Archive | CMS

PDGM Summit Comes to New England March 30

    PDGM 2020 NATIONAL SUMMITS Monday, March 30, 2020  |  Worcester, MA Key Insights  |  Best Practices  |  Lessons Learned PDGM is here! Gain the tools and knowledge needed to understand and adapt your business to these important changes at our regional summit, at the AC Hotel Worcester, 125 Front St. Worcester, Massachusetts from 9:00 […]

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Here we go! iQIES and PDGM

The Alliance has heard of numerous issues with iQIES registrations and OASIS submissions since the iQIES transition.  NAHC is in contact with CMS regarding these.  CMS has assured us that they are aware of and are working on the resolution of the issues.  We understand CMS is also working to provide a list of all […]

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NGS Reminder: Medicare Beneficiary Identifier Change Days Away

Beginning January 1st 2020, providers will be required to use the new Medicare number, also known as the MBI, for all Medicare transactions. Information on the MBI transition is on our website by clicking Learn about MBI banner on www.NGSMedicare.gov. After January 1, 2020 the Medicare claims processing system will not process a claim without […]

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No MBI = No Payment

No MBI = No Payment   As of January 1, 2020, all Medicare home health and hospice claims must include new Medicare Beneficiary Identifiers (MBI), regardless of the date of service. Claims without MBIs will be rejected. In a recent Provider Outreach and Education call for hospices, NGS reported that about 30% of New England […]

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MD flyer PDGM Ref info

Alliance Provides Free PDGM Card for Referring Physicians

One of the challenges of implementing Medicare’s new home health Patient-Driven Groupings Model in January is educating referring physicians about agencies’ needs for more specific patient information and faster turnaround time for signed documents. To help our members meet that challenge, we’ve developed a free card that agencies can download and distribute to referral partners. […]

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PDGM. Here we go!

CMS issued its final rule for the 2020 payment model, PDGM, on October 31. It included rates of payment that go into effect on January 1, 2020. The final rule offered some minor tweaks to the payment model and set out 2020 payment rates. The rule includes a 4.36 percent cut (which CMS refers to […]

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Delayed. Again.

NH Medicaid is unlikely to meet the Electronic Visit Verification (EVV) timeline established by the 20th Century Cures Act. The Act requires that states implement an EVV for Medicaid personal care services and home health services. The Act originally required states to launch EVV in 2019 for PCS and 2022 for home health. Last year, […]

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NAHC on PDGM

Sign up for the webinar series or video with the Alliance discount codes. PDGM: What’s Coming in 2020 Payment groups to more than double. In the PDGM era, the number of payment groups will increase from 153 currently to 432. Effect? “Helpful…it more laser targets the level of payment,” Dombi said. With 153, there were […]

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Medicare POC requirements

Special alert from the National Association of Home Care and Hospice regarding Advance Directive Information in the Home Health Plan of Care as a condition for payment A very serious issue involving Medicare home health has surfaced that requires the immediate attention of your organization. Effective January 13, 2018, the “Plan of Care” (POC) Condition […]

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Northeast PDGM Summit 3.12.19

. The Home Care Hospice & Palliative Care Alliance of NH will co-sponsor with the National Association for Home Care & Hospice (NAHC), the Forum of State Associations, and the Home Health Financial Management Association, a PDGM Summit on March 12, 2019. . Register online: Check your e-mail for your member code Is your agency […]

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CMS Guidelines Unclear for Medication Disposal

Providers are waiting for DEA guidance on the updated rule that allows hospice nurses to dispose of meds when a patient dies.  Judi Lund Person, VP of Regulatory and Compliance at NHPCO has met with representatives of the DEA and hopes to have more information by the end of January. For now providers are advised […]

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Centers for Medicare & Medicaid Services (CMS)

CY 2019 Home Health Prospective System Rate Update and CY 2020 Case-Mix Adjustment Methodology Refinements; Home Health Value-Based Purchasing Model; Home Health Quality Reporting Requirements; Home Infusion Therapy Requirements; and Training Requirements for Survey On October 31, 2018, the Centers for Medicare & Medicaid Services (“CMS”) released a final rule which includes finalized CY 2019 […]

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CMS Unveils Proposed Rule for Medicare Home Health Payments

On July 2nd. CMS published itsMedicare Home Health Rate Rule and plans for 2020 payment reform. Here’s a synopsis of rate changes: The HHPPS episodic payment rate, after case mix and wage index adjustments, will increase by 2.1%. Per visits payments will also increase by 2.1% The rural add-on for 2019 will be 3% for […]

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CMS Releases Proposed 2019 HHPSS Update

CMS released its 600-page 2019 Proposed Medicare HHPPS Update at 4:15pm yesterday.  You can download the document at this link: https://s3.amazonaws.com/public-inspection.federalregister.gov/2018-14443.pdf While it will take a while to digest the entire proposal, below is a list of the basic elements, as sent to State Associations by Bill Dombi, president of NAHC. 2019 Payment rates The […]

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NH DHHS Proposes Changes to Home Care and Hospice Licensing Rules

  The NH Bureau of Health Facilities Licensing has released proposed revisions to the He-P 809 rules for licensing of home health care agencies and the He-P 823 rules for home hospice agencies. Public hearings will be held on June 11th — noon for the hospice rules and 1:00 pm for the home care rules. […]

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CMS Provides Guidance on Medicare Advantage Supplemental Benefits

Home care agencies could have an expanded role in providing services to enrollees in Medicaid Advantage (MA) Plans. CMS has issued two memos to the MA Plans instructing the plans on changes for contract year 2019. One memo relates to the expanded interpretation of the definition for “primarily health-related” supplemental benefits that plans will be permitted […]

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Get Answers from NGS

  On April 5th, NGS’s Home Health Clinical Consultant Lauri Domingo will be in Concord for a half-day education session on CMS’s Targeted Probe & Educate Process and home health documentation requirements. It’s from 9:00am – 12:30pm at the Holiday Inn, 172 North Main Street in Concord. Don’t miss this chance to get your questions […]

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Update: Medicare Targeted Probe & Educate

the new CMS Targeted Probe & Educate (TPE) initiative that started on October 1. The Targeted Probe & Educate (TPE) is for ALL types of Medicare providers. It is modeled after demonstration projects with home health agencies and hospitals. Both home health providers and hospice providers may be the subject of a TPE. Theoretically, an […]

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CMS Releases Draft Version of the HHCOP Interpretive Guidelines

The Centers for Medicare & Medicaid Service (CMS) has issued a draft version of the home health Conditions of Participation (CoPs) Interpretative Guidelines (IGs). CMS issued the IGs to the National Association for Home Care & Hospice (NAHC) with a request for stakeholder feedback. CMS is unable to entertain individual comments and requests that aggregated […]

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