Volume 5, Number 42 September  21, 2016



Dear Healthcare at Home Colleague,

I spent this week digging into the CMS decision to postpone its Pre-Claim Review pilot in Texas, Florida, Michigan, and Massachusetts. It comes down to their admission that it is not working in Illinois but the jury is out regarding why it is not working. CMS says Illinois providers are at fault and need more education. Illinois providers, and their state association, are convinced that it is Palmetto GBA reviewers who do not understand their own rules. There is also much confusion as to why the experiment, if CMS believes it has failed, was not stopped in Illinois rather than merely being postponed for future pilot states. 

I interviewed several Illinois HHA owners and an official with the Illinois Homecare and Hospice Council this week and I sat in on the IHHC conference call with NAHC's Bill Dombi. Last June, I also participated in the CMS Open Door Forum in which staffers outlined the Center's expectations for the experiment, expectations that largely failed to materialize. 

To the best of my ability, I have analyzed the Illinois experiences as reported by HHAs in Chicago and downstate. The three articles in this week's issue are the result of that analysis. I hope you find them useful. Most of all, I hope these articles are not read solely in Illinois. Even though early results have proven that Pre-Claim Review, in its current form, fails in its mission to separate fraudulent providers from honest ones, CMS continues to give every indication that they intend to go forward with the 5-year pilot and eventually expand it nationwide. Every Medicare provider reading this page needs to be prepared, not just my readers in the pilot states. 

I have done my best to help you prepare but there are of course many other sources. You need them all. Consider just one thing you will learn in my articles. Illinois is experiencing an 80% pre-claim "non-affirmation" rate. What will it mean to beneficiaries if that happens in 50 states? If there is a bottom line, it is this: every Medicare agency in the five pilot states and beyond needs to get on the phone with their Representatives and Senators and teach each one's staffer assigned to healthcare issues the truth about how badly this experiment is going. They are getting a different message from CMS, as you will see in my lead article.

Just before pressing 'send' on this week's issue, I saw that CMS has canceled its Open Door Forum that had been set for October 5. Their reason is that is conflicts with a National Provider Call on Emergency Preparedness Requirements. We will keep watch for any announcement of another ODF dedicated to the Pre-Claim Review experiment.

We will get back to our normal variety of topics next week but for now this is the story that impacts most of you so we have dedicated the entire issue to it.

Have as great of a week as you can. Keep making a difference!

Editor signature
Tim Rowan



CMS Postpones Pre-Claim
To many, CMS's decision to postpone implementation of the Pre-Claim Review experiment in Texas, Florida, Michigan, and Massachusetts does not come as a surprise. Poorly trained reviewers make so many mistakes, it may be wise to turn the program off in Illinois as well, where it has already begun but is not working.

Illinois Home Health Providers Frustrated, Angry, But Not Powerless
Almost everything that can go wrong has gone wrong in the first state burdened with poorly planned Pre-Claim Review experiment.

Home Health Providers Bear Some Responsibility Too
In marriage and in Medicare, there are always two valid sides to every argument. Just because most of the blame for the Illinois fiasco can be attributed to PGBA does not mean that HHAs are blameless. Those who intend to be in business next year must set the bar higher for employees who create, review, and submit clinical documentation.

Texas Association Urges Members to Continue PCR Training
In spite of the announced PCR delay, the Texas Association for Home Care and Hospice is warning its members to remain vigilant and continue preparing, saying, "PCR is still coming."

 
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Notable Upcoming Conferences Free Webinars

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


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

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

2018 Annual Conference

AHHC of North Carolina

May 7-9
Sheraton Imperial Hotel & Convention Center

Register


West Coast Payer and Provider Summit to Address Social Determinants of Health for Complex PopulationsA World Health Care Congress Executive Series Event

June 4-5

Doubletree Resort Paradise Valley
Scottsdale, AZ


Download agenda

Post Acute 360: Strategy and Solutions Conference

Presented by: Lincoln Healthcare Leadership

June 25-27
Gaylord National Resort
National Harbor, MD
Information and Registration


NAHC Financial Managers Meeting

July 15-17
Austin, TX
Information and Registration


Leading in a Changing World

Texas Association for Home Care & Hospice 49th Annual Meeting
August 8-9
Moody Gardens Hotel & Spa
Embassy Suites Frisco Hotel & Convention Center
Frisco

Information and registration


Home Care Cruise

Sponsored by: HealthCare Synergy
Featuring: Melinda Gaboury, Michael Tidd, Paula Pettit
Dates: August 24-27
Location: Carnival Inspiration, Los Angeles to Ensenada, Mexico

Information and Registration

(Early Bird Pricing Ends May 15)


Medicare and Managed Care Reimbursement Necessities

Presented by HealthCare Synergy, Inc. and Illinois Homecare & Hospice Council

Featuring: Melinda Gaboury, COS-C
Date: Wednesday, September 5
Time: 8:30 am CDT
Location: Northern Illinois University

This is an In-person Workshop and Live Webinar

Information and Registration

(HealthCare Synergy clients, call for a special discount: 714-229-8700; ext 118 for Rangsey Ouk or ext. 137 for Edleen English.)

To maximize your reimbursement, you need to be well informed. Melinda Gaboury of Healthcare Provider Solutions, and a trusted consultant for HealthCare Synergy, will help you stay on top of constantly changing regulatory requirements so you can get paid.


Hospice Financial and Administrative Management Academy

Presented by: The Health Group, LLC

Date: September 17-18
Location: Mirage Las Vegas

Information and registration


2018 National Leadership Conference *

Home Care Association of America

Date:
September 22-25
Location: Marriott Wardman Park Hotel
Washington DC

 

Information for Providers and Exhibitors


*HCTR will see you there.

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

Conference Title
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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


Patients' Right to Freedom of Choice of Providers: How to Avoid Lawsuits

 

Presented by Elizabeth Hogue, Esq.

 

Thursday, June 14 (Encore Date: 6/21)
Recording available 24/7 On Demand; option to purchase CD & handouts.
1:00 - 2:30 pm EDT

 

Register here

 

Conflict between hospitals and home health agencies, private duty agencies, hospices and HME companies that receive referrals from hospitals may be intensifying regarding patients' right to freedom of choice. Hospitals say that they comply with all requirements while some post-acute providers maintain the exact opposite. Now post-acute providers are suing hospitals for violations.
  • What exactly are hospitals supposed to do?
  • What do post-acute providers say are common violations?
  • What is an example of a recent lawsuit filed against hospitals for violations?
  • What can hospital discharge planners/case managers do to avoid these types of lawsuits?
  • How can providers help ensure that patients' rights are honored instead of filing court cases against hospitals?
Participate in this teleconference to learn the answers to all of these questions! Extensive handouts will be provided that will also serve as a resource when questions come up in the future.


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



Bridging the Gap Between Acute and Home Care with PICO Single-Use NPWT

Sponsored by: ElevatingHOME

Featuring:
Ravi K. Bashyal, MD, Director of Outpatient Hip and Knee Replacement Surgery, Northshore University Health System
Kristi Huebner, RN, MSN, CWS, Professional Education Manager, Smith & Nephew

Date: Friday, August 10
Time: 1:00 pm EDT

Registration

This webinar will provide participants with insight into how PICO Single Use NPWT may benefit wound care patients in the home care setting. Additionally there will be a discussion about prophylactic use on incisions for prevention of readmission to the acute care setting. Participants will gain insight into appropriate utilization of PICO NPWT in the home care setting and how participation in this program may improve patient outcomes.



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


Three-Part Webinar Series by Relias Learning

August 8: A Journey to Achieving Quality Care
Presenter: Diane Geis, EVP and Chief Personnel Officer, Altercare of Ohio, Inc. and TSG Resources, Inc.
Register

August 15: Best Practices in Dementia Care for A Competitive Edge
Presenter:
Teepa Snow, MS, OTR/L, FAOTA, Positive Approach, LLC
Register: Facility Professional
Register: In-Home Professional

August 28: Developing Managers as Leaders: Top Down is Dead. Lead From the Middle!
Presenters:
Jan Wilson, M.Ed., SPHR, SHRM-SPC, Director, Learning and Design Outcomes, Relias
Register

, ,

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


Secrets to a Positive Home Health Survey Experience

Presented by Curaport
Featuring:
Heather Calhoun, RN, BSN, COS-C, HSC-D, Home Health Solutions, LLC

Date: Tuesday, August 28
Time: 2:00 p.m. EDT

Fee: $99 (per attendee)

Information & Registration

Your Home Health Agency will be surveyed soon. Even if that is 9 months away – that will be here before you know it! With all the changes that are constant in the world of Home Health, one thing that does not change is the importance of preparing well for a surveyor to walk through your door. How to prepare for and perform well in your next Survey should not be a secret.

Heather Calhoun of HHS will be leading this education session on uncovering the secrets to preparing your Agency to excel in your next survey. Learning objectives for this webinar are:

  1. Describe 3 ways that an agency can be survey ready
  2. Develop processes in the agency that will ensure success during a survey
  3. List 2 things to avoid during a survey
  4. Discuss educational opportunities within the agency in preparation for the survey
*This education session is approved for one (1) contact hour of Continuing Education for Nursing.

*Curaport, LLC is an approved provider of Continuing Education by the California Board of Registered Nursing. All states accept this certification for their licensing requirements. No refund shall be given, except for any change in date or time of the webinar. In such case, a full refund shall be given to the registrant upon their request.

 



Home Health Proposed Rule: CY2019/2020 Payment & Policy Changes

Presented by HEALTHCAREfirst

Featuring:

Deanna Loftus, HEALTHCAREfirst Director of Regulatory Compliance
Liz Silva, HEALTHCAREfirst Director of Home Health & Hospice
Mary St. Pierre, RN, BSN, MGA, Home Health Regulatory Expert

Wednesday, August 8
2:00 pm EDT

Free Registration

On July 2nd, CMS issued a proposed rule outlining changes for CY2019 and CY2020. Join HEALTHCAREfirst for a two-part webinar series where we will break down the proposed changes and discuss what it may mean for home health agencies. In session one, we discussed the proposed changes for CY2019, including a review of the 2.1% payment increase, home health value-based purchasing refinements, updates to the HH QRP requirements, and changes to the rural add-on structure. In session two, we will cover the proposed changes for CY2020, including implementation of the Patient Driven Groupings Model (PDGM) and changes to OASIS. You won’t want to miss this webinar series to learn more about the possible overhaul of the home health prospective payment system and CMS's continuing shift towards value-based care.

 



Understanding Social Determinants to Improve Health Care

Presented by Curaport

Featuring: Christina A. Nuqui, M.S.W., of Home Healthcare Solutions, LLC

Date: Thursday, July 12
Time: 2:00 p.m. EDT
Fee: $79 (per attendee)

Information and registration

This education session is pending approval for one (1) contact hour of Continuing Education for Social Work from the National Association of Social Workers.

Addressing the Social Determinants of health will be the most important factor of health care reform. This webinar will discuss what Social Determinants are, and how they can help you better understand your patient. In addition, we will discuss how Social Determinants affect access to health services, Re-Hospitalizations, & Individual Behaviors.



Introduction to the CMS Electronic Medical Documentation Interoperability (EMDI) Program

Presented by: ElevatingHome
Featuring:

  • Pallavi Talekar, Project Manager, Scope Infotech, Inc.
  • Ray Wilkerson, Sr. Business Analyst, Scope Infotech, Inc.
  • Nandini Ganguly, Business Analyst, Scope Infotech, Inc.
  • Briana Barnes, Project Coordinator, Scope Infotech, Inc.
Date: Wednesday, August 8
Time: 1:00 p.m. EDT

Registration

 

Participants will gain understanding of the CMS-driven Electronic Medical Documentation Interoperability program, focused on reducing provider burden by engaging health care providers and stakeholders in pilots that establish secure communication to share medical documentation by aligning with nationally recognized interoperable standards. This event is designed for providers and vendors who are willing to enhance their workflows and communication to achieve efficiency by reducing time and cost.

In this session participants will learn about interoperability and shift in the health care IT landscape, EMDI pilot program details, EMDI pilot program benefits, and how to partner with the EMDI to achieve interoperability.



The Penalty Box Compliance Series Part 8: The IMPACT Act

Presented by Curaport
Featuring Kristi Bajer, RN, MSN

Wednesday, May 23
1:00 p.m. EDT
$39

Information and registration

This education session is approved for one (1) contact hour of Continuing Education.



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