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July 25, 2024 | |||||||||||||||||||||||
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![]() This Week at CT Healthcare At Home
News Update
Source: NAHC, July 19, 2024
On Friday, July 12, the Centers for Medicare & Medicaid Services (CMS) released guidance to states on the steps needed to ensure compliance with rate transparency provisions of the Medicaid Access Rule. The guidance touches upon several items important to NAHC-NHPCO Alliance members and homecare providers, including:
The guidance is online here.
Source: NAHC, July 18, 2024
Some hospice providers have reported erroneous claim rejections associated with the certifying physician enrollment edit. The reason code associated with the edit is 17729 – The attending physician’s National Provider Identifier (NPI) data on the claim does not match the PECOS Enrolled Physicians File, or the dates do not fall within the physicians effective/termination dates. Claims potentially impacted are those with dates of service beginning on June 3, 2024, and later. Claims rejected in error are those where the physician was enrolled/validly opted out on the date of certification/recertification (appearing with a “Y” in the Ordering & Referring Data File (ORDF)) but rejected with reason code 17729. The error is system-wide, so it impacts hospice claims processing for all Medicare Administrative Contractors (MACs).
To support our members, the NAHC-NHPCO Alliance has been working with all three HH/H MACs and the Centers for Medicare & Medicaid Services (CMS) to find an immediate solution. In response to our outreach, CMS implemented a fix on Monday, July 15. We have been informed the agency is working with the MACs on a process to correct previously rejected claims.
***The Connecticut Association for Healthcare at Home submitted a comment letter last week to Congressman Earl Blumenauer addressing the draft of the Hospice Care Accountability, Reform, and Enforcement Act (Hospice CARE Act). Thank you to the Hospice and Palliative Care Committee for their feedback. ***
Source: NAHC-NHPCO Alliance, July 16, 2024
The NAHC-NHPCO Alliance submitted a comment letter to the office of Representative Earl Blumenauer (D-OR-3) regarding the discussion draft of the Hospice Care Accountability, Reform, and Enforcement Act (Hospice CARE Act), which focuses on hospice payment reform and program integrity. The NAHC-NHPCO Alliance recognizes the importance of strengthening program integrity to combat bad actors, while also ensuring that access to care is not negatively impacted and quality providers are not unduly burdened.
NAHC and NHPCO have worked closely with Rep. Blumenauer for years on these issues and remain committed to continuing the dialogue to achieve optimal outcomes for hospice providers and the continued delivery of quality end-of-life care for patients and their families.
We have always been a strong advocate for safeguarding the integrity of the hospice benefit to ensure continued availability of hospice services for future generations. Likewise, we have long emphasized a need to improve the benefit to meet the evolving needs of beneficiaries and their families, ensuring they receive compassionate, person-centered end-of-life care.
We thank all the Alliance members who provided feedback and input for our comments. We expect Rep. Blumenauer’s office to review all the submissions when considering modifications to the draft and then to formally introduce legislation some time before the November elections. The Alliance expects future opportunities to provide feedback and will keep our members updated at every step, continuously seeking input and guidance.
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![]() Source: HomeHealthLine
Clinical judgement should be used to determine if the patient is able to respond for each of the Social Determinants of Health (SDoH) OASIS items, CMS clarified in the July 2024 quarterly OASIS Q&As – released July 11.
This was in response to a question asking if a clinician is required to ask the questions for the SDoH items, such as A1005 (Ethnicity), A1010 (Race), A1250 (Transportation), B1300 (Health Literacy) and D0700 (Social Isolation), if a patient is confused and consistently does not respond appropriately to questions.
Each OASIS item should be considered individually and coded based on guidance specific to that item, CMS states in their response.
The July Q&As include three questions covering additional topics such as:
Editor’s note: To view the full CMS July 2024 quarterly OASIS Q&As, visit here.
Source: Home Health Care News, July 19, 2024
The home health industry has its very own boogeyman — the bad actor.
However, there’s a difference between providers that have made errors in claims processing or quality of care provisions versus those taking part in purposeful fraudulent activity, according to National Association for Home Care & Hospice (NAHC) President William A. Dombi.
“The outright fraud, where it’s very overt and purposeful, is the greatest concern,” he told Home Health Care News. “What makes a bad actor is a party that gets into home health care for purposes of stealing from Medicare, Medicaid and others. Their goal is not to provide care, in contrast to those who may make mistakes, but still have a goal to provide compliant high-quality care.”
Put simply, the bad actor is the type of provider that regulators want to drive out of home health care, and the type that industry peers work to avoid being associated with.
Membership News
Source: Hospital & Healthcare Compensation Services, June 2024
The HCS Home Care and Hospice Salary & Benefits studies are now underway! This is the fifth year the Connecticut Association for Healthcare at Home (CAHCH) has partnered with Hospital & Healthcare Compensation Service (HCS) on the studies. Both studies are also published in cooperation with the National Association for Home Care & Hospice.
The reports are recognized as the authoritative source for comprehensive marketplace data for home health hospice agencies. Last year’s Home Care Report contained data from 1,018 home health agencies and included data from 16 Connecticut agencies. The Hospice Report had data from 704 hospice agencies and included data from 10 Connecticut agencies.
Both studies include questions on staffing issues, nursing vacancy turnover rates and sign-on bonuses used by agencies to attract new employees. The results cover job data by salary, hourly and per-visit rates with job data breakouts by auspice, revenue size, region, state and CBSA. Regional data for 19 fringe benefits, planned salary increases, productivity, caseload and shift differential data are also covered.
The New England Home Care & Hospice Conference and Trade Show is the region’s premier event for home care and hospice agencies. The conference is hosted by the six New England state home care associations, which collectively represent nearly 400 organizations. This coming year, the conference heads to the Holiday Inn By the Bay in Portland, ME from April 15-17, 2025.
The conference is designed for senior and mid-level administrative and clinical staff. The conference features multiple keynote sessions, workshops, and intensive programs. Topics are designed to meet the needs of all agencies, including Medicare-certified, private duty, and hospices. The trade show is the largest home health and hospice expo in the Northeast.
We are pleased to open the call for speakers up to any and all who are interested. The deadline to submit proposals is Friday, September 6 end of day.
For more information on our conference you can go to www.NEHCC.com!
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