‘Going Green’ Project Update

HCL wants to take this time to update all agencies regarding our ‘Going Green’ project.  We have had a number of phone calls from agencies as to when the electronic manuals will be in place.  Everything is going well but, as many of you know, implementing new technology does not always go as quickly and smoothly as we hope and plan.  HCL is spending the extra time prior to implementation to, hopefully, assure as few glitches as possible when the project goes live.  At this time we project “Going Green” will be in place at some point during the next quarter.   

Soon, agencies having HCL manuals, will receive an email providing each agency with a unique user name and password, as well as instructions for accessing the agency’s manuals online.  Invoices for payment of future updates will be mailed.  HCL staff will also be available by phone for those agencies needing additional assistance with the agency’s implementation of the ‘Going Green’ project.   

Thanks to everyone for your patience and understanding.  HCL is as anxious as you to have this project implemented and we are confident you will be very pleased once it is in place.     

Merryl Messer,

Executive Vice President

Social Media: Protecting Patient Privacy

In this age of increasing use of social media, serious concerns arise over protecting Patient rights and privacy. Please follow this link to the National Council of State Boards of Nursing for guidelines for the responsible use of social media.

https://www.ncsbn.org/2930.htm

Essential Components Name tag drawing winner

Congratulations to:

 Sheela Maliyil with Covenant Plus Health Care, Inc.

** Gift card is mailed to home address **

Important Notice Home Health Care CAHPS Participation Requirements for the Calendar Year 2014 Annual Payment Update

To receive the annual payment update (APU) for calendar year 2014 (CY 2014), all Medicare certified home health agencies (HHAs) that serve 60 or more patients between April 1, 2011, and March 31, 2012, who meet Home Health Care CAHPS (HHCAHPS) Survey eligibility criteria must contract with an approved HHCAHPS Survey vendor and have that vendor administer the Home HHCAHPS Survey on a continuous (monthly) basis from April 2012 through March 2013. This rule was included in the Home Health Prospective Payment System (HH PPS) Update Final Rule for CY 2012, which was published in the Federal Register on November 4, 2011. The HH PPS for CY 2012 is available at 

• Medicare-certified home health agencies are eligible for an exemption from participating in the HHCAHPS Survey for the CY 2014 APU if they serve 59 or fewer survey-eligible patients between April 1, 2011, and March 31, 2012. To be exempted from participating in the HHCAHPS Survey for the CY 2014 APU, HHAs must count the number of home health patients they served between April 1, 2011, and March 31, 2012, who meet HHCAHPS survey eligibility criteria and then report that count on the Participation Exemption Request Form for the CY 2014 APU, which will be available at https://homehealthcahps.org on April 1, 2012.

•  All Medicare-certified HHAs that submitted a Participation Exemption Request for the CY 2013 APU are advised that that exemption will expire on March 31, 2012. Unless HHAs qualify for an exemption from participation in the HHCAHPS Survey for the CY 2014 APU, all such HHAs must begin their participation in the HHCAHPS Survey beginning with the April 2012 sample month.   

•  Medicare-certified HHAs that do not qualify for an exemption from participating in the HHCAHPS Survey for the 2014 APU who have not yet begun their participation in the HHCAHPS Survey are strongly advised to go to the Web site, https://homehealthcahps.org ,  to register for user credentials and review the list of approved HHCAHPS Survey vendors. All such HHAs are advised to contract with one of the approved HHCAHPS Survey vendors and complete the online “Authorize a Vendor” form on the HHCAHPS Web site so that they may begin their participation in the HHCAHPS Survey as soon as possible.  

Please contact the HHCAHPS Coordination Team via e-mail at hhcahps@rti.org or by phone at (866) 354-0985 if you have any questions about this announcement. 

ISSUANCE OF REVISED NOMNC and DENC, FORM CMS-10123 and CMS-10124



CMS is issuing a new combined Notice of Medicare Non-Coverage. This notice will replace the CMS 10123 (Original Medicare notice) and the CMS 10095 (Medicare Advantage notice).

This combined notice retains the form number of the current Original Medicare Notice (CMS 10123) and the name of the MA notice (Notice of Medicare Non-Coverage, or NOMNC).

CMS also is issuing a new Detailed Explanation of Non-Coverage, or DENC, with the form number CMS 10124.

Providers are required to issue the new combined notices as soon as possible, but no later than May 1, 2012.

To download the new form and form instructions go to www.cms.gov/BNI06_FFSEDNotices.asp.

CMS Extends Discretionary Enforcement of Version 5010

On March 15, 2012 CMS announced that it will extend enforcement of compliance with Version 5010 standards until June 30, 2012. CMS states Fee-for-Service entities are reporting 70% success with receipt and processing 5010 claims; other entities are reporting similar success rates. State Medicaid agencies are reporting success as well.

The Office of E-Health Standards and Services (OESS) states they are aware of several issues preventing complete transitions to the new standards which warrants the extension of enforcement for another three months. CMS and OESS urges the industry to work together to help resolve the remaining issues. OESS will offer additional provider calls, technical assistance, and work closely with vendors, providers, and clearinghouses during the next few months.

The Medicare FFS program will continue to host separate provider calls to address outstanding issues related to Medicare programs and systems. They announced, “Medicare Administrative Contractors (MAC) will continue to work closely with clearinghouses, billing vendors, or healthcare providers requiring assistance in submitting and receiving Version 5010 compliant transactions. If any entity is experiencing difficulty reaching a MAC, please contact Karen Jackson at Karen.Jackson1@cms.hhs.gov“.

The Medicaid program staff at CMS will continue to work with individual States. Issues related to implementation problems with the States may be sent to Medicaid5010@cms.hhs.gov.

February Administrator Training Name Tag drawing winners

Congratulations to the following individuals:

Day 1, Feb. 28, 2012

Stephanie Douglas with Abicare Home Health

Day 2, Feb. 29, 2012

Samuel Asadu with Promptime Home Healthcare Services

***Gift certificates are mailed to your home address***

Agencies with patients of Medistat Group facing payment suspension

Agencies continue to be visited by the OIG and patient records are being seized.   By tomorrow agencies should have received a letter from Health Integrity informing them of payment suspensions.   There may be a time limit for supplying information as to why the payments shouldn’t be suspended.  This is typically 15 days.  

Agencies in this situation should seek legal counsel from an attorney knowledgeable in Medicare and  State of Texas regulations. 

Other agencies, who have had a minimal number of patients referred by the Medistat Group, should continue to follow the previous instructions for transferring care to another physician.  Agencies should beware of any employees from this group attempting to transfer their patients to another physician associated with Medistat. 

If your agency needs assistance with review of records, HealthCare ConsultLink can help.   

Please call 888-258-1894 if we can be of assistance. 

Agencies with patients referred by Dr. Jacques Roy or Medistat Group Associates

The news has been filled with reports of fraudulent activities related to Medicare home health agencies located in the DFW area and this physician.  Agencies continue to be visited by the OIG and patient records are being seized.  Approximately 78 agencies will have payments suspended. 

 For agencies currently having patient(s) referred by this physician group, it is recommended patient(s) be provided with appropriate notice and discharged .  Patient(s) may be readmitted if the home health agencies obtain orders from physicians outside this group. 

 Agencies need to immediately review the documentation in the patient records to assure these patients meet Medicare criteria related to homebound status and medical necessity.

 Upon review of the records and determination of the number of patients involved, a home health agency may want to consult an attorney to determine the agency’s potential exposure. 

 If your agency needs assistance with review of records, HealthCare ConsultLink can help.  

Please call our toll free #888-258-1894 if we can be of assistance. 

URGENT!! Texas Department of Aging and Disability Services Website Update Notice

Website Update Notice