Volume 8, Number 31 May  29, 2019




Dear Healthcare at Home Colleague,

Our lead news story this week concerns an investigative finding by the HHS Office of Inspector General that extrapolated a $55,000 overpayment into a $7.5 million repayment demand. You will want to read how the accused Illinois HHA is fighting back in court. Many agencies hit with unreasonable overpayment demands have chosen the Chapter 11 route and closed their doors. Click below on "OIG Uses Homebound Status and Skilled Care Need to Target Providers" to read the official OIG statement.

We accompany this story with one of our occasional editorial comments, believing the details needed some elaboration and interpretation. We interviewed an attorney and a former CMS employee to try to understand how reviewers' extrapolation power started to spiral out of control. In the process, we think we found the source of the problem. You'll be surprised to discover who it is. But a solution may be on the horizon. Apparently, CMS has decided it is as much of a victim of the situation as the accused HHAs are. When an agency shuts down instead of paying, CMS is left with nothing.

This is important because it could happen to any home health agency, in fact, to any Medicare provider. In our opinion piece, we think the experts we interviewed gave us a solid understanding of not only how this happens but why extrapolation became a death sentence. Click on "What Does the OIG vs EHS Story Mean?" As always, let us know what you think by writing to editor@homecaretechreport.com.

In our continuing examination of strategies to prepare for the major Medicare reimbursement changes coming in January, we invited a guest author to discuss the advantages of outsourcing coding and billing functions. Though Kristin Donar is Director of Revenue Cycle Management for HEALTHCAREfirst, she has sent us a vendor-neutral argument in favor of letting professionals take over certain tasks in order to improve accuracy and timeliness and, consequently, increase episode payment levels.

News for non-medical providers:
While the news is heavily oriented toward Medicare skilled providers this week, private duty providers will be interested in our Vendor Watch column, especially you who are searching for value to add to your services. GrandCare is a technology company that places large-screen communication systems into homes to allow designated family members and professional caregivers to remotely monitor and communicate with clients in their residences. The Wisconsin company announced the appointment of a new CEO this week, longtime friend of and occasional contributor to this publication, Laura Mitchell, who started in marketing and rose up through the ranks to take the reins.

It was good to see so many regular readers in New York, Colorado, and Pennsylvania this month. I get to stay home for a while but am looking forward to meeting more of you at the NAHC Financial Managers conference in July, the LincolnHealth Senior Living 360 gathering in August, and the HCAOA Annual Meeting in September.

Senior staff reporter Darcey Trescone and I wish you a great week and a great summer. Keep making a difference!

 

Editor signature
Tim Rowan



OIG Uses Homebound Status and Skilled Care Need to Target Providers
A Chicago-area HHA received a $7.5 million overpayment bill from the OIG. This is the OIG statement on one example case among many.

What Does the EHS vs. OIG Story Mean?
This could happen to any HHA. Understand the financial and political motivations on all sides before it happens to you.

Outsourcing Coding and Billing: Key to PDGM Success?
As PDGM will demand a higher level of accuracy and timeliness, it may make sense to outsource coding and billing to experts.

CMS News: Hospice Compare and PACE Improvements
— National Training Program Monthly Update Webinar
— May 2019 Hospice Compare refresh of quality data is now available; now includes additional information on hospice characteristics to complement existing quality and patient experience metrics.
— Final rule removes redundancy, reduces administrative burden on PACE providers.

Vendor Watch
— GrandCare Systems appoints Laura Mitchell as new CEO, expands executive team

 
When you click on these ads,
you make sure HCTR continues to come to you for free.



























During the 2nd Quarter of 2019, web sites of the above advertisers were visited by home care and hospice executives and staff 2157 times.

To inquire about placing your message here, contact:

Kristin@rowanresources.com

Last Week's Most-Read Stories:
PDGM Vendor Perspectives and Preparations
Casamba and Thornberry discuss their PDGM perspectives and preparations.
 
Music as Medicine to Improve Patient Outcomes
Singfit is using music as medicine to address the needs of dementia and COPD patient's in home care.

As of this date, approximately 33,781,000 Baby Boomers have become Medicare eligible.



Notable Upcoming Conferences Free Webinars

 

3rd Interoperability Forum

Office of the National Coordinator for Health IT (ONC) 

Date: August 21-22
Location: Renaissance Hotel, Washington, DC

Register Online

This event will bring people together from ONC, the healthcare industry, and the technology sector to:
  • Learn about recent efforts to advance interoperability nationwide
  • Identify concrete actions in response to current interoperability barriers
Attendees will hear keynotes from industry influencers, have the opportunity to view demos showcasing innovative solutions and participate in tracks focused on various aspects of interoperability. Co-led by industry leaders and supported by ONC experts, the tracks will provide an opportunity to discuss the latest issues and identify actions that can be taken to address key barriers to interoperability in a group setting.
Who: Health IT standards and technology community, including developers, policymakers, technology staff at provider organizations, and consumers.

SAGE/2019 *

Hosted by Honor

Date: September 10
Location
: Portofino Hotel & Marina, Redondo Beach, CA
Time: 9:00 am - 5:00 pm

Information and Registration
(Rowan Report subscribers have been offered a 25% discount; use discount code "Rowan" when you register)

How we care for our aging population is one of the most daunting and important challenges we face as family members, as community builders, as leaders in our industry.
That’s why Honor is launching SAGE/2019, a day of inspiring keynotes, lively panel discussions, and intimate conversations on the most compelling topics in senior care and wellness. We’re bringing together thinkers and doers, innovators and entrepreneurs, academics and leaders in healthcare and home care.
You’ll meet creative thinkers who are shifting the narrative about aging, company founders who are driving change, and visionaries who are imagining what’s possible in the future. This is a unique opportunity to network with thought leaders, peers, and potential partners, to revolutionize how we think about aging, and, most importantly, to take action.

Home Health, Home Care, Hospice GROWTH SUMMIT *

Date: Sept. 17-19
Location: Green Valley Ranch, Las Vegas

Information and Registration

Join renowned agency mentors Cheryl Peltekis and Melanie Stover for an owners' and executives' ONLY event focusing on how to survive and thrive in this rapidly changing environment. Cheryl and Melanie will break down exactly how to maximize your agency’s growth during this time of disruption in an easy to follow system you can use, over and over.

HCAOA 2019 Annual Leadership Conference *

Home Care Association of America

Date: September 22-23
Location: Marriott Tucson Starr Pass Resort

Information


NAHC 2019 Conference & Expo *

October 13-15
Seattle

Information and Registration


Two Sales Training Boot Camps: Home Health and Hospice & Palliative Care

Presented by Healthcare Strategica, LLC

Featuring: Michael Ferris
Location: Westin Lake Las Vegas Resort

Bootcamp 1: PDGM Home Health Sales
Date: November 12-13

Bootcamp 2: Hospice & Palliative Care Sales
Date: Novenber 14-15


Register with code "HCTR" for $100 off.


PDGM Success Seminars hosted by Axxess *
Sponsored by: BKD, Aegis Therapies, HealthCare ConsultLink, Home Health Care News, Gateway Home Health Coding and Consulting, Worldview, Connected Home Living, Laengrich Healthcare Partners and Swift Medical

Dates and Locations (open to all Home Care providers):
  • Dallas, TX Tuesday, September 24
  • Houston, TX Thursday, September 26
  • Boston, MA Tuesday, November 5
  • Fort Lauderdale, FL Thursday, November 14
  • Chicago, IL Tuesday, October 22
  • Columbus, OH Thursday, November 12
  • Las Vegas, NV Friday, October 4
  • McAllen, TX Tuesday, December 3
  • San Antonio, TX Thursday, December 5
Information and Registration (early bird discount code: Axxess2020)
The one-day seminars will focus on the following learning objectives:
  • The PDGM impact numbers that matter most, along with operational strategies to ensure proper reimbursement                   
  • Specific actions to take for each PDGM risk factor, including coding, non-groupable diagnoses, LUPA avoidance and management, chronic care management, and therapy management
  • How to drive growth for your organization through institutional referral strategies and the use of specialty programs, including wound care and complex nursing
Including specifics such as:
  • How to get the most important OASIS information you need in five minutes
  • Implementing maintenance therapy programs and telemonitoring
  • Setting up visit schedules that prevent avoidable LUPAs 
  • How each component of PDGM builds the case weight 
  • Restructuring intake processes to obtain necessary billing information

*The Rowan Report will see you there.

Your state or national association meeting not listed? Send the details to Conferences@RowanResources.com using this format:

Conference Title
Sponsoring Association
Date(s)
Hotel or Conference Center, City, State
URL

Interoperability for Service Providers through CMS’s EMDI Initiative

Presented by: ElevatingHOME and VNAA

Featuring: Pallavi Talekar, Project Manager, Scope Infotech, Inc.; Ray Wilkerson, Sr. Business Analyst, Scope Infotech, Inc.; Nandini Ganguly, Business Analyst, Scope Infotech, Inc.; Kishan Patel Business Analyst, Scope Infotech, Inc.; Briana Barnes, Project Coordinator, Scope Infotech, Inc.

Date: Tuesday, July 30
Time:
12:00 pm EDT
Fee:
Free to ElevatingHome, VNAA, and Alliance for Home Health Quality Improvement members

Registration

Representatives from the EMDI Initiative team will discuss interoperability using health IT standards, including Fast Healthcare Interoperability Resources (FHIR). Participants will learn about pilot opportunities with CMS to enhance provider workflow using three critical use cases. Participants will:
  • Gain knowledge of interoperability concepts and use of latest standards, including FHIR;
  • Gather information on three critical use cases in the post-acute care setting to reduce provider burden and enhance their interoperability footprint; and
  • Identify next steps for participation in an upcoming pilot opportunity with CMS.


Security Risk Assessment Tool Overview and User Feedback Session

Presented by: CMS

Date: Wednesday July 17

Time: 1:00 pm EDT

Fee: Free

ONC and the HHS Office for Civil Rights are holding a training session and overview of the Security Risk Assessment (SRA) Tool. The tool is designed to assist small to medium providers in conducting an internal security risk assessment. This assessment will aid providers with their security risk analysis as required by the HIPAA Security Rule and the CMS EHR Incentive program. Following the webinar, participants will have the opportunity to ask questions and provide feedback.
 
Register


PDGM’s Behavioral Adjustments - What You Need to Know Now

Sponsored by eSolutions

Featuring: Karri Wright, Sr. Director, Product Management at Homecare Homebase

Date: Thursday, August 29
Time: 2:00 pm CDT
Fee: Free

REGISTER NOW

The webinar covers:

  • CMS assumptions and intended adjustments and their impact on:
    • Upcoding
    • Comorbidities
    • LUPA Avoidance
  • Considerations for HHAs
  • Evaluating your HHA data now to assess tomorrow based on today’s reality


A QUALITY JOB: Clinical Management & Care Coordination Under PDGM

Hosted by VNAA
Sponsored by MatrixCare/Brightree
Presented by Simione Healthcare Consultants

Featuring: Laura Wilson, RN, BSN, Sr. Manager, Simione Healthcare Consultants
Date: Wednesday, September 11
Time: 12:00 pm EDT

Free Registration

PDGM is so much more than a billing change! Home health agencies preparing for payment reform need to look closely at clinical operations to make accommodations that will uphold quality, including care alternatives that add value to the equation. In this webinar, we’ll share insights based on the findings of gap analyses to help your organization make a successful transition under the new requirements. Recommended Attendees: Clinical Managers, Intake Staff, Coders / QA, Finance & Billing personnel Hosted by VNAA, sponsored by MatrixCare/Brightree, presented by Simione Healthcare Consultants



Webinar hosts, send your announcements to: Conferences@RowanResources.com

Did you receive this issue as a forward from a colleague? Would you like to have your own free subscription? Click here.

Home Care Technology Report is published by Rowan Consulting Associations, Inc., Colorado Springs, CO. All rights reserved. Request reprint permission by writing to editor@homecaretechreport.com.

HCTR is free to subscribers and supported by its generous advertisers. To inquire about presenting your message to our 5,000 subscribers, write to Kristin in our ad sales department, Kristin@RowanResources.com.