Volume 8, Number 25 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

 
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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

NAHC Financial Managers Meeting *

July 14-16
Sheraton Grand Hotel
Chicago

Information and Registration


Senior Care 360: Strategy and Solutions Conference *

Presented by: Lincoln Healthcare Leadership

Date: July 31 - August 2
Location: Gaylord National Resort, National Harbor, MD

Information and Registration


 

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.

HCAOA 2019 Annual Leadership Conference *

Home Care Association of America

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

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

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


"Motivating Providers to Deliver Care Vitually"

Sponsored by Arizona Telemedicine Program and Southwest Telehealth Resource Center

Presented by Jan Ground, PT MBA

Date: June 6, 2019
Time:
12:00pm MT
Fee: Free

REGISTER NOW

Learning Objectives:

1. Define the problem: be clear on the problem to be solved with telehealth initiatives.

2. Sponsorship: identify the right sponsorship, be clear on what is specifically needed from each level of sponsors.

3. Reinforcement: start with positive reinforcement, move to negative reinforcement on the clearly defined behavior changes

Jan Ground PT, MBA, has been leading clinicians and other healthcare personnel through change for more than twenty years. She led the virtual care work for the Colorado Permanente Medical Group and was the Innovation Hunter for the Colorado Region of Kaiser Permanente (KPCO). Most of her work supported innovation initiatives to enable people to get care anywhere and providers to provide care from anywhere. Areas of focus have included video visits, remote patient monitoring, e-visits, as well as the use of mobile apps and social media in care delivery. In all of these efforts, motivating providers to provide care differently was the most significant barrier to success. Jan has trained physicians and staff inside and outside of KP in Innovation, Meeting Management, and Leading People through Change. Jan has degrees in psychology, physical therapy, exercise science, and business administration from Middlebury College, Middlebury, VT; Emory University, Atlanta, GA; and the Univ of S. FL



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

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