January 22, 2019 Edition of The Situation Report

PAC POWER

STORM STORIES

STAT REPORTS

Please join us for HCA’s PAC Reception on February 11 in Albany as we kick off our 2019 campaign. Every contribution counts!

HCA seeks stories from members about your agency’s efforts to help patients before, during and after this past weekend’s winter storms.

In meeting with DOH, HCA discusses issues encountered

by LHCSAs in completing 2017 Statistical Reports.

HCA requested, and DOH will hold, Feb. 5 and 6 webinars on upcoming state-run emergency preparedness exercises.

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Your Source for HOME CARE News, Policy and Advocacy

UPCOMING PROGRAMS

EMERGENCY PREP WEBINARS

Vol. 4, Issue 3| January 22, 2019

HCA Reacts to Executive State Budget Proposal Engage in Grassroots Advocacy Initiatives TODAY!

NEW: Advocacy Essentials Webinar Feb. 6, 2019 10:30 a.m. to noon HCA PAC Reception and State Advocacy Program Feb. 11, 2019 (PAC Reception) Feb. 12, 2019 (Advocacy Day) Albany Upstate LHCSA Forum Feb. 19, 2019 (Utica) WCEI 5-Day Onsite Skin and Wound Management Course March 4-8, 2019 (Herkimer)

On Tuesday, January 15, Governor Cuomo delivered his combined Executive Budget proposal for state fiscal year 2019-20 and his annual State of the State Address. Throughout the presentation, the Governor outlined his upcoming policy and fiscal agendas, triggering the process of state budget negotiations.

Though the priorities outlined in his presentation were not specific to home and communitybased care, the 2019-20 budget legislation includes several changes and allocations to home See ADVOCACY p. 2

Slate of HCA Bills Helps Position Home and Community Based Care for Support in New Session A series of HCA bills has been introduced/reintroduced in the State Legislature, laying groundwork for home care, hospice and MLTC support in the formulation of the state budget and in the new legislative session.

The bills are introduced by the Assembly and Senate Health Chairs, the immediate-past Senate Aging and Finance Chairs, and the Assembly Insurance Chair.

See BILLS p. 4

INSIDE HCA Reacts to Executive State Budget Proposal.............................................1 Slate of HCA Bills Positioned in New Session....................................................1 Join the HCA PAC for its Kickoff Fundraiser of 2019!........................................5 HCA Discusses Home Care-Mental Health Partnerships with State Council…..5 Tell Us Your Winter Storm Preparedness, Response Stories.............................6 HCA, DOH Discuss LHCSA Stat. Report Issues, Status Update….........................6 CMS to Host Feb. 12 PDGM Webinar….............................................................8 DOH to Hold Two Webinars on Preparedness Drills…....................................8 Meeting Eyes NHTD/TBI Issues...................................................................…9

OIG Updates Work Plan….............................................................................10 New Medicare Card Mailing Complete…........................................................10 October Global Cap Report: Medicaid Spending $49M Above Projections….......11 New Version of Hospice Quality Reporting User’s Manual Now Available.......…11 Upcoming Deadlines and Due Dates….............................................................12 CMS Transmittal: Revocations Allowed Only From Active Billing Hospice..…......13 1/23 CMS Hospice Webinar on Achieving Full Payment Update......................…13 PHHPC Committee Meeting Agenda Posted..................................................…14 Employers Must Post 2018 Injury/Illness Summary Beginning Feb. 1..............14 Health Resources........................................................................................…14

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

ADVOCACY from p. 1 care, hospice and managed long term care services, as outlined in a memo circulated to members this morning (see https://hcanys.org/wp-content/uploads/2019/01/ Memo201920StateBudgetProposal.pdf).

In the coming weeks, including our February 12 State Advocacy Day, HCA will be pressing for the following supports and changes to the budget:  

Funding adequacy for home care, MLTC and hospice for state wage mandates and essential services.

Supporting workforce recruitment and retention to address sustainability of the existing workforce and capability to increase urgently needed personnel.



Supporting home care and hospice infrastructure, including clinical and health information technology.



Promoting savings and state health goals through home care and hospice by strategic positioning of home care to achieve savings and promote patient and population health.

With the final state budget due April 1, we will be working with the Legislature, Governor’s office, state agencies and fiscal staff to ensure that the needs of the membership are addressed. Like HCA, hundreds of groups will be vying for the attention of the Legislature to address their own budgetary priorities, so it is important that our collective voice rises to the surface.

To assist HCA with our lobbying and advocacy efforts, it’s critically important that providers themselves – the experts in the field – have a say in this important piece of the legislative process. In the coming weeks, HCA will be relying upon the membership to engage with lawmakers in Albany and in their communities for home care, hospice and MLTC support.

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. 3 January 22, 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

Volume 4, No. 3 January 22, 2019

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

Continued from previous page



Dates to remember: 

TODAY: Register for Advocacy Day and schedule appointments with your lawmakers. In advance of Advocacy Day, ask to meet in their district offices to introduce your agency, the important services and benefits you provide to the lawmakers’ constituents and community, provide written materials on your agency, offer to be of assistance to the office with their constituents’ health care needs, and offer to host the official and/ or staff on a home visit. Ask the official/ staff to support home care, hospice and MLTC in the budget!



February 2 & February 14: The Governor’s 21-day and 30-day budget amendments are due. HCA will analyze and report on any amendments made to the Executive Budget Proposal.



February 5: Health/Medicaid Budget Hearing. HCA will testify on behalf of the membership on the budget proposals and the Association’s priorities.



Early March: Preparation and passage of budget positions by the Senate and Assembly.



Mid-March: Establishment of joint Senate and Assembly conference committees to reconcile budgetary positions.



Mid-late March: Final budget negotiations.



April 1: Final budget due.

We ask the HCA membership to take part in the following advocacy initiatives this week: 







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Register for HCA’s Advocacy Essentials webinar on February 6 at 10:30 a.m.

This webinar will help demystify the advocacy process, provide you with advocacy tips, and show ways that home care, hospice and MLTC representatives can sustain various kinds of advocacy in your day-to-day business. To register, click the online link and send us your contact information at https:// www.surveymonkey.com/r/ Feb6AdvocacyWebinar.

Register for Advocacy Day – HCA will host its annual Advocacy Day on Tuesday, February 12 in Albany! Once you are registered, call and schedule a meeting with your state Senator and Assembly member’s offices to meet with your lawmakers to discuss key budgetary priorities on February 12. A registration form is at the back of this week’s Situation Report.

Respond to HCA Advocacy Alerts – In the coming days and weeks, HCA will alert members about key advocacy initiatives, including calling and emailing lawmakers to ensure the industry’s positions are heard.

Invest in the HCA PAC! By investing in the HCA PAC, you are investing in home and community-based services.

(See related p. 5 story about our 2019 kickoff PAC reception on February 11 in Albany.)

For more information about HCA’s budget memo or advocacy initiatives, please do not hesitate to contact any of the HCA Policy staff.

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

Volume 4, No. 3 January 22, 2019 

BILLS from p. 1 The new Senate Health Committee Chairman, Senator Gustavo Rivera, is sponsor to several of these bills.

HCA is extremely pleased to have this immediate display of support from the new Senate Health Chair.

These bills help provide a proactive platform for home care, hospice and managed long term care (MLTC) plans in the upcoming deliberations. They will be joined by a series of additional HCA proposals, now underway, to assist certified home health agencies, licensed agencies and MLTCs with adequate wages and reimbursement, workforce, infrastructure and positioning, as well as modifications or counter-proposals to those that the Executive has put forward in the Governor’s newly introduced budget bills. (See related p. 1 story.)

Newly introduced/reintroduced bills in detail The bills already introduced/reintroduced thus far by members Richard Gottfried (Assembly), Gustavo Rivera (Senate), Susan Serino (Senate), Kevin Cahill (Assembly) and Catharine Young (Senate) address the following areas:  Home care, hospice, MLTC workforce needs, including rate add-ons targeting workforce shortage areas and disciplines; pilots that allow use of funds to support unique personnel needs in home and community care (such as transportation, child care, training/education, career development, peer support and other); labor market analyses leading to reimbursement levels necessary for competitive recruitment, retention and compensation of home care and hospice staff; state policies and actions to promote entrance into home care and hospice as a valued and encouraged area of health care practice and employment; and more. (The bills include S.1359, S.1420 by Senator Serino.)  Incorporation of home care in the state’s prevention, public health and primary care strategies to promote improvement in health, population health and cost efficiency. This emphasis, especially in line with state budget negotiations, could help position home care more strongly in term of its roles and partnerships, yielding system savings for reinvestment in workforce and infrastructure needs. A separate proposal has been introduced to support home and community-based sepsis intervention and a continuum response to sepsis through the HCA-innovated sepsis tool. (Bills include S.1816, S. 1817 by Senator Rivera; the measures are also being introduced by Assemblyman John McDonald.)  Quality innovation, clinical and health information technology supports essential to home care, hospice, MLTC and the evolving infrastructure. These bills advocate state budget allocations for capital infrastructure, use of the Fidelis/Centene windfall funds, and methodological reimbursement provisions ensuring premiums and rate adequacy for such essential costs. (These bills include A.1128

by Assemblyman Gottfried and S.1791 by Senator Rivera.)  Updates the terms and conditions for coverage of home care under private and commercial coverage, and also prevents artificial and inequitable limits on home telehealth coverage inadvertently left behind when the 2015 telehealth insurance parity law was enacted. (These bills include A.408 by Assemblyman Cahill and S.888 by Senator Young) HCA will be providing further detail on these and other pending bills as well as our slate of new legislative language areas for our 2019 priority agenda.

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

Volume 4, No. 3 January 22, 2019 

Invest in the Future of Home and Community-care Services – Join the HCA PAC for its Kickoff Fundraiser of 2019!

Formed in 2009, the HCA Political Action Committee (PAC) is dedicated to supporting and representing the interests of home care, hospice and managed long term care services providers. This year, the HCA PAC has set a fundraising goal of $20,000!

Please join us in Albany on Monday, February 11 to support the HCA PAC’s first fundraising event of 2019 at the Hyland Library located on the second floor of the Renaissance Hotel on Monday, February 11 from 5 to 6:30 p.m.

With your investment, the HCA PAC will support lawmakers that work to preserve and protect the home and community-care services industry in New York State. By collectively pooling resources, the home care industry’s message can be heard loud and clear by lawmakers.

Protecting home care, hospice and managed long term care services providers, patients and their families cannot be done without commitment from industry-wide and legislative leadership. When you and your home care colleagues contribute to the HCA PAC, it reinforces and reminds lawmakers of the importance of home care, hospice and managed long term care services.

Please plan to join us in Albany on February 11, 2019 for this kickoff fundraiser. Minimum donations of $100 will be accepted in advance and at the door.

More information is in our PAC Reception and Advocacy Day registration form at the back of this week’s edition of The Situation Report.

Please contact HCA’s Director for Public Policy and Advocacy, Alyssa Lovelace, with any questions.

HCA Discusses Home Care-Mental Health Partnerships with State Geriatric Mental Health Council Last Thursday, HCA President Al Cardillo addressed the New York State Geriatric Mental Health Council in a meeting substantially devoted to HCA and State Office of Mental Health (OMH) collaborative work to promote policies, funding and removal of barriers for partnerships between home health and mental health providers.

Mr. Cardillo described HCA’s legislation, signed by the Governor in October, folding home care into the State Geriatric Mental Health Collaboration Program. This approach promotes comprehensive, holistic and integrated mental and physical health care for individuals in the community with co-occurring

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Volume 4, No. 3 January 22, 2019 

needs. Mental health advocacy groups have already called for expanded funding under the program in the new budget, which HCA will reinforce during a meeting with the Governor’s office this Friday.

Mr. Cardillo also addressed the fiscal, procedural, workforce/training, audit and regulatory barriers that currently obstruct the goals of integrated mental health and home health services, suggesting legislative changes that HCA could draft and bring to the budget and/or legislative tables.

OMH program directors for long term care services and supports presented data outlining the service needs, usage, gaps, areas for further study, and potential areas for policy and program direction.

HCA appreciates the continuing input of our members in this overall effort and looks forward to the new critical opportunities this work between HCA and OMH can yield for patients, families, providers, health plans and overall system goals and savings.

For further information, please contact Al Cardillo at acardillo@hcany.org.

Tell Us Your Winter Storm Preparedness, Response Stories HCA seeks stories from your agency to help illustrate the role of home care and hospice in recent winter weather preparation and response on behalf of your patients.

We’ve collected incredibly descriptive and illustrative stories for past events like Hurricanes Sandy and Irene, but would like to do the same for events like this past weekend’s snow storm.

How many Level 1 patients do you have that needed advance preparation or specific actions to keep them safe during this past weekend’s storm? In what specific ways did you need to act on your emergency preparedness plans to shift staffing assignments to reach patients most at-risk? What hardships did your staff experience, or heroic efforts did they take, to help patients in need at home before, during or after the storm?

HCA collects these stories to let lawmakers and the public know about the critical access role of home care and hospice providers in reaching patients during times of weather-related and other emergency response efforts.

We are preparing our monthly newsletter, the HCA Capitol Report, for distribution to elected representatives next week and we would like to include your stories in this publication, along with any pictures you might have to accompany your stories. Please send these vignettes to HCA’s Communications Director Roger Noyes today at rnoyes@hcanys.org.

HCA, DOH Discuss LHCSA Stat. Report Issues, Status Update Last week, HCA participated in a meeting held by the state Department of Health (DOH) to obtain further input from agencies that have completed the 2017 Licensed Home Care Services Agency (LHCSA) Statistical Report and new Registration process. Also participating were other associations, some HCA LHCSA members and other LHCSAs. As reported to members in numerous communications, the 2017 LHCSA Statistical Report included a new Registration process that had to be completed by January 1, 2019. If not completed, the LHCSA would not be

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

Volume 4, No. 3 January 22, 2019 

able to operate, provide services or receive reimbursement from any source for the provision of services and face fines.

DOH reported that 1,317 LHCSAs had submitted the Report, which includes the Registration form, and 167 had not. Most of the non-submissions were from LHCSAs covered by the Metropolitan Area Regional Office.

In November and December, HCA had contacted members whose names were on the list of non-submitters and urged them to complete the report.

DOH is conducting site visits of the non-submitters and will provide them with information on the LHCSA Statistical Report and Registration process. If DOH cannot locate anyone at the agency, DOH will send letters that include information about the Report and fines for not registering. If the agency is not operating, DOH will ask for its license.

DOH reviewed the following issues encountered by LHCSAs in completing the Statistical Report, including issues that HCA, our members and other LHCSAs had raised: 

Downloading and installing the software and Report



Inability of Apple computers to download the software



Validating, finalizing and saving the Report prior to submission



Uploading the report to the Gateway



Difficulty in completing the new workforce sections



Slowness of the Report software

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Lack of clarity on certain questions

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Assisted Living Programs not understanding that they had to complete certain sections of the LHCSA Report even if they only serve patients in the ALP (in addition to completing the 2017 ALP Statistical Report)



Printing out the Report after submission



The need for instructions to include a sample completed Report

DOH intends to address some of these issues and urges LHCSAs to send any concerns about the 2017 Report and Registration process, and any additional questions, to hcstatrpts@health.ny.gov (please copy Andrew Koski at akoski@hcanys.org). DOH requests the words “LHCSA Registration Recommendations” in the subject line.

DOH also agreed to let the Associations know if it intends to make any changes to the 2017 Statistical Report for the 2018 Report.

HCA and the other Associations all thanked DOH for its efforts to obtain a high completion rate and for seeking our further input.

HCA, along with some LHCSA members, were part of a LHCSA Statistical Report Workgroup in 2017 and 2018 to discuss revisions to the prior Statistical Report and we have continued to make suggestions for changes to the process and forms.

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

Volume 4, No. 3 January 22, 2019 

CMS to Host Feb. 12 PDGM Webinar The U.S. Centers for Medicare and Medicaid Services (CMS) is hosting a February 12 webinar (1:30 to 3 p.m.) on the home health Patient Driven Groupings Model (PDGM) that is scheduled for implementation on January 1, 2020. Registration is at https://blh.ier.intercall.com/details/52b3eed973ec47d296600bfc8ac16b3c.

It will provide an overview of the PDGM model, including low utilization, partial, and outlier payment adjustments, followed by questions and answers.

Additional information on PDGM is at the following links: 

https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/HomeHealthPPS/index.html



https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/HomeHealthPPS/Downloads/ Overview-of-the-Patient-Driven-Groupings-Model.pdf

DOH to Hold Two Webinars on Emergency Preparedness Drills Members encouraged to register for 2/5 or 2/6 programs The state Department of Health Office of Health Emergency Preparedness (DOH OHEP) will hold two webinars in February to help home care and hospice providers prepare for upcoming emergency preparedness exercises to be held outside of New York City.

The webinars are intended to prepare providers for upcoming DOH-led drills from February to May of this year.

These include Coalition Surge Test (CST), Interoperable Communications (IOC) and Medical Countermeasures (MCM) exercises outside of New York City (NYC) and in the Long Island, Lower Hudson Valley, Capital District, Central New York and Western New York regions.

At HCA’s request, DOH will hold the two webinars – on February 5, from 11 a.m. to noon and February 6, from 1 to 2 p.m. – to brief home care and hospice providers on these exercises. Registration is at www.NYLearnsPH.com (after registering, search the course catalog for OHEP-HEPCEX-2019).

The CST drill will involve a simulated emergency that results in some hospitals having to evacuate patients and seek placement in other acute-care hospitals, nursing homes or back to the patient’s home with home care. Central DOH staff will notify agencies with offices in these regions about the drill and will send notifications to certain staff roles in the Health Commerce System (HCS) Communications Directory for each agency.

During the drill, there will be no survey to complete. Instead, home care providers might receive phone calls from hospitals participating in the drill who want to know if home care providers can take any patients and provide homecare to them.

The January 14, 2019 edition of The Situation Report includes an explanation of the IOC/MCM Exercise, the dates it will be held and a two-week window during which the CST will be held.

HCA encourages all home care and hospice providers who serve patients outside of NYC to participate in one of the two February webinars so that they can learn about being part of the CST/IOC/MCM exercises. Though

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Volume 4, No. 3 January 22, 2019 

home care and hospice providers are not required to participate, such involvement can be used to meet one of their federal and/or state emergency preparedness requirements.

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.

Meeting Eyes NHTD/TBI Issues A January 11 state Department of Health (DOH) meeting provided updates on the conflict of interest (COI) requirements and other issues affecting the Nursing Home Transition and Diversion (NHTD) and Traumatic Brain Injury (TBI) waiver programs.

The meeting materials are at https://hca-nys.org/wp-content/uploads/2019/01/COI-January-11-2019.pdf.

Some specific updates include: 

The U.S. Centers for Medicare and Medicaid Services (CMS) has approved the TBI waiver application through August 31, 2022 and the NHTD application through June 30, 2023.



DOH has approved Public Partnerships, LLC to administer the housing payment contract for NHTD so that it now administers this for both TBI and NHTD.

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DOH is preparing a crosswalk of previous staff role qualifications versus currently approved qualifications which will be presented for stakeholder comment.

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Retroactive TBI rate increases (to October 13, 2015) are under CMS review for addressing the Fair Labor Standards Act (FLSA) changes. The new rate is expected to be implemented by the end of January. The rate increase for NHTD was implemented in July 2017.



A minimum wage rate increase for TBI was submitted to CMS for review. Upon approval, DOH will submit a similar request for NHTD.



The minimum wage increase will include both 2018 and 2019 increments and will be included in the 2019 rate.

Conflict of Interest DOH reported that CMS has agreed to extend the implementation date for COI under NHTD and TBI to January 1, 2021. Under this provision, service coordination must be independent of direct waiver service provision, unless the state can demonstrate that the only willing and qualified entity to provide case management and/or develop service plans in a geographic area also provides home and community-based services (HCBS).

Providers can still offer both service coordination and direct waiver services, but cannot provide both services to the same consumer.

CMS has approved DOH’s request that COI not apply to assistive technology; environmental modifications; vehicle modifications; moving assistance; and congregate/home delivered meals.

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

Volume 4, No. 3 January 22, 2019 

OIG Updates Work Plan The federal Office of Inspector General (OIG) has updated its Work Plan.

The new topics are at https://oig.hhs.gov/reports-and-publications/workplan/index.asp.

They include the following: 

Duplicate Payments for Home Health Services Covered Under Medicare and Medicaid: OIG will determine whether states made Medicaid payments for home health services for dual eligible beneficiaries who are also covered under Medicare.



States’ Compliance with New Requirements to Prevent Medicaid Payments to Terminated Providers: This study, mandated by the federal Cures Act, will examine the extent to which terminated providers included in the U.S. Centers for Medicare and Medicaid Services’ terminations database have been terminated from all state Medicaid programs and the amount of Medicaid payments for items/ services associated with terminated providers. Additionally, this study will examine the extent to which state contracts with managed care entities include a provision that terminated providers are excluded from all managed care networks.

New Medicare Card Mailing Complete The U.S. Centers for Medicare and Medicaid Services (CMS) has finished its nationwide mailing of new Medicare cards.

As of January 11, fee-for-service health care providers submitted 58 percent of claims with new Medicare Beneficiary Identifiers (MBIs). While providers can continue using the former Social Security Number-based Health Insurance Claim Numbers during the transition period, CMS encourages providers to use the new MBIs for all Medicare transactions.

Providers can individually look up MBIs if they have access to their Medicare Administrative Contractor’s secure provider portal (see https://www.cms.gov/Medicare/New-Medicare-Card/Providers/MACs-ProviderPortals-by-State.pdf). Patients can get their new Medicare numbers or print official cards through MyMedicare.gov.

If your Medicare patients say they did not get a card, instruct them to:

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

Look for unopened mail. CMS mailed new Medicare cards in a plain white envelope from the Department of Health and Human Services.



Sign into MyMedicare.gov to get their new numbers or print official cards. They need to create an account if they do not already have one.



Call 1-800-MEDICARE (1-800-633-4227), so CMS can help get their new cards.



Continue using their current cards (pending a new one) until December 31, 2019.

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

Volume 4, No. 3 January 22, 2019 

October Global Cap Report: Medicaid Spending $49M Above Projections The state’s latest Medicaid Global Cap Report finds that overall spending was $49 million above projections for the first seven months of the state fiscal year (as of October 2018) across all sectors, a difference of $13.857 billion in actual spending versus $13.808 billion in estimated spending.

The report is here: https://www.health.ny.gov/health_care/medicaid/regulations/global_cap/monthly/ sfy_2018-2019/docs/oct_2018_report.pdf.

The Medicaid Global Spending Cap has increased 6.7 percent, from $19.5 billion in fiscal year (FY) 2018 to $20.8 billion in FY 2019. Specifically, the state Department of Health (DOH) mentions the following two significant pressures on the Global Cap: 

Medicaid spending in major Medicaid Managed Care categories was $49 million over projections.



Medicaid spending in major fee-for-service categories was $87 million over projections with clinic spending $13 million above estimates. This is a result of total claims billed being 10.8 percent higher than anticipated through October.

In other important items: 

DOH reports that total Managed Long Term Care (MLTC) spending exceeded its monthly cap, by $39 million, due to higher-than-expected enrollment. There were approximately 7,000 more individuals enrolled in the MLTC partial capitation plan than budgeted.



Total Medicaid enrollment reached 6,179,628 at the end of October 2018. This reflects a net increase of 31,594 enrollees since March 2018.



The state’s Accounts Receivable (A/R) ending balance for FY 2018 was $224 million. DOH is expected to recoup $174 million by the end of FY 2019, resulting in a projected A/R balance of $50 million by March 2019. Through the end of October, retroactive rates owed to the state were $137 million. This reflects net recoveries of $90 million since March 2018.

For further information, contact Patrick Conole at (518) 810-0661 or pconole@hcanys.org.

New Version of Hospice Quality Reporting Measure User’s Manual Now Available The U.S. Centers for Medicare and Medicaid Services (CMS) has recently posted a PDF Version 3.00 of the Hospice Quality Reporting Program (HQRP) Quality Measure (QM) User’s Manual.

The measure specifications for Hospice Visits when Death is Imminent Measure 1 and Measure 2 are included in this new version.

See the Downloads section at: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-AssessmentInstruments/Hospice-Quality-Reporting/Current-Measures.html.

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

Volume 4, No. 3 January 22, 2019 

Upcoming Deadlines and Due Dates

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Requirement/Change

Effective/Due Date

More Information

LHCSA Registration Process

Must be submitted with LHCSA Statistical Report; if not submitted by January 1, 2019, agency will not be able to operate or receive reimbursement from any source

https://commerce.health.state.ny.us/public/hcs_login.html

OASISͲD for Certified Home Health Agencies

January 1, 2019

OASISͲD Guidance Manual: https://www.cms.gov/Medicare/QualityͲInitiativesͲPatientͲ AssessmentͲ Instruments/HomeHealthQualityInits/Downloads/OASISͲDͲ GuidanceͲManualͲfinal.pdf

Changes to New York’s Paid Family Leave program

January 1, 2019

https://paidfamilyleave.ny.gov/2019

2018 Adult Care Facility 4th Quarter Statistical Information Report

January 31, 2019

https://commerce.health.state.ny.us

2017 CHHA and LTHHCP Statistical Report

February 1, 2019

https://commerce.health.state.ny.us/public/hcs_login.html

2017 Hospice Cost and Utilization Report

February 1, 2019

https://commerce.health.state.ny.us/public/hcs_login.html

Webinar on Upcoming Emergency Preparedness Exercises

February 5, 2019 – 11 a.m. to noon

www.NYLearnsPH.com (search course catalog for OHEPͲ HEPCEXSͲ2019)

Webinar on Upcoming Emergency Preparedness Exercises

February 6, 2019 – 1 to 2 p.m.

www.NYLearnsPH.com (search course catalog for OHEPͲ HEPCEXSͲ2019)

HCA Advocacy Day

February 12, 2019

Andryeyeva court case to be heard

by New York State Court of Appeals

February 12, 2019

https://www.nycourts.gov/ctapps/courtpass/Docket.aspx (enter APL number 2018Ͳ00038)

Comments due on LHCSA Registration Proposed Rule

February 17, 2019

https://regs.health.ny.gov/sites/default/files/proposedͲ regulations/New%20Requirements%20for%20Annual%20Registr ation%20of%20Licensed%20Home%20Care%20Services%20Agen cies.pdf

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

February 27, 2019

megan.kash@health.ny.gov

IOC/MCM exercise – Western NY

April 3, 2019

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

Transition Period for Using Health Insurance Claim Number (HICN) or new Medicare Beneficiary Identifier (MBI)

April 1, 2018 to December 31, 2019

https://www.cms.gov/Medicare/NewͲMedicareͲCard/index.html

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

Volume 4, No. 3 January 22, 2019 

CMS Transmittal: Revocations Allowed Only From Active Billing Hospice Transmittal No. 4187 (https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/ 2018Downloads/R4187CP.pdf) from the U.S. Centers for Medicare and Medicaid Services (CMS) creates a new Common Working File (CWF) edit to ensure that the provider identifier on Type of Bill (TOB) 8xB matches the most recent provider identifier on a hospice benefit period.

Currently, the CWF will allow Notices of Revocation/Termination (NOTR) – TOB 8xB – if the provider identifier on the NOTR matches the provider on the hospice election period. This occurs even if a transfer notice (8xC) or a change of ownership notice (8xE) has changed the billing provider on a benefit period within that election. To prevent errors, an edit is needed in CWF to ensure that only the active billing provider can submit a revocation.

This new requirement and CWF edit will be effective for hospice claims received on or after July 1, 2019.

CMS to Host Hospice Webinar on Achieving a Full Annual Payment Update: January 23, 2019 The U.S. Centers for Medicare and Medicaid Services (CMS) is holding a webinar on Wednesday, January 23 (2 to 3:30 p.m.) for hospice providers on the Annual Payment Update (APU) process to achieve full APU. CMS’s webinar will cover: 

The relationship between the APU and the Hospice Quality Reporting Program;



Associated data submission requirements; and



The reconsideration process for providers who are identified as being noncompliant.

Registration for this webinar is limited to 1,000 attendees on a first-come, first-serve basis. Space is limited.

Interested HCA members can register for the webinar at: https://events-na2.adobeconnect.com/content/ connect/c1/1411885136/en/events/event/shared/default_template_simple/event_registration.html?scoid=1434400014.

For questions or additional information on logistics of this training, write to PACTraining@econometricainc.com.

13

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

Volume 4, No. 3 January 22, 2019 

PHHPC Committee Meeting Agenda Posted The state Department of Health (DOH) has posted the agenda and supporting documents for the January 24 Public Health and Health Planning Council (PHHPC) Establishment and Project Review Committee meeting on January 24.

The information is at https://www.health.ny.gov/facilities/public_health_and_health_planning_council/meetings/2019-01-24/.

The agenda includes applications by: 

One Certified Home Health Agency (CHHA) to expand into five counties as part of a regulatory waiver submitted under the HCA-developed Hospital-Home Care-Physician Collaboration program.



Three CHHAs for a transfer of ownership, change in the controlling entity, and change in ownership, respectively.



An entity to become a Licensed Home Care Services Agency (LHCSA) associated with an Assisted Living Program (ALP).



One LHCSA for an asset purchase of an existing LHCSA; one LHCSA for a change in ownership and to be associated with an ALP; and one LHCSA for a change of ownership.

All approved applications will go to the full PHHPC for review at its February 14 meeting.

The meeting will be webcast at https://www.health.ny.gov/events/webcasts/.

Employers Must Post 2018 Injury/Illness Summary Beginning Feb. 1 Employers are reminded of their obligation to post a copy of the U.S. Department of Labor Occupational Safety and Health Administration (OSHA) form 300A (https://www.osha.gov/recordkeeping/RKforms.html) which summarizes job-related injuries and illnesses logged during 2018.

Each year, from February 1 to April 30, the summary must be displayed in a common area where notices to employees are usually posted. Businesses with 10 or fewer employees and those in certain low-hazard industries are exempt from OSHA recordkeeping and posting requirements.

Visit OSHA’s Recordkeeping Rule webpage (https://www.osha.gov/recordkeeping2014/records.html) for more information on recordkeeping requirements.

Health Resources 

“Health Information Technology: Approaches and Challenges to Electronically Matching Patients’ Records across Providers,” by the Government Accountability Office https://www.gao.gov/assets/700/696426.pdf

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

14

State Advocacy Day Events DAY ONE Monday, February 11, 2019 5:00pm – 6:30pm

HCA PAC Reception

Parking for Legislative Office Building If you are driving and would like to park at the Empire State Plaza, we recommend the V-Lot which is closest to the Legislative Office Building, where we will be meeting. Elevators are accessible in the V-Lot to the Concourse level. Identifications must be shown when entering to park in the V-Lot.

Hyland Library Renaissance Hotel 144 State Street Albany, New York 12205 HCA will hold a special HCA PAC fundraising reception. Attendees are asked to make a minimum $100 donation to the HCA PAC. See back page for registration and donation details. The HCA PAC is a vital resource for building relationships with influential elected officials and getting our message heard.

DAY TWO Tuesday, February 12, 2019 8:00AM – 4:00PM

HCA State Lobby Day ID Required for Access to LOB The Legislative Office Building is a Government building; therefore you will need to go through a security check point to access this area. Please be sure to bring a valid photo ID and allow additional time to go through the security process.

Breakfast and Lunch Provided in Room 711-A A light breakfast will be provided at the beginning of our Advocacy Day on February 12th. A deli style lunch will be available at 12:00pm.

Room 711‐A Legislative Office Building 198 State Street Albany, New York 12210 8:00 AM – 12:00PM

State Leaders Address HCA Board and Members HCA is inviting key Senate and Assembly Committee Chairs, legislative fiscal and program staff leaders, as well as key representatives from the Governor’s office, Department of Health, and Division of Budget to meet with and present to Advocacy Day participants. A schedule of presenters will be provided prior to the meeting.

12:00PM – 12:30 PM

Lunch 12:30PM – 4:00PM

Legislative Office Visits Meeting Room Day Access You are welcome to utilize Room 711A throughout the day as needed and light refreshments will be available in the afternoon.

For HCA Board Members: HCA will schedule your afternoon legislative visits.

For all other HCA Members – Please schedule your own appointments during this period.

DAY ONE REGISTRATION

DAY TWO REGISTRATION

and/or DONATION

Monday, February 11, 2019

Tuesday, February 12, 2019

5:00pm – 6:30pm

8:00AM – 4:00PM

HCA PAC Reception

HCA State Lobby Day

Hyland Library Renaissance Hotel 144 State Street Albany, New York 12205 HCA will hold a special HCA PAC fundraising reception. Attendees are asked to make a minimum $100 donation to the HCA PAC.

Room 711‐A Legislative Office Building 198 State Street Albany, New York 12210

A minimum $100 donation is requested. ______ I will attend the Fundraising Reception on February 11th (See donation instructions below) ______ I cannot attend but would like to make a donation as indicated. (See instructions below)

ADVOCACY DAY REGISTRATION _____________________________________________________ Name _____________________________________________________ Organization

___ VISA ___ MasterCard ___ AmExp

_____________________________________________________ Email

Card Number_______________________________________

_____________________________________________________ Phone

Expiration Date________________ Security Code_______ Name on Card______________________________________ Card Billing Address_________________________________

# _________ Additional guests will attend Advocacy day with me from my organization.

__________________________________________________ City/State/Zip_______________________________________ Cardholder’s Signature_______________________________ Email________________________ Phone_______________

Please make your donation checks payable to: HCAPAC Checks will be accepted at the door that evening. However, if you are unable to attend but would like to make a donation, please mail your donations to: HCA PAC, 388 Broadway, 4th Floor, Albany, NY 12207 Anonymous contributions are prohibited. However, if you do not want your name to be published in recognition materials, please check this box. 

PLEASE FAX COMPLETED FORM TO (518) 426-8788