Volume 5, Number 42 June  29, 2016



Dear Healthcare at Home Colleague,

Though we have no targeted news article about it in this week's issue, we continue to watch CMS's attempts to explain the regulatory details underlying its 5-state pilot of a pre-claim approval system. Couched as a cash-flow enhancing measure for non-fraudulent providers, the rule looked less and less like that as more clarifications appeared this week.

First, additions to the official FAQ page confirmed that physician-signed plans of care and Face-to-Face documents will have to be submitted with your application for pre-claim approval. Agency workers from coast to coast have told us over the years how difficult it is to get physicians signatures by the END of a 60-day episode. The single sentence asserting this requirement makes clear that CMS has no understanding how heavy of a burden this will impose. If you listen closely, you can almost hear the implied "no big deal" at the end of this statement:

"Pre-claim review does not create new documentation requirements. Home Health Agencies will submit the same information they currently submit for payment, but will do so earlier in the process."

The other clarification that was far less comforting than intended is the confidence that MACs will have no trouble processing hundreds of thousands of additional pages per day. 

[These are] the same contractors that currently process claims and conduct medical review on home health services. Clinical staff are assigned to medical review and trained to ensure consistency. In addition, we will employ private sector standards in our pre-claim review program, such as making every effort to respond to pre-claim review requests within 10 business days of receipt of an initial pre-claim review request, providing responses that are specific about missing information, and giving providers an opportunity to resubmit the pre-claim review request an unlimited number of times for re-review. During re-submission, the MAC will make every effort to issue a decision within 20 business days.

"Every effort" is somewhat less confidence-inspiring than "guarantee," especially when the historical record of the rate of payment denials overturned by the ALJ for improper interpretation of the rules by these same clinical staff is taken into consideration. Do the math yourself:

  • X days from start-of-care until all physician signatures are secured, PLUS
  • 10 days to receive pre-claim denial #1, PLUS
  • X days to gather missing or update inaccurate documents and re-submit, PLUS
  • 20 days to receive pre-claim denial #2, PLUS
  • X days to gather missing or update inaccurate documents and re-re-submit, PLUS
  • 20 days to receive pre-claim approval.
  • Add another two weeks to this is you submit via US Mail. Your MAC will always reply using the same document delivery system you use.

Have we reached the deadline after discharge to submit a final claim yet? If not, we are very close. Consequently, providers in Illinois, Florida, Texas, Michigan and Massachusetts, you have two goals. 1) Do not submit pre-claim requests that have a chance to be denied. 2) Do not submit via US Mail. 

We will keep an eye on this rule. Early guinea pigs in Illinois are urged to share their first experiences with us in August. In the meantime, there is other news this week...

Two of our regular sponsors have successes to announce:
Procura/ContinuLink/Igea reported record revenue for their recently closed fiscal 2016. And Consolo hospice software is expanding its headquarters, hiring dozens of new staff, and releasing software features we have not seen in other hospice software.

We also feature two guess essayists this week, each with a timely topic. Attorney and agency owner Jeffrey Grossman opines about the benefits of paying living wages, overtime, and travel time to non-medical caregivers. And home care veteran Merrily Evdokimoff, RN,PhD, teaches us about the advantages of using "Health Navigators," a new but rapidly growing job description.

Have a terrific Independence Day weekend. Keep making a difference!

 

Editor signature
Tim Rowan



Fueled by $12M Investment, Consolo Services Group Aims to Transform Hospice Software Market
In a crowded field of hospice EMR providers, Consolo has its sites set on the front row with mileage management, business intelligence, and data analytics.

Agency Owner Finds Silver Lining in SCOTUS Support of Wage Rules
Guest author Jeffrey Grossman, Esq., considers the positive impacts of new wage protections on agency bottom lines.

IRS Notice 2016-40 Extends WOTC Transition Relief for 3 Additional Months
WOTC Tax Credits are typically worth $2,400 to $9,600 per employee. For-profit organizations should apply by September 28 to receive a credit for all employees hired since 1/1/15.

Use of Health Navigators for Improved Patient Activation in Home Health Care
Merrily Evdokimoff, RN, PhD, teaches Community Health Nursing at the University of Massachusetts-Boston. In this guest article, she references several examples of the value of lay medical navigators in healthcare systems. She suggests it is time healthcare at home providers give the movement a serious look.

Procura Releases FY16 Results, Shows Record Growth, 100+ New Customers
Procura's fiscal year ended March 31 reporting record revenue and introducing four new key executives.

 
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During the 3rd Quarter of 2017, web sites of the above advertisers were visited by home care and hospice executives and staff 2425 times.

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Last Week's Most-Read Stories:
Vendors and Consultants Concerned About Pre-Claim Review Rule
The more we get to know CMS's pre-claim review pilot, the more it becomes apparent that it will have some good consequences among all the disastrous ones.
 
CMS Tries to Justify Home Health Prior Authorization Rule
In its quest to quell Medicare fraud, CMS has imposed a new burden on honest and dishonest agencies alike in five states. This week, spokespersons tried to explain the new Pre-Approval of Claims process as a benefit to providers.

As of this date, approximately 22,077,000 Baby Boomers have become Medicare eligible.



Notable Upcoming Conferences Free Webinars

ICD-10 Coding Conference
Texas Association for Home Care & Hospice

Featuring Lisa Selman-Holman
September 13-14
Westin Galleria
Houston

Receive up to 11 clock or contact hours.

http://tahch.org/tahchorg/education/icd10


Public Policy Leadership Conference
Visiting Nurse Associations of America

Wednesday, September 14 at 8:00 AM through Thursday, September 15 at 3:00 PM
Washington Court Hotel
Washington, DC

More information and registration

 


By the Numbers: ICD-10 Coding Conference
Texas Association for Home Care & Hospice
September 13-14
Westin Galleria Hotel
Houston


Information and registration



By the Numbers: ICD-10 Coding Conference

Texas Association for Home Care & Hospice
September 13-14
Westin Galleria Hotel
Houston

Information and registration


HURRICANE Home Care Marketing Boot Camp 2.0 *
October 5-7
Embassy Suites Philadelphia Airport
http://homecaremarketing.net/hurricanebootcamp/

Home Care Sales and Marketing Society *
6th Annual Conference

Learn tactics and techniques for gaining more patients and clients. This year, two breakout tracks: "Field Sales Tactics" and "Internal Operational Excellence: Intake, Admissions and Inquiry."

October 6-7
Bally's Hotel and Casino
Las Vegas
Click here for more information


Annual Meeting *
National Association for Home Care and Hospice

October 23-25
Gaylord Palms Resort and Convention Center
Orlando

Information and Registration


Pre-Claim Revue Implementation
Palmetto GBA and CGS Tours Texas in Partnership with TAHC&H

Multiple Locations:
October 11 – McAllen
October 13 – San Antonio
November 16 – Houston
November 17 – Dallas
Details for each conference


The Journey Forward
South Carolina Home Care & Hospice Association Annual Conference
December 5-6
Hyatt Place + Hyatt House | Historic District
Charleston
www.schchaconferences.com

The 6th Annual Medicare Compliance Cruise *

Presented by Pearson & Bernard, PSC

January 15-22
Departs from Ft. Lauderdale
Information and registration


2017 Northeast Home Health Leadership Summit

Sponsoring Associations:

  • Connecticut Association for Healthcare at Home
  • Home Care and Hospice Alliance of Maine
  • Home Care Alliance of Massachusetts
  • Home Care Association of New Hampshire
  • Home Care and Hospice Association of New Jersey
  • Home Care Association of New York State
  • New York State Association of Health Care Providers
  • Rhode Island Partnership for Home Care
  • VNAs of Vermont

January 17-19, 2017
Colonnade Hotel
Boston

Information and Registration


OASIS-C2: The Next Steps

Texas Association for Home Care & Hospice
Presented by Lisa Selman-Holman
January 19, 2017
Westin Riverwalk Hotel

San Antonio 
Details and registration


Homecare 100 *February 4-7
Ritz-Carlton
Amelia Island, FL
Registration is full. To be added to the waiting list, contact Miriam Adams at madams@lincolnhc.com

National Leadership Conference *
Sponsored by:
Visiting Nurse Associations of America

Alliance for Home Health Quality and Innovation

April 19-21

Hilton San Diego Bayfront
https://www.homebasedcareevents.com/

Omaha System International ConferenceA Key to Practice, Documentation and Information Management
April 20-22, 2017
Eagan, MN
Bi-annual conference offers opportunities to gain knowledge about using electronic health records across diverse settings, exchanging health information, and enabling data sharing among practice, education, and research. For additional information about the conference, the call for poster abstracts and award nominations, and to register, visit www.omahasystem.org/conferences.html.
Email abstracts to lchoromanski@gillettechildrens.com

ATA Annual Meeting

American Telemedicine Association
April 23-25
Orange County Convention Center
Orlando

http://www.ata2017.org


Pediatric Home Care Conference

Texas Association for Home Care & Hospice
May 9
Omni Austin Hotel Southpark

Details and registration


New England Home Care & Hospice Conference & Trade ShowMay 16-18
Radisson Hotel
Manchester, NH
Brochure and Registration

Annual Conference *Home Care Association of Colorado
May 17-19
Keystone Resort & Conference Center
Keystone, CO
http://www.homecareofcolorado.org


Home Health Emergency Preparedness CoP Requirements:
Getting Your Agency Ready

Featuring Mary St. Pierre, RN, BSN, MGA
Free, sponsored by HEALTHCAREfirstSeptember 13

1:00 pm Central Time
Omni Austin Hotel Southpark

Details and registration

http://www.healthcarefirst.com/webinars/

  • Overview of the emergency preparedness requirement
  • What surveyors will be looking for
  • Steps home health agencies should take to prepare

Our Home Care Landscape: Big Challenges, Bigger Opportunities *
Annual Meeting of the Home Care Association of America
October 8-11
Austin, TX
Information and registration

AHHC 2017 Leadership ConferenceAssociation for Home & Hospice Care of North Carolina
October 9-10
Holiday Inn Resort
Wrightsville Beach

Click here to register

HCSSA Administrator Program
Texas Association for Home Care & Hospice
November 13-15
Westin Galleria
Houston
tahch.org

*HCTR will see you there.

4th Annual Home Care Winter Warm-Up
Home Care Association of Florida

January 16-17
Boca Raton Marriott
Keynotes by Stephen Tweed, Bill Dombi, 12 others

Information and Registration


CONNECTED HEALTH: Remote Patient Monitoring and Telehealth Summit

6th Annual Care Coordination and Technology Congress

January 24-26
Renaissance Atlanta Waverly Hotel & Convention Center
Agenda:
Designing successful bundles without collaboration between inpatient and post-acute (PAC) providers inhibits the cost-savings opportunities that make bundled payment a valuable model for hospitals and health systems. Designing care management incentives and solutions for complex patients requires integration across hospitals, home care, and the extended continuum of provider organizations.
Register for in-person or online participation


2018 National Leadership Conference
ElevatingHOME Annual Meeting
March 7-9
Grand Hyatt
Washington DC
Information and registration

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

2017 Regulatory Updates, Including Home Health Conditions of Participation

Free Webinar Hosted by DeVero Software and Relias Learning
Featured Speakers: Michael Tidd, Healthcare Synergy; Robert Love, DeVero
Tuesday, March 21
2:00 pm EDT / 11:00 am PDT

Register Here


A New Approach for Home Health Face-to-Face:
Updated Info, Updated Insights

Sponsored by Kinnser Software
Featuring Arlene Maxim, RN
Thursday, April 20
1:00 pm EDT

Learn:

  • What CMS requires for "adequate documentation" under Face-to-Face
  • How to handle inadequate progress notes provided by the physician/in-patient facility
  • Exactly what to include on your checklist of items for the physician's packet

Free: Register here



How to be the TOP DOG Sales Rep
Sponsored by PlaymakerCRM
Featuring Cheryl Peltekis, RN
December 14
2:00 EST
Register here


Grow Your Census with Online Marketing Tools

Sponsored by Shoshana Technologies

October 20
http://rosemarksystem.com



Clinician Recruitment, Retention & Satisfaction: Does Technology Help or Hinder?

Sponsored by Brightree and Elevating Home
Featuring: Karri Harpole, RN, BSN, Brightree; Tarrah Lowry-Schreiner, President & CEO, Sangre de Cristo Hospice & Palliative Care; Wendy Cofran, CIO, Century Health Systems, Inc.; Melissa Polly, MBA, Brightree Product Marketing (moderator)

Wednesday, July 26
1:00 pm EDT

Learn:

  • Best practices related to the use of technology and the best way to engage clinicians in a model that provides the most value the organization, including recruitment, retention and satisfaction; 
  • From colleagues, how to get the most value from the use of technology from clinical documentation and nurse satisfaction to operational efficiencies; and,
  • How changes in the post-acute environment, from regulatory drivers to value-based care, drive effective utilization of technology.

Register



    Navigating the Final Rule for Medicare PPS for CY 2017
    Sponsored by PPS Plus
    Tuesday, November 15, 1:00 - 2:30 pm CST
    Featuring Dave Macke, CHFP, FHFMA
    Director of Reimbursement Services, VonLehman & Company
    FREE

    Register here


    Workforce Webinar Series: Stacking the Odds in Your Favor
    Best Practice Selection Strategies


    Presented by ElevatingHOME

    All programs in the series have been archived for those unable to attend live:

     

    • Part 1, "Why Staff Leave and How to Keep Them," sponsored by Exact Recruiting, a Simione Talent Solution. Click here to view this session.
    • Part 2, "From Turnover to Engagement for the Healthcare Executive," sponsored by Relias. Click here to view this session.
    • Part 3, "The ROI of Using Pre-Hire Assessments," sponsored by Relias. Click here to view this session.
    • Part 4, "Stacking the Odds in Your Favor: Best Practice Selection Strategies," sponsored by Home Health Selection Solutions. Recorded 11/28, recording available soon.

    Upcoming topics in the Workforce Webinar Series:

    Part 5: "Recruiting and Compensation Strategies that Work," sponsored by Exact Recruiting, a Simione Talent Solution
    December 5 | 1:00 p.m. ET

    Register here

     

    Part 6: "Employee Engagement: Your Key to Exceeding Home Health and Hospice Outcomes," sponsored by Fazzi Associates
    December 12 | 1:00 p.m. ET

    Register here

     

    Part 7: TBD
    December 19 | 1:00 p.m. ET
    Details coming soon.


    Why your claims are being denied:  Performing a self-assessment of your ZPIC, Pre-Claims, and VBP liabilities

    Featuring Michael McGowan, CEO, OperaCare
    Tuesday, January 17
    2:00 p.m. EST
    Cost:  $79
    Register


    2017 What You Need to Know about Electronic Visit Verification

    EVV offers many benefits to agencies and care providers, and choosing the right solution can lead to improved operating efficiency, caregiver communication, quality of care, and client satisfaction.

    Wednesday, March 15
    11:00 am MST - 12:15 pm MST

    Register Here



    How to Attract and Retain Health System Relationships

    Presented by Netsmart
    Ongoing
    Free
    Watch now

     


    Under Pressure — OASIS Service Utilization Review

    Presented by Michael McGowan of OperaCare
    Thursday, April 6
    12:00 p.m. EDT
    Cost: $49
    Registration



    What You Need To Know About Electronic Visit Verification
    Presented by Darby Anderson, CDO, Addus HomeCare Corporation
    Sponsored by CellTrak
    Wednesday, April 12
    1:00 p.m. EDT
    Cost:  Complimentary
    Registration link
     


    Understanding the Effect Functional Scoring Has on Your Agency
    Presented by Chad Whitefield, PTA, Managing Partner of Advance Rehabilitation Management Group
    Thursday, April 13
    2:00 p.m. EST
    Cost:  $99
    Registration link 


    Increase Referrals, not Overhead- Streamlining the Intake Experience

    A streamlined, efficient intake process creates a better patient experience and improves referral relationships. During this webinar, industry experts will share their quick tips and best practices for improving your intake process and managing your organization's revenue cycle.

    Sponsored by Forcura
    Featuring: Craig Mandeville, Founder & CEO of Forcura Jessica Stover, Senior Manager of Blacktree Healthcare Consulting
    Tuesday, Oct 3
    2:00 pm EDT

    Registration


    QAPI Overview

    Presented by Diane Link, BlackTree Healthcare Consulting
    Tuesday, May 23rd
    2:00 p.m. EST
    Cost:  $99
    Registration


    International Guidelines for Home Health Nursing

    Presented by: International Home Care Nurses Organization (IHCNO)

    Wednesday, October 25
    11
    :00 a.m. - 1:00 p.m. EDT
    Registration

    www.ihcno.org/Registration

    Contact person: Marilyn Harris marilyn@ihcno.org



    Patient Engagement & Health Literacy

    Presented by Curaport

    Featuring Stephanie Koehn, RMA, CPC CPPM, CPCO
    Thursday, December 7
    2:00 p.m. EST
    Cost: $39
    Click here to register



    QAPI Series, Part 4: Revenue Cycle Management

    Presented by Curaport

    Featuring Diane Link and Nick Seabrook of BlackTree Healthcare Consulting
    Tuesday, December 12
    2:00 p.m.EST
    Click here to register



    Strategic Use of Technology in Home Health and Hospice Organizations

    Presented by: Elevating Home and Brightree

    Thursday, October 12
    1:00 p.m. EDT

    Speakers include:

    • Melissa Polly, Brightree (Moderator)
    • Paul Pisano, CEO, Interim Healthcare - Hartford
    • Tarrah Lowry-Schreiner, CEO, Sangre de Cristo Hospice & Palliative Care
    • Todd Montigney, Managing Director and Founding Member, BlackTree Healthcare Consulting
    • Nick Knowlton, CommonWell Alliance and Brightree

    Registration



    The Penalty Box Compliance Series: Part 3, Care Planning for HHGM & VBP Success

    Presented by Curaport
    Featuring Kristi Bajer, RN, MSN, VP OperaCare
    Wednesday, December 6
    1:00 p.m. EST
    $39

    Click here to register



    Navigate your Way to Referral Success in 2018

    Presented by Home Care Sales

    Featuring Melanie Stover and Cheryl Peltekis
    Friday, December 15
    12:00 p
    .m. EST
    Registration and Information



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