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Pilot Program to Determine Home Care Fraud

CMS is developing a pilot program to determine how many Medicare fraud cases are taking place in home health agencies. A contractor search is currently underway to help implement the new initiative. Many Medicare fraud experts are commending the endeavor, believing the move to be positive in an industry with long-standing allegations of fraud. Statistically valid […]

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New Generation ACO Model Announced

The U.S. Department of Health and Human Services has announced a new initiative from the Centers for Medicare & Medicaid Services’ Innovation Center (CMS Innovation Center), the Next Generation Account-able Care Organization (ACO) Model of payment and care delivery. According to the press release issued last week, the new project was established to “encourage quality […]

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Claims, Pricers, and Codes

CY 2015 HH PPS PC Pricer and PPS Main Frame Pricer Updates Available The PC Pricer is a tool used to estimate Medicare PPS payments. The final payment may not be precise to how payments are determined in the Medicare claims processing system due to the fact that some data is factored in the PC […]

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Excellence in Nursing Award Seeks NH Nominations

The Foundation for Healthy Communities is pleased to announce that nominations are being accepted for the 2014 Clint Jones NH Nursing Award!  This award recognizes a registered nurse, new to the profession of nursing, who exemplifies the practice of high quality nursing care and demonstrates an exceptional commitment to the nursing profession. Selection criteria include […]

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NGS Reminds Providers of Annual User Recertification

CMS requires National Government Systems (NGS) to conduct an annual recertification of all current Medicare online system users for the Direct Data Entry (DDE) and durable medical equipment (DME) Claim Status Inquiry (CSI) systems. Access codes were scheduled to be sent to all active users last week, March 9 through March 13, to complete the […]

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Visiting Nurses Bring New Mothers Comfort

  A New York Times Article recently highlighted the work visiting nurses do for new and expectant first time moms living on the margin.  The article showcased a Memphis, TN nurse, Beth Pletz and her clients.  High infant mortality rates continue to plague the American health care system. The Times report cites studies that have […]

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Home Health Care Symposium March 26 in Portsmouth

ChartaCloud Technologies, member of the Home Care Association of New Hampshire, will host a one day symposium themed “Foundational Home Health Care Services Technologies for Profitability, Performance and Compliance”. The symposium’s agenda is designed to allow home health care service organizations to become more deeply informed regarding current conditions and trends in the home health […]

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Federal Court Rules to Strike Down Controversial New Overtime Rule

The U.S. District Court for the District of Columbia invalidated a proposed new U. S. Department of Labor (DOL) overtime rule that had been slated to take effect on January 1, 2015. “This decision is a huge victory for patients and their families who will be able to continue receiving home care services without interruption. […]

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Nursing Award Nominations Sought

It’s time to begin the process for the 2015 Clint Jones NH Nursing Award, which we hope to present to a deserving recipient during National Nurse’s Week, which runs from May 6-12. This annual award honors the late Clint Jones, who managed the NH Nursing Workforce Partnership through the Foundation, and more information on the […]

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Notes from NAHC: CMS offers Solution to FISS and CWS Errors

NAHC reported that CMS has made modifications to the FISS and CWF systems to allow for  resubmission of NOEs when they contain errors.  We have received more detail and some clarification from CMS and have learned that hospices will now be able to immediately resubmit NOEs or NOTRs that contain BILLING errors.  This will allow […]

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Updates from NGS

National Government Services (NGS), the Medicare Administrative Contractor (MAC), for New Hampshire (New England and NY/NJ) has posted the following information on its website. NGS has announced a new way for providers to submit first-level appeals using Electronic Submission of Medical Documentation, or esMD. Some providers may be familiar with esMD, as it can also […]

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Ayotte Signs on to Renew Older Americans Act

Kelly Ayotte, (R- NH) has signed on to sponsor legislation has been introduced in the US Senate that would renew the Older American Act, which was first passed in 1965. This bill reauthorizes programs through 2018 and includes provisions that aim to protect vulnerable elders by strengthening the Long-Term Care Ombudsman program and existing elder […]

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CMS Announces Series of Calls on F2F Documentation

The Centers for Medicare and Medicaid Service (CMS) announced the first in a series of special Open Door Forums on Wednesday, Feb. 11 at 1:00 p.m. ET to discuss the voluntary draft paper and electronic clinical templates to reduce the burden of the face to face narrative mandate. Special Open Door Participation Instructions: Participant Dial-In […]

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CMS Initiative: Better Care. Smarter Spending. Healthier People.

CMS issued news releases under the title “Better Care. Smarter Spending. Healthier People.” Links to the news releases are below. The first release outlines an ambitious goal for CMS: to have 85% of Medicare fee-for-service payments in value-based purchasing by the end 2016, and 90% by 2018. The other two releases restate information that we […]

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Association makes recommendations to NH DHHS on Step 2 Managed Medicaid

Recently the Granite State Home Health Association made recommendations to Nicholas A. Toumpas, Commissioner of NH Department of Health and Human Services regarding Medicaid’s managed care program.  Member agencies actively participate in the Choices for Independence program, and believe the waiver program is an important option for many people to remain in their communities, close […]

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Legislation to Establish 40 Hours a Week

Senator Susan Collins (R-ME), Chairwoman of the Senate Special Committee on Aging, along with three of her colleagues Senators Joe Donnelly (D-IN), Joe Manchin (D-WV) and Lisa Murkowski (R-AR), introduced legislation to cancel the Affordable Care Act’s (ACA) 30 hour definition of full-time work and return the U.S. to the more universally accepted standard of […]

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Hospice Claims Returned in Error for Edit U5181

Some hospice claims are being returned in error for edit U5181 when the timely certification date falls within a reported provider liability period for a late notice of election (NOE) filing. Until the system is corrected, hospices receiving this edit in error should change the occurrence code 27 date to the date following the occurrence […]

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NH Surrogate Decision Maker Law Now in Effect

New Hampshire’s new “Surrogate Decision Maker Law” took effect on January 1st. This law amends RSA 137-J — the state’s advance directive statute — and creates a hierarchical list of family members/friends who may make health care decisions for patients in certain situations for a limited time period. It’s important that home care and hospice agencies […]

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