Volume 8, Number 43 — 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!
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 2020, web sites of the above advertisers were visited by home care and hospice executives and staff 4523 times. To inquire about placing your message here, contact: Kristin@rowanresources.com As of this date, approximately 33,781,000 Baby Boomers have become Medicare eligible. |
Last Week's Most-Read Stories:
PDGM Vendor Perspectives and Preparations
Music as Medicine to Improve Patient Outcomes
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WEBINAR: 5 Crucial Ways to Prepare for PDGM
Sponsored by: HealthCare Synergy
Featuring: Michael Tidd, LVN, COS-C, COS-D
Dates: November 13
Time: 10:00 am PST / 1:00 am EST
Information and RegistrationAgencies are rapidly trying to prepare for the PDGM payment model. We will show you the most crucial ways an agency can prepare for the internal changes needed for PDGM. While most agencies are focusing on how to instruct clinicians on the change, PDGM has the most impact on office functions. Attend and gain insight on the things the agency needs to be doing now to prepare for January 1, 2020.
Objectives:
1. Learn agency level changes that can be implemented to be successful in 2020
2. Understand how to approach budgeting and finances under PDGM
3. What do your clinicians really need to know to ensure the agencies continued successMichael Tidd has over 19 years of experience in the Home Care Industry and is a frequent speaker at HealthCare Synergy Workshops and Webinars. He is a Software Developer, LVN and Certified in ICD-9/10 Coding and OASIS (COS-C, HCS-D). As the Clinical Manager for HealthCare Synergy, he directs the Outsourced Management Services, assists in directing the development of the Healthcare Assistant Web Edition, oversees the Clinical Documentation Auditing provided to clients and directs the Clinical Form Development for the Healthcare Assistant Web Edition. Michael continues to educate agencies in the ongoing regulations that CMS produces, the proper application of the Medicare Conditions of Participation and completing timely, accurate and defendable clinical documentation to survive in the current Medicare Reimbursement Model.
Webinar: Post-Acute Care Quality Reporting Programs
Presented by: CMS
Date: Thursday, November 14
Time: 2:00 - 3:00 pm EST
Fee: Free
Description: The Centers for Medicare & Medicaid Services (CMS) will be hosting a webinar for Medicare-certified hospice providers to provide an overview on Hospital Quality Reporting Program (HQRP) requirements.
During this webinar, CMS subject matter experts will provide information on the following topics:
- Hospice Item Set (HIS) reporting requirements;
- HQRP compliance cycle;
- How to achieve hospice compliance;
- CAHPs survey requirements; and
- How to switch CAHPS survey research vendors.
CMS will answer questions at the end of the webinar as time permits.
Register
Conference: Successful Home Health Transformation
Hosted Dixon Healthcare Solutions, Inc.
Date: December 5-6
Location: Bally's, Las Vegas
Time: 7:00 am - 4:00 pm
Speakers: Richard K. Dixon, Cheryl Peltekis, RN, Meaghan McCormick, Esq., Donna Floyd, RN, BSN, J'non Griffin, RN, MHA, HCS-D, BCCH-C, COS-C, WCC; Annette Lee, RN, MS, HCS-D, COS-C; Cory Mertz, managing partner for a leading healthcare M&A firm.Approved for up to 10 hours of Continuing Nursing Education by Corexcel, an accredited provider by the American Nurses Credentialing Center's Commission on Accreditation.
WEBINAR: PDGM Preparation: Operational StrategiesSponsored by Kornetti & Krafft Health Care Solutions & MedBridge
Date: December 5
Time: 1:00 pm EST
Knowing that resources are tight as PDGM approaches, Kornetti & Krafft is offering a free overview of OASIS D1 to ensure that changes to this critical data collection instrument do not get lost in the shuffle.
What is Included:
- Highlight key differences between OASIS D and D1
- Make an informed decision about the use of "=" as a response
- As an outsourced OASIS/Coding company, the most commonly seen OASIS errors and proven strategies for success will be included.
Homecare 100 *January 19-22
JW Marriott Miami Turnberry Resort
Miami, FL
https://www.homecare100.com/
WEBINAR: Key Documentation Issues for 2020 & the Future
A 90-Minute Lunch & Learn Audio Conference by Elizabeth E. Hogue, Esq. Health Care Attorney
Date: March 18
Time: 1:00 - 2:30 EDT
Encore date: March 25; On-demand recording available
Information and Registration
Documentation remains a key requirement for home care providers as the consequences for inadequate documentation become more severe.
- What can home health agencies do to avoid denials by ZPICs, RACs, etc., for lack of homebound status and reasonable and necessary care?
- What kind of documentation must home health agencies, hospices, private duty agencies and HME companies maintain regarding gifts to referral sources and payments to physicians who make referrals to them?
- How can providers avoid an increase in enforcement action in this area?
- What kinds of documentation problems are private duty agencies facing with regard to recoupments from state Medicaid Programs?
- What dangers do electronic medical records cause for all types of home health providers?
- Is it true that if it wasn't documented, it wasn't done?
Gather your staff members to emphasize effective documentation yet again. Real examples of cases involving problematic documentation will be presented. Questions and case examples are welcome, and extensive handouts will be provided for use by staff members.
Recordings Available: Pandemic Recovery - Rebuild Stronger Than Ever
Texas Association for Home Care and Hospice
Two days of keynote and breakout presentations for home health and hospice providers.
Free Webinar: Home Care Marketing Best Practices for Medicaid Agencies
Presented by: Ankota
Featuring: Steve "The Hurricane" Weiss
Date: June 18
Time: 12:00 EDT
Fee: FreeHere are a few biographical fun-facts about Steve:
- As a marketer, grew Care Choice, a private duty home care agency from 16 clients to over $5 million in annual revenue
- His company, Hurricane Marketing Enterprises runs marketing boot camps and provides other services to help agencies grow and thrive
- Steve has been a featured key-note speaker in many national conferences
- Check out his website here: homecaremarketing.net
- The best things about a session with Steve are his passion for home care, his great stories and his infectious energy!
Virtual Conference: Virtual Summit on Health System Recovery from the COVID-19 Pandemic
The Nation’s Health System Leaders Engage in a Real-Time Dialogue on Pandemic Recovery and the Future of Health Care in America
Sponsored by: Global Health Care, LLC
Featuring:
- David Brailer, MD, PhD, Executive Chairman, Health Evolution, Former National Coordinator for Health Information Technology, Former CEO, CareScience
- Bruce D. Broussard, MBA President and CEO, Humana, Former Chair and Chief Executive Officer, US Oncology
- Michael W. Cropp, MD, MBA President and CEO, Independent Health, Chairman, Alliance of Community Health Plans
- Wyatt Decker, MD, MBA CEO, OptumHealth
Date: June 22-25
The Nation’s Health System Leaders Engage in a Real-Time Dialogue on Pandemic Recovery and the Future of Health Care in America
All health care providers offering full-time, hands-on services to COVID patients click here to register at no cost.
Virtual Conference: ATA Annual Meeting
American Telemedicine Association
Date: June 22-26
Free Webinar: What Your Plumber Knows That You Don't: 21 Dangers of Ignoring Online Marketing
Presented by: Savii
Featuring: Tim Rowan, MA and Roger McManus, MBA
Date: June 24
Time: 2:00 - 3:00 EDTLocal businesses used to be able to stand out from the crowd with TV and Yellow Pages ads. Those days are gone. Today, savvy marketers leverage the power of the Internet to make the case that they are the best choice among a throng of competitors. Many home care agencies, however, have not yet learned this lesson. They either ignore this critical tool because they do not understand it, or mistakenly assume that their mostly older clients are not attuned to using the Internet.?Preview: it is their adult child who picks a home care agency for them, not the elderly persons themselves.
Webinar Series: Sales Training, Home Health and Hospice
Presented by: Healthcare Strategica, LLC
Featuring: Michael Ferris
1 - 8-week Hospice & Palliative Care Sales Training Course2 - 8-week Home Health Sales Training
Rowan Report subscribers: Register with this link to receive $100 discount.
We have taken our best of class industry specific sales training bootcamps and are offering them via Webinar to enable you to continue to train your sales team in today's world of limited travel and social distancing.
The Hospice and Palliative Care course will be offered live every Tuesday starting May 19 through July 7, 2020.
The Home Health course will be offered live every Tuesday starting May 21 through July 9, 2020.
Each class will have participation exercises, homework assignments, quizzes and question and answer opportunities.
Each participant will receive their own course materials and individual coaching and feedback. At the conclusion of the course each student will receive a certificate of completion, an invitation to join the exclusive Sales Mastery Group* and opportunity to join the 52-week Sales Training Excellence Course.*
* Only available to Sales Professionals that have successfully completed the 8-week Sales Training Course – additional fees may apply.
Each session will be offered on-demand and if unable to attend the live webinar, you will be able to view the recording and participate in exercises, questions, coaching and quizzes. If you start after the first webinar date, you will be provided with access to those classes missed so that you can get caught up or you may elect to attend via the recorded sessions.
FREE WEBINAR: COVID-19 Forum: How Coronavirus is Reshaping Home Health and Hospice Financial Operations *
Sponsored by: HealthRev Partners
Moderator: Tim Rowan
Panelists: Bobby Robertson, Chip Carroll, Holly Miller, John Reisinger, Rachel Bracken (details below)Date: July 9
Time: 2:00 pm EDT
Not only is the home care industry under tremendous clinical pressure, but you are also likely feeling a financial squeeze. Because of this, forward-thinking agency leaders are exploring new strategies and opportunities to remain solvent. In this webinar, our panelists will chat about ways to achieve financial success when so many are struggling. They will discuss:
Panelists:
Bobby Robertson | President & Founder, Missouri Home Hospice
Chip Carroll | Director of Strategy & Business Development, Playmaker Health
Holly Miller | Chief Revenue Officer, Playmaker Health
John Reisinger | Principal, Innovative Financial Solutions for Home Health
Rachel Bracken | Vice President of Services, HealthRev Partners
Moderated by Tim Rowan | Editor, Healthcare at Home: The Rowan Report
Part III: "Agency Leadership and Operations" is set for July 23.
Virtual Conference: NAHC Financial Managers Annual Meeting
July 27-30
Conference: Leading Age Leadership Conference
Hosted by: VNAA, Elevating Home, and Leading Age
In light of the President’s national emergency declaration to address the coronavirus pandemic, LeadingAge is postponing the 2020 Leadership Summit originally scheduled April 20-22 to August 10-12, 2020 at the Omni Shoreham Hotel in Washington, DC.
We understand that the possibility or reality of COVID-19 means all-hands-on-deck at our member communities and travel bans for our Business Partners, with a singular focus on the health and welfare of residents, clients, staff, and families.
LeadingAge will continue to assist with information and resources to help you respond to COVID-19. You’ll find a clearinghouse of resources—updated daily—at leadingage.org/coronavirus-resources.
If you registered for the conference, you will be sent an email with information on your registration and hotel reservation.
With the Leadership Summit, LeadingAge has designed an event for forward-thinking leaders to connect, engage in dialogue, and deepen their knowledge about the future—how we can shape it, and the paths to get there together.
*The Rowan Report will see you there.
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
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:
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: FreeThe 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 ConsultantsFeaturing: 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
Your state or national association meeting or webinar 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
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