Archive | CMS

Screenshot_2021-01-06 MM11855 - MM11855 pdf

RAP Changes Now Underway

There’s no upfront payment for home health agencies in 2021 Welcome to the new year here! You have five days to have your RAP submitted and accepted, or your home health agency will face a hefty penalty. Adjusting to this time frame will require workflow and policy changes, even as agencies are still dealing with […]

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Be Ready for BIMS!

The Centers for Medicare & Medicaid Services (CMS) plans to incorporate the Brief Interview for Mental Status (BIMS test) to assess for patients’ cognitive impairments as part of OASIS E. Due to the pandemic, a Medicare and Medicaid interim final rule issued last May delayed the new OASIS-E items for at least a year following […]

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Medicare Issues 2021 Final Payment Rule

CMS finalized the CY 2021 Home Health PPS Rate Update, which also covers quality reporting requirements and new regulations for home infusion therapy. The rule is relatively unchanged from last year. Base payment rates are increased by 2%. The PDGM behavioral adjustment remains at 4.36%. The national standard base rate for a 30-day period of […]

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PEPPER Data- The Free Comparative Billing Report You Need!

The RELI Group, along with its partners TMF Health Quality Institute and CGS, is contracted with the Centers for Medicare & Medicaid Services to develop, produce and disseminate provider-specific comparative data reports, referred to as the Program for Evaluating Payment Patterns Electronic Report, or PEPPER. PEPPER summarizes one provider’s Medicare claims data statistics and provides comparative […]

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The World Health Organization (WHO) added a new code to the international ICD-10 database: U07.1 (2019-nCoV acute respiratory disease. As of April 1st, 2020, the code will be available for use in the United States. Renowned coding expert Lisa Woolery, RN, BSN, BCHH-C, COQS presents an important, timely, and free webinar, Coding COVID-19: using new ICD-10 […]

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Waivers for Home Health Care Providers: UPDATE

Home Health Agencies (HHAs) CMS is revising its existing waiver that allows Occupational Therapists (OTs) to perform initial and comprehensive assessments beyond cases in which only therapy services are ordered by expanding it to permit Physical Therapists (PTs) and Speech Language Pathologists (SLPs) to do the same. The waiver thus permits OTs, PTs, or SLPs […]

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News from CMS

Q4 2019 PEPPERs are now available for home health agencies. These reports summarize provider-specific data statistics for Medicare services that may be at risk for improper payments. Visit the PEPPER Resources website for helpful information.   CMS issued a new MLN Matters Article MM11880 on Billing for Home Infusion Therapy Services On or After January 1, 2021 […]

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MACs Resume Medical Review on a Post-Payment Basis

MACs Resume Medical Review on a Post-Payment Basis  To protect the Medicare Trust Fund against inappropriate payments, Medicare Administrative Contractors (MACs) are resuming fee-for-service medical review activities. Beginning August 17, the MACs are resuming with post-payment reviews of items/services provided before March 1, 2020. The Targeted Probe and Educate program (intensive education to assess provider […]

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Get Your Hospice PEPPER

Q4 2019 PEPPERs are available for hospices. These reports summarize provider-specific data for Medicare services that may be at risk for improper payments. Providers can use the data to support internal auditing. Download your agency’s report on the PEPPER Portal.  The PEPPER Team is committed to ensuring and maintaining the confidentiality of each provider’s PEPPER. […]

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The Physician Assistant’s New Role in Medicare Home Health

The Physician Assistant’s New Role in Medicare Home Health July 9, 2020 Announcement as pdf: PA’s New Role in Home Health Care The Alliance has worked with the NH Society for Physician Assistants to clarify state regulatory issues related to PAs’ new authority to certify Medicare home health eligibility and oversee plans of care.  Please […]

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Regulatory update for Hospice Administrators

NHPCO confirmed with CMS that temporary exemptions for HQRP Requirements end on June 30, 2020 and starting on July 1, 2020 hospices providers are expected to resume timely quality data collection and submission of CAHPS® Hospice Survey and HIS records for all new HIS admission records and any HIS discharge records that occur on or […]

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CMS Approved NH Medicaid’s Request

  For CFI Providers –CMS-approved NH Medicaid’s request to amend the state’s 1915 Waiver for Long term Services and Supports. An Executive Summary of the changes is in the first 18 pages of the 85-page document. This amendment is in effect during the COVID-19 public health emergency. The Centers for Medicare & Medicaid Services (CMS) […]

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OASIS-E Delayed

OASIS-E has been delayed. OASIS Answers has created a short video to summarize the OASIS-E delay which you are free to share with staff. OAI explains the OASIS-E Delay from OAI Admin on Vimeo. Per the language in the rule it appears that the earliest that OASIS-E could be implemented is January 1st, 2022, with the actual […]

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PDGM 2020 VIRTUAL SUMMITS

April 28 & April 29 The current COVID-19 pandemic is demonstrating that more than ever quality care in the home is the future of American health care. Home health agencies are busier than ever and facing greater changes than ever. A new payment system is one of those challenges and to help you successfully manage […]

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COVID 19 Response: CMS Regulatory Changes for HHA

CMS that came out on 3/30/2020 that includes home health.   Additional Background: Sweeping Regulatory Changes to Help U.S. Healthcare System Address COVID-19 Patient Surge: (Includes Home Health information on further use of telehealth) https://www.cms.gov/newsroom/fact-sheets/additional-backgroundsweeping-regulatory-changes-help-us-healthcare-system-address-covid-19-patient   CMS Accelerated and Advanced Payment Fact Sheet: https://www.cms.gov/files/document/accelerated-and-advanced-payments-fact-sheet.pdf   Families First Coronavirus Response Act-Increased FMAP FAQs https://www.medicaid.gov/state-resource-center/downloads/covid-19-section-6008-faqs.pdf

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HIPAA & Telehealth Technology – from Joan Usher

As we are considering telehealth visits to reduce person to person contact we must also follow HIPAA guidelines for our communications with patients. A covered entity (health care provider) that wants to use audio or video communication technology to provide telehealth to patients during the COVID-19 nationwide public health emergency can use any non-public facing […]

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PDGM Summit Goes Virtual

After much deliberation and understanding that our members’ health and safety come first, the Home Care Alliance of MA and NAHC are happy to announce that the March 30 PDGM Conference will be presented as virtual all-day conference rather than an in-person event.  Below will highlight how we will be moving forward with this event. […]

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Congress Passes Coronavirus Funding, Telehealth Waivers

In response to spread of COVID-19, the novel coronavirus, Congress passed an $8.3 billion supplemental appropriations package designed to combat the spread of the novel coronavirus. This new federal spending will largely be directed to the Department of Health and Human Services (HHS) to be used for stockpiling medical supplies, conducting research, and supporting community […]

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CMS Takes Action Nationwide to Aggressively Respond to Coronavirus National Emergency

The President’s declaration empowers the Secretary of Health and Human Services (HHS) to authorize CMS to take proactive steps through 1135 waivers and rapidly expand the Administration’s aggressive efforts against COVID-19 led by the White House Coronavirus Task Force. The HHS Secretary is authorized to waive certain Medicare, Medicaid and Children’s Health Insurance Program (CHIP) […]

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New Coronavirus (COVID-19) Resources for Home Health & Hospice

The National Association for Home Care & Hospice (NAHC) has created a new resource page specifically for helping the home care and hospice community remain informed and deal safely and appropriately with the spread of COVID-19, the Coronavirus. The Coronavirus Resources Page, to be updated constantly until this crisis has passed, will be populated with the latest information, […]

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