4-8, 2019 Valley Residential Services 323 Pine Grove Rd. Herkimer, NY 13350
HCA to Reach Legislators, Staff with New Monthly Newsletter
2017-18 QIVAPP Funding Distributed to MLTC Plans
In fulfillment of HCA’s strategic plan and member feedback, HCA is introducing a new monthly e-newsletter that we are sending to the Legislature, beginning with our first issue on Wednesday.
Quality Incentive Vital Access Provider Pool (QIVAPP) program funding was distributed to managed long term care (MLTC) plans at the end of November. Plans will be working with providers through the end of the year to
Register at https:// hca-nys.org/eventseducation/upcomingevents
See REACH p. 2 INSIDE HCA Participates in Newly Launched LTC Financing Study Group...................1 HCA to Reach Legislators, Staff with New Monthly Newsletter.......................1 2017-18 QIVAPP Funding Distributed to MLTC Plans......................................1 It’s HCA Membership Renewal Time............................................................2 Member Hiring Announcement...................................................................3 Administration Convenes Major Human Services Workforce Summit...........4 Reminder: Complete HCA’s Annual Finance, Program Survey........................5 HCA Gains Update on Facility Transformation Program Funds.......................6 HCA Seeks Home Care Exemption in Federal “Public Charge” Rule Change....6
See QIVAPP p. 5
Northeast Summit Discount Deadline Extended to Dec. 12...........................7 CMS Taps HCA for National Hospital Innovations Network Presentation........8 MMCARP Meeting Offers News on Contract Limits, VBP.................................8 Increases Coming for White-Collar Exemption Salary Thresholds..................9 Upcoming Due Dates and Deadlines..........................................................11 Become Wound Care Certified at WCEI Course in Herkimer on March 4-8......12 CMS to Host Hospice Public Reporting Webinar: Dec.13..............................12 OIG Posts Semiannual Report....................................................................12 CMS Posts Draft Revisions to HHCCN...........................................................13 Health Resources.....................................................................................14
The Situation Report: the Home Care Association of New York State REACH from p. 1 Called the HCA Capitol Report, this new publication will be sent as an email newsletter displaying very brief teaser summaries of each article with links to longer versions and/or content that already exists online. It will also contain a menu of department or sections, including a welcome message, a monthly feature on bills or laws, a “trending” section with links to news articles, an “innovations” section to spotlight some of the exciting advancements being made in the field, and any upcoming events. Please consider and send us innovations that you are doing for inclusion in this space to elevate the recognition of your role, your importance and our collective advocacy. As you know, HCA’s main member newsletter, The Situation Report, is dense with policy updates and technical information geared toward our HCA member audience. We wanted to reach legislators in a more concise way with a different tone and choice of articles. This month’s edition will be an early one, in order to avoid the busy holiday period and as legislators and their staff gear up for the 2019 state legislative session. Going forward, we will circulate the newsletter on the last Wednesday of each month, to recap the month’s news and give a forward look to the coming month. Look for the first edition of this exciting new feature later this week.
It’s HCA Membership Renewal Time By now your organization should have received HCA’s membership renewal packets in the mail, as we head into a new and exciting membership year for 2019. There’s a lot new happening at HCA: new policy staff; new program areas under development; exciting education offerings; new upcoming communications vehicles; and other work to fulfill our mission on behalf of the membership. Your renewal packets included a letter from HCA’s Senior Director of Membership Laura Constable, along with an invoice and our annual member value statement, which, this year, highlights some of the ways that members have rated HCA’s offerings. You can read our Value Statement online at https://hca-nys.org/wp-content/ uploads/2018/12/2019-HCA-Value-Statement.pdf. Please return your membership renewals as soon as possible. If you have any questions, or did not receive the materials to renew, contact Laura Constable at (518) 810-0660 or lconstable@hcanys.org. Home Care Association of New York State (HCA) 388 Broadway, 4th Floor, Albany, NY 12207 Tele: 518-426-8764; Fax: 518-426-8788; Website www.hcanys.org
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The Situation Report is a weekly publication of the Home Care Association of New York State (HCA). Unless otherwise noted, all articles appearing in The Situation Report are the property of the Home Care Association of New York State. Reuse of any content within this newsletter requires permission from HCA. 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 V ice 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 GROUP from p. 1 HCA President Al Cardillo was tapped to participate in the group along with key individuals in the field. In addition, high-ranking and influential government officials have been invited to the group, including: Megan Baldwin, the Governor’s Assistant Secretary for Health; state Office for Aging Commissioner Greg Olsen; state Department of Health Assistant Commissioner Mark Kissinger; and others. Medicaid, originally created as a health coverage program for low-income individuals without insurance, has become the state and nation’s primary payor for long term care because other prevalent mainstream or chronic care coverages are fundamentally absent, coinciding with the magnitude of out-of-pocket cost for care. This leaves the majority of individuals to face expenditures which drive them to poverty and Medicaid, and it dominates state budgets – and state budget pressures. In New York State, Medicaid is approximately 40 percent of the entire state budget and much of that is attributed to long term care. New York State has led the way in attempting to develop alternatives, for example in the late 1980s with the creation of the New York State Partnership for Long Term Care and the Catastrophic Health Care Expense Program. The LTC partnership, combined with
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state tax credits for purchasing these policies, has been helpful, but not the overarching solution sought. The state’s Catastrophic Health Care Expense program was successfully piloted, but slashed without consideration from the state budget and repealed during one of the state’s budget shortfall years in the late 1990s. Congress has considered many proposals over the years to cover long term care and/or catastrophic care (which would include long term care). Except for two proposals, these all have failed to demonstrate financial feasibility and draw adequate support for passage. Congress passed President Reagan’s Catastrophic Coverage Act in 1988, which would have provided substantial coverage under Medicare, but repealed it just a year later. In 2010, Congress passed Senator Edward Kennedy’s “Community Living Assistance Services and Supports Act,” or CLASS Act, creating a substantially private financing mechanism for long term care, but repealed it in 2013 before it was ever implemented. So this new study group has brought together key individuals to freshly look at the potential landscape. Continued on next page
HIRING: RN / Staff Development Education Supervisor – Home Health Full Time 9 am-5 pm Driven to Be the Best. NYU Winthrop Hospital’s Home Health Agency ranks as a top-performing US Home Health Agency! Come join our stellar team of nurses, therapy professionals and social workers who provide home health care to our maternal, child and adult population. We have an exceptional opportunity for a Staff Development Education Supervisor to be responsible for home health staff education, development and professional growth, including orientation program (didactic and practical components). Collaborating with the Director of Quality Management/Staff Development and the departments’ management team, you will identify, develop and plan appropriate staff development programs to support agency needs to provide optimum patient outcomes. Working with the Administrator and the Director of Patient Services, you will research, coordinate and establish new programs for the agency. We require:
NYS Registered Nurse License BSN with 2 years’ experience in Education in a Certified home care agency; Master’s degree in Nursing, preferred 2-3 years clinical nursing practice 2 years’ community health nursing Good communication and basic computer skills, knowledge of agency clinical and business functions
To apply for our Staff Development Education Supervisor position, visit https://jobs.winthrop.org/job/8799934/registerednurse-staff-development-supervisor-home-care-mineola-ny/ An EOE m/f/d/v.
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Continued from previous page Over the past several years, HCA has proposed that such reform be included in the state budget. In addition, HCA wrote and secured introduction of legislation that would modernize the state insurance law provisions for home care and bring the coverage into alignment with the mainstream use, role and capacity of home care across the span of patients’ medical needs. The legislation has been introduced by the Insurance Committee Chairs of both houses, but a provision in the federal Obamacare law poses severe restrictions on states’ ability to modify their insurance coverage laws. HCA has been working to find approaches that might work within these limitations.
term care, including long term care insurance, riders on traditional major medical/hospital insurance, life insurance contracts with permissive use for long term care, Continuing Care and Life Care Communities, a “Long Term Care Compact” proposal that was developed several years to incentivize private contributions for long term care with a Medicaid match, and more.
The group canvassed a wide range of areas and possibilities for exploring expanded coverage for long
HCA will keep the membership closely apprised of the proceedings and directions of this new group.
Mr. Kissinger discussed plans for initiating a state Long Term Care Council which would examine long term care and aging systems and generate recommendations for future policy and program actions.
Administration Convenes Major Human Services Workforce Summit The Administration has convened a major human services workforce summit entitled Partnership for the Future: Develop a Roadmap for New York’s Human Services Workforce. Gathering last Thursday in Albany, the summit featured principals from the Governor’s Office, the state’s Department of Labor, State Education Department, State University of New York, New York State Higher Education Services Corporation, New York Association of Training and Employment Professionals, BOCES, panels of best-practice organizations, and discussion facilitators from key state agencies like Health, Mental Health, Aging, Labor and other. HCA President Al Cardillo was asked to represent home care’s voice in the summit. Among the many areas of human services represented, HCA was also joined by several home care providers who were selected by the Administration. State administrators offered keen insights into potential education, recruitment and placement supports, which HCA will immediately explore and work to bring to the membership. Breakout groups developed lists of recommendations to consider. Areas covered a wide range: workforce pipelines; financial support for training; regulatory streamlining; alignment of credentials across similarly practicing roles; recruitment and retention; practical needs for supporting workers (e.g., transportation, peer support, HR-investment, and others); and promotion of health and home health/hospice professions specifically. Mr. Cardillo offered recommendations for home care, hospice and MLTC in every category, and further urged the Administration to examine its regulations and policies that have had the effect of being regressive or counterproductive when it comes to health care worker employment, recruitment and retention. He later discussed next steps and follow-up ideas with the Governor’s office. HCA believes this summit may produce momentum for proposals that could appear in the upcoming state legislative session. HCA will work to be among the organizations closely engaged with the Governor’s office in shaping support for the home and community based field.
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The Situation Report: the Home Care Association of New York State
QIVAPP from p. 1 required in-service training of 12 hours for HHAs and 6 hours for PCAs).
process these payments to eligible home care providers. HCA had previously notified the membership of the draft QIVAPP funding amounts anticipated for 2019.
The agency has a written, implemented and currently active quality assurance program.
QIVAPP is available to home care providers who contract with MLTC plans to provide aide services in New York City and meet certain criteria:
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 meet(s) 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.
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
More information on QIVAPP is available on the state Medicaid Redesign Team website (https:// www.health.ny.gov/health_care/medicaid/ redesign/mrt_61.htm).
Reminder: Complete HCA’s Annual Finance, Program Survey HCA needs your responses to our annual financial/program survey. You can complete it online at https://www.surveymonkey.com/r/201819industrysurvey. Please designate one person at your organization to complete the survey, though the process may require input from several staff in various roles. Your aggregate results, coupled with other data analysis, will culminate in our centerpiece home care, MLTC and hospice financial and program trend report. This report is presented to policymakers, legislators and the media in early 2019, coinciding with our advocacy agenda. We ask for your responses as soon as possible, but no later than January 7. Our survey is directed at HCA’s home care provider members, but we are supplementing this effort by also separately analyzing other reports that provide a picture of the financial experiences of hospices and MLTC plans, including cost reports, utilization reports, statistical reports and Medicaid Managed Care Operating Reports. No agency-specific (just aggregate) data will be shared, and we ask that you complete as much of the survey as possible to the best of your ability. All the information you need is on the survey start page at the above link; but if you have any questions about this process, do not hesitate to contact HCA’s Communications Director Roger Noyes at rnoyes@hcanys.org.
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HCA Gains Update from DOH on Statewide Health Care Facility Transformation Program Last week, HCA confirmed that awards for the Statewide Health Care Facility Transformation Program II (SHCFTP Phase 2) have not yet been announced by the state Department of Health (DOH). There has recently been confusion amongst provider types regarding the program and its associated deadlines. The state confirmed that award decisions for SHCFTP Phase 2 are not yet finalized at this time, and all applicants will receive notification via e-mail of final determination status. A press release will also announce the list of awardees. In addition, Phase 3 of the Program has not yet been released either. The Statewide III Request for Application (RFA) grant opportunity will be announced via the Medicaid Redesign Team (MRT) LISTSERV. To subscribe to the MRT LISTSERV, visit the MRT website (https://www.health.ny.gov/health_care/medicaid/redesign/listserv.htm). SHCFTP, administered by DOH, is intended to help support the goals of the Delivery System Reform Incentive Payment (DSRIP) program, which aims to reduce hospital inpatient costs and improve outcomes across the state. HCA has advocated for years that the state set aside funding specifically for home and community based providers in order to increase capital to support caring for patients in their homes and communities, and out of the hospital. During recent budget negotiations we succeeded in obtaining not only targeted funding for home and community-based care, but increased amounts. More recently, in coordination with other community-care organizations, we’ve issued a call for the Cuomo administration to invest in home care and community care a proportionate amount of the windfall funds from the Fidelis Care sale to Centene. The funding was included in the state budget but the investments, to date, have been devoted substantially to the institutional sector and other programs. More information about the issue was reported by Crain’s Health Pulse in an article at https://hca-nys.org/wp-content/uploads/2018/12/ Crains-Behavioral-Health-Fidelis-Windfall.pdf. When the awardees are announced, HCA will notify the membership. Please contact HCA Policy staff with questions.
HCA Seeks Home Care Exemption in Federal “Public Charge” Rule Change Rule would limit, deny immigration for those on public assistance, with implications for home care patients and the individuals who support them HCA today commented on a new federal proposal that would limit or deny permanent legal status to immigrants if they rely on a wide range of government services, such as Medicaid, food assistance, and housing assistance. Our comments seek exemptions of individuals employed or seeking employment as home care or personal care aides. The proposal comes from the U.S. Department of Homeland Security (DHS). It would change the definition of “public charge,” a term used to determine whether individuals may enter the U.S. or adjust to legal permanent resident (LPR) status (i.e., obtain a “green card”) based on their use of public assistance. The rule seeks to broaden the programs that the federal government would consider in so-called “public charge” determinations of an immigrant’s admissibility. These determinations would include health, nutrition,
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and housing programs, such as cash assistance for income maintenance, government-funded institutionalized long-term care and programs that were previously excluded from public charge determinations. “Because home care services are almost exclusively covered by public programs like Medicaid and Medicare (by about 90 percent), wage pressures from state and federal government reimbursement rate shortfalls have resulted in wage stagnation and a labor environment where over half of all home care workers rely on some form of public assistance, including the 40 percent of New York home care workers who are immigrants and would have their immigration status imperiled by DHS’s proposal because they might rely on public assistance,” HCA states in our comments. “Of greatest concern, this change in ‘public charge’ policy would cast a shadow on the prospects for many in the home care workforce to continue serving the medical, supportive and assistive needs of patients under the state’s Medicaid program, and statistics show that an access-to-care crisis would almost certainly result,” we add. HCA’s comments provide background on the current workforce shortages that exist in home care at a time when demand is growing. Many of the individuals working in the home care field – up to a quarter, by one national estimate – are immigrants. Nearly half rely on some form of public assistance. “In many regions of the state and country, these extraordinarily dedicated individuals and the patients who rely on their services would be significantly affected by DHS’s proposal to change the federal ‘public charge’ policies.” HCA’s comments are at https://hca-nys.org/wp-content/uploads/2018/12/ DHS_Proposed_Public_Charge_Comments.pdf.
Northeast Summit Discount Deadline Extended into Overtime: Now Dec. 12 The Northeast Home Health Leadership Summit discount deadline has been extended into overtime. You now have until December 12 to score the best discount and truly “Play to Win!” Please register as now so that you don’t miss out on this opportunity as the costs go up 8% to our regular rate after December 12. Also, take advantage of our special “Leadership Succession Planning Discount,” which offers even lower rates by December 12 for a member of your team. This means you can rack up two separate discounts for bringing a “mentee” from your organization to join you. But they must also register by December 12 for the biggest savings. We’ve considered all of the core issues on your worry-andwatch list with: a Patient-Driven Groupings Model (PDGM) reactor panel; a session on the Home Health Prospective Payment System (HHPPS) and other federal payment and regulatory updates; a look at new models of care
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from the federal Center for Medicare & Medicaid Innovation (CMMI); strategies to prepare for expanded inhome Medicare Advantage benefits; recruitment and retention insights; cross-generational workplace communications strategies; and more. To register, visit: http://nehomehealthsummit.com/.
CMS Taps HCA for National Hospital Innovations Network Presentation Officials from the U.S. Centers for Medicare and Medicaid Services (CMS) Division of Quality and Innovation asked HCA President Al Cardillo to present to a national group of its innovation providers last Thursday. The group, comprised of the national Hospital Innovations Improvements Networks, focused on behavioral health challenges for hospitals, including the challenges of care in med-surge, care transition, and readmission/ER avoidance, which are challenges that home and community-based services are designed and further equipped to help address. Special training and competencies are needed for appropriate service and management of patients with severe behavioral and mental health conditions. Also vital is an effective, accessible, responsive infrastructure for care transition and community health/mental health management. In the CMS-hosted webinar, Nancy Landor, RN, of the Healthcare Association of New York State (HANYS), a leader of the Readmissions Affinity Group, presented data and innovations on the care and challenges of this population in the hospital sector. Mr. Cardillo followed, describing HCA’s joint initiative with the State Office of Mental Health (OMH) to promote home health-mental health collaboratives for integrated physical and mental health care for individuals in the community. He described: our joint work over the past year and a half; the new HCA legislation signed by the Governor in October to promote home health-mental health collaboration; the latest collaboration with the New York State Association for Community Living (ACL); and all of the next steps planned by HCA, OMH and ACL, including further outreach to the Governor’s Office. Mr. Cardillo briefed state colleagues after the presentation, and a follow-up meeting is planned between HCA, OMH and the Governor’s office. In addition, HCA and HANYS will be discussing how we and hospital/ home care providers can further bring together the two sectors to address this complex problem. HCA will keep members apprised of the important opportunities we are working to cultivate through this initiative.
MMCARP Meeting Offers News on Contract Limits, VBP HCA participated in this past week’s Medicaid Managed Care Advisory Review Panel (MMCARP) meeting. The advisory panel was created to monitor enrollment of Medicaid recipients in managed care plans and ensure access to care in these health care delivery systems. During the meeting, participants received updates on behavioral health, including Health and Recovery Plans (HARPs) for managing behavioral health needs; health homes; Managed Long Term Care (MLTC); the State’s 2017 MLTC Member Satisfaction Survey; and more. During the Office of Health Insurance Program’s (OHIP) MLTC status update, the state provided a number of updates, including information regarding the recently implemented LHCSA/MLTC contract restrictions:
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Since October, there have been 91 requests for exceptions to the LHCSA/MLTC contract restrictions by six MLTC plans. Continued on next page
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Continued from previous page
The state Department of Health (DOH) will be issuing two letters to MLTC plans in the near future: one that will include a notice of a monthly reporting process for plans to indicate which LHCSAs are in their network, when their contracts are ending, and if they will be requesting exceptions; and another letter containing information about an Annual Certificate of Compliance, which is to be completed by the MLTC plans and returned to DOH, attesting that their LHCSA contracts are within the mandatory ratios for their region. Meanwhile, earlier in the fall, HCA surveyed our MLTC and provider members for preliminary information on the impact of the limits for plans and providers. HCA will be looking to propose amendments in the upcoming legislative session to assist plans and providers with flexibility and burden relief.
A Frequently Asked Questions (FAQ) document will also be released soon, as a follow up to the LHCSA Contract Limitation Guidance that was released in August.
OHIP also discussed the Minimum Wage Compliance Survey. On November 6, DOH notified managed care organizations (MCOs) of a survey process (to be instituted on a weekly basis) that would ensure all provider network contracts and Consumer Directed Personal Assistance Services Fiscal Intermediary Administrative Agreements are reviewed to account for wage adjustments related to the minimum wage mandate. The survey will conclude at the end of calendar year 2018, at which time the state will determine whether the survey period should be extended. DOH also provided an update on MLTC Value-Based Payment (VBP):
In November, the Department released the final rates for the January-June 2017 Potentially Avoidable Hospitalization (PAH) measure.
The 2018 MLTC contract template references a baseline of July-December 2016.
The baseline period has changed to January-June 2017 for the upcoming VBP year.
Requests for final results of MLTC VBP Category 1 measures at a provider level for July-December 2016 or the January-June 2017 period should be sent by MLTCs to nysqarr@health.ny.gov.
For additional MMCARP updates or for questions, please contact Alyssa Lovelace at alovelace@hcanys.org.
Increases Coming for White-Collar Exemption Salary Thresholds By: Frank J. Fanshawe, Principal and Ashley Solowan, Law Graduate, Jackson Lewis, P.C. As 2018 comes to an end, the New York State income thresholds for exemption from overtime pay (the “whitecollar exemption”) will be increasing on December 31, 2018. This threshold will continue to increase annually until the minimum wage reaches $15 an hour across New York State. The current state levels were updated in December 2017 and range from $780 to $975 per week ($40,560 to $50,700 annually) depending on the location of the employee. The new salary thresholds will range from $832 to $1,125 per week ($43,264 to $58,500 annually) depending on the location of the employee. Please note
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that there are also federal thresholds that apply in all states; however, since New York’s thresholds are higher than the federal standards, employers should focus their compliance on the state thresholds at this time, barring any changes in the federal policy. The new white-collar exemption salary thresholds on December 31, 2018 will be as follows (per week):
NYC – Large Employers (11 or more): $1,125 NYC – Small Employers (10 or fewer): $1,012.50 Long Island & Westchester: $900 Remainder of New York State: $832
Under the white-collar exemption, certain employees are exempt from overtime payment requirements even if they work more than 40 hours per week (i.e. administrative, executive, and professional employees who qualify for the exemption). One important factor in determining exemption from overtime is the salary threshold. If an employee currently qualifies as exempt from overtime, but will make less than the new threshold, they will be considered non-exempt going forward and will become eligible for overtime, meaning overtime is required. For employers, this may mean having to increase employee salaries to meet the upcoming threshold increases to avoid new overtime costs. If salaries are not appropriately increased, employers may be required to pay overtime to previously exempt employees. Employers should develop a plan to implement these new thresholds as they will have a significant impact on their business in the upcoming year. More information on the state definitions for “executive,” “administrative” and “professional” exemptions can be found here:
https://www.labor.ny.gov/legal/counsel/pdf/administrative-employee-overtime-exemptionfrequently-asked-questions.pdf
https://www.labor.ny.gov/legal/counsel/pdf/executive-employee-overtime-exemptionfrequently-asked-questions.pdf
https://www.labor.ny.gov/legal/counsel/pdf/professional-employee-overtime-exemptionfrequently-asked-questions.pdf
Please note that HCA legal articles are for general, informational purposes, are not legal “advice,” and do not create an attorney-client relationship. Because each case is unique, the information provided should be considered to be general in nature, and should never be considered a substitution for legal counsel. Readers should not take, or refrain from taking, any action based on information in this article without first seeking legal advice from competent counsel.
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Upcoming Deadlines and Due Dates
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Requirement/ Change
Effective/ Due Date
More Information
MLTC Enrollment LockͲ In Starts
Dec. 1, 2018
https://www.health.ny.gov/health_care/medicaid/program/update/2018/2018Ͳ06.htm#mltc
Transition Period for Using Health Insurance Claim Number (HICN) or new Medicare Beneficiary Identifier (MBI)
April 1, 2018 to Dec. 31, 2019
https://www.cms.gov/Medicare/NewͲMedicareͲCard/index.html
2017 LHCSA Statistical Report Due
LHCSAs will face fines if submitted between Nov. 16, 2018 and Dec. 31, 2018
https://commerce.health.state.ny.us/public/hcs_login.html
LHCSA Registration Process
Must be submitted with LHCSA Statistical Report; if not submitted by Nov. 16, 2018, agency will incur fines
https://commerce.health.state.ny.us/public/hcs_login.html
Federal Deficit Reduction Act Compliance Certification form
Dec. 1 to Dec. 31, 2018
https://omig.ny.gov/draͲcertification
State Mandatory Compliance Certification form
Dec. 31, 2018
https://omig.ny.gov/sslͲcertification
Minimum Wage Increase
Dec. 31, 2018
https://www.labor.ny.gov/workerprotection/laborstandards/workprot/minwage.shtm
Submission of marketing materials used prior to November 1, 2018 by Fiscal Intermediaries to state Department of Health under “amnesty” review process
Dec. 31, 2018
https://www.health.ny.gov/health_care/medicaid/redesign/mrt90/mltc_policy/docs/2018Ͳ10Ͳ 22_fiscal_advert_policy.pdf
OASISͲD for Certified Home Health Agencies
Jan. 1, 2019
OASISͲD Guidance Manual: https://www.cms.gov/Medicare/QualityͲInitiativesͲPatientͲAssessmentͲ Instruments/HomeHealthQualityInits/HHQIOASISUserManual.html
2017 CHHA and LTHHCP Statistical Report
Feb. 1, 2019
https://commerce.health.state.ny.us/public/hcs_login.html
2017 Hospice Cost and Utilization Report
Feb. 1, 2019
https://commerce.health.state.ny.us/public/hcs_login.html
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Become Wound Care Certified at WCEI Course in Herkimer, NY on March 4-8 HCA members get a discount for the March 4-8 on-site Skin and Wound Management course being offered by the Wound Care Education Institute (WCEI) in Herkimer, NY in March. The course offers an evidence-based approach to wound management to help clinicians stay current with the standards of care; plus RNs, LPNs, OTs, PTs and other professionals are eligible for Wound Care Certification board-certified exams. To learn more about accreditation opportunities and course learning objectives and materials, please download the flyer here and encourage your clinician teams to register: https://hca-nys.org/wp-content/uploads/2018/12/ 2019WCC-Flyer_ONSITE-120418.pdf.
CMS to Host Hospice Public Reporting Webinar: Dec.13 The U.S. Centers for Medicare and Medicaid Services (CMS) is hosting a Hospice Public Reporting webinar on Thursday, December 13 from 1 to 2:30 p.m. It will cover the following two topics:
Hospice and palliative care composite process measure: Comprehensive Assessment at Admission (National Quality Forum No. 3235), including background, how this measure is calculated, and using your Quality Measure report to understand your performance.
The 4.5-month data correction deadline for public reporting policy updates finalized in the fiscal year 2019 final rule, including how this change will be implemented and the implications.
HCA members interested in joining the webinar can register at: https://engage.vevent.com/ index.jsp?eid=3536&seid=1296. Additional information is available on CMS’s Spotlight & Announcements homepage at: https://www.cms.gov/ Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Hospice-Quality-Reporting/Spotlight.html.
OIG Posts Semiannual Report The federal Office of Inspector General (OIG) has posted its Semiannual Report for the period of April 1, 2018 to September 30, 2018. The report is at https://go.usa.gov/xPtBM. The Report describes OIG’s work identifying risks, problems, abuses, deficiencies, remedies, and investigative outcomes relating to the administration of programs and operations that were disclosed during the reporting period. It includes expected recoveries, criminal and civil actions, and other statistics as a result of OIG’s work during Fiscal Year (FY) 2018 when OIG issued 163 audit reports and 45 evaluations, resulting in 578 new recommendations issued to Health and Human Services (HHS) operating divisions. Continued on next page
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The Situation Report: the Home Care Association of New York State
Volume 3, No. 48 December 10, 2018
Continued from previous page The report identifies a number of studies that impact home care, hospice and managed care. These include:
New York Claimed Federal Reimbursement for Consumer-Directed Personal Assistance Services That Did Not Meet Medicaid Requirements (A-02-16-01026, https://oig.hhs.gov/oas/reports/region2/ 21601026.pdf), June 2018.
Most of New York’s Claims for Federal Reimbursement for Monthly Personal Emergency Response Service Charges Did Not Comply with Medicaid Requirements (A-02-15-01019, https://oig.hhs.gov/ oas/reports/region2/21501019.pdf), April 2018.
Vulnerabilities in the Medicare Hospice Program Affect Quality Care and Program Integrity: An OIG Portfolio (OEI-02-16-00570, https://oig.hhs.gov/oei/reports/oei-02-16-00570.pdf), July 2018.
Weaknesses Exist in Medicaid Managed Care Organizations’ Efforts to Identify and Address Fraud and Abuse (OEI-02-15-00260, https://oig.hhs.gov/oei/reports/oei-02-15-00260.pdf), July 2018.
Medicare Advantage Appeal Outcomes and Audit Findings Raise Concerns About Service and Payment Denials (OEI-09-16-00410, https://oig.hhs.gov/oei/reports/oei-09-16-00410.pdf), September 2018
CMS Posts Draft Revisions to HHCCN On November 27, the U.S. Centers for Medicare and Medicaid Services (CMS) posted proposed nonsubstantive changes to the Home Health Change of Care Notice (HHCCN). It is accepting comments for 60 days. The proposed changes are at https://www.cms.gov/Regulations-and-Guidance/Legislation/ PaperworkReductionActof1995/PRA-Listing-Items/CMS10280.html?DLPage=1&DLEntries=10&DLSort=1&DLSortDir=descending. Home health agencies (HHAs) are required to provide the HHCCN 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 only proposed change to the existing form is to include a new expiration date (6/2021). The instructions also remove language regarding a discontinued document (i.e. Home Health Advance Beneficiary Notice of Non-coverage), as well as the brief description of that document. The document was also formatted to “ease readability.” The current HHCCN should be used until CMS reviews comments received on the proposed changes and issues a final new form. The current form is at https://www.cms.gov/Medicare/Medicare-GeneralInformation/BNI/HHCCN.html. CMS estimates that HHAs will deliver about 13.6 million HHCCNs annually. For more information, contact Andrew Koski at akoski@hcanys.org or (518) 810-0662.
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The Situation Report: the Home Care Association of New York State
Volume 3, No. 48 December 10, 2018
Health Resources
“Reforming America’s Healthcare System Through Choice and Competition,” by the U.S. Department of Health and Human Services https://www.hhs.gov/sites/default/files/Reforming-Americas-Healthcare-System-Through-Choiceand-Competition.pdf
For more information, contact Andrew Koski at akoski@hcanys.org or (518) 810-0662.
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