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:: NAHC Report
NAHC Report: Issue# 2190, 5/7/2013
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ARTICLE ARCHIVES MEMBER RESOURCES eNEWSLETTERS CARING STORE
Senior Groups Send Letter Opposing President’s Home Health Copay Proposal
VA Issues its Final Rule on Payment Regulation for Non-VA Providers
For Your Information: Underserved Population (UP) Networking Calls
NAHC/Home Care & Hospice Events
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Senior Groups Send Letter Opposing President’s Home Health Copay Proposal

In response to the President’s proposed FY 2014 budget, the Leadership Council of Aging Organizations (LCAO) recently sent a letter to the President and Congressional leadership that included strong opposition to the President’s proposal to impose a home health copayment.

The LCAO is a 68-member coalition of national organizations, including the National Association for Home Care & Hospice that is concerned with the wellbeing of America’s older populations and is committed to representing their interests in the policy-making arena. The President’ proposed budget submitted to Congress included a provision that would impose a $100 copay on home health episodes not preceded by a hospital or nursing home stay, beginning in 2017 for new Medicare beneficiaries.

“We oppose proposals to cut benefits or shift additional costs onto beneficiaries,” the letter states, “which ignore the widespread economic insecurity experienced by older adults and people with disabilities. Half of the Medicare population live on annual incomes of $22,500 or less and already face significant out-of-pocket health costs.”

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Underserved Population (UP) Networking Calls
The Home Health Quality Improvement (HHQI) National Campaign Invites Your Agency to Join

The topics of the calls relate to specific needs of the following:

  • Underserved regions
  • Dual-eligible patients
  • Health disparities
  • Small home health agencies

The calls are free and there will be ample time to ask questions and discuss issues/barriers related to the specific topic with subject matter experts.

Below is information for the upcoming May UP Networking calls:

May 8 from 3 – 4 pm (Eastern) - Improving Patient Outcomes with Early Intervention to Fill Nutritional Gaps
Learn more about a Bayada collaborative project with a nutritional vendor to assess and provide early nutritional interventions to improve outcomes, quality of care, and quality of life with Allison Sterner, Clinical Support Specialist on the Visit Clinical Leadership team.

May 22 from 3 – 4 pm (Eastern) - Hospice and Palliative Care & the Underserved Populations
Join to learn more on how to utilize Hospice and Palliative services to meet the needs and barriers of the underserved populations with Sally Welsh, MSN, RN, NEA-BC, CEO of the Alliance for Excellence in Hospice and Palliative Nursing and Dr. Joy Buck, Associate Professor, School of Nursing Research Center, West Virginia University Health Sciences Center, Eastern Division.

To join the teleconferences:

  • Email: hhqi@wvmi.org for an email calendar invitation for one or all of the calls
  • Call: 1.866.439.4480 Access Code: 858242# on these days at these times

Click here to obtain flyer for up and coming calls and to access previously recorded calls.

Visit the CARING Store online for the latest Resources

VA Issues its Final Rule on Payment Regulation for Non-VA Providers

The Department of Veterans Affairs (VA) has issued a final rule that amends its payment regulation for non-VA providers to include providers of home health and hospice services. Because the newly applicable methodology cannot supersede rates for which VA has specifically contracted, the rule will only affect home health and hospice care providers who do not have existing negotiated contracts with VA. The rule also rescinds internal guidance documents that could be interpreted as conflicting.

On February 18, 2010, the VA issued a proposed rule to implement certain payment methodologies for all non-VA inpatient and outpatient health care professionals and providers, which included paying according to Medicare fee schedules and prospective payment systems, as applicable. However, when the final rule was published on December 17, 2010, the regulation included an exception for implementing the payment methodologies for home health and hospice services.

The VA cited administrative and systems problems that prevented their ability to implement the Medicare payment system for home health and hospice services on such short notice. As a result, home health and hospice providers have been paid according to a payment rate structure outlined in the 2004 VA Handbook, which for home health providers, pays for services on the Medicare low utilization payment adjustment (LUPA) rates. For hospice services, the VA uses locally calculated Medicare hospice payment rates as the maximum reimbursement rates to purchase a comprehensive package of bundled home hospice services.

In the December 2010 final rule, the VA indicated that their intention is to promulgate another proposed and final rule once they are able to apply the payment methodologies to home health and hospice services. A proposed rule was published in the Federal Register on November 21, 2011, and the final rule was published in the Federal Register on May 6, 2013. Additionally, the rule rescinds the alternative pricing methods the VA has applied to home health and hospice providers.

Effective November 15, 2013, non-VA home health and hospice providers that do not have a negotiated contract with the VA for services will be paid the lowest of the following amounts:

  • The applicable Medicare fee schedule or prospective payment system amount (“Medicare rate”) for the period in which the service was provided;
  • The amount negotiated by a repricing agent if the provider is participating within the repricing agent's network and VA has a contract with that repricing agent. For the purposes of this section, repricing agent means a contractor that seeks to connect VA with discounted rates from non-VA providers as a result of existing contracts that the non-VA provider may have within the commercial health care industry;
  • The amount that the provider bills the general public for the same service. Home health providers will need to complete an OASIS assessment on any VA patient for which the Medicare rates will be applied in order to generate a home health resource group (HHRG). To view the final rule click here.

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