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NAHC Report: Issue# 2198, 5/17/2013
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OIG Updates Exclusion Advisory
Advocates for the Disabled in Kansas Show Mixed Feelings towards Governor’s Initiatives
For Your Information: Vote for Modern Healthcare’s 100 Most Influential People in Healthcare
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OIG Updates Exclusion Advisory

On May 8, 2013 the Office of Inspector General (OIG) issued a Special Advisory Bulletin that updates the scope and effect of the legal prohibition on payment by federal health care programs for items or services both furnished by an excluded person and at the medical direction of an excluded person. The Advisory Bulletin describes how statutory amendments made since the most recent Advisory in 1999 have expanded OIG’s authority to exclude individuals and entities from federal health care programs. It also explains how exclusions may be violated as well as the administrative sanctions that the OIG can pursue. The Special Advisory Bulletin also includes recommendations about the scope and frequency of screenings. Of particular interest to home health and hospice providers is guidance about the need to screen volunteers for exclusion.

The guidance explains that payment prohibition applies to all methods of federal health care program payment, regardless of if the payment comes from itemized claims, cost reports, fee schedules, capitated payments, a prospective payment system or other bundled payment, or another payment system. Payment prohibitions apply even if the payment is made to a state agency or to a person that is not excluded and includes items and services beyond direct patient care. The bulletin also explains how excluded persons are prohibited from furnishing administrative and management services that are payable by the federal health care programs even though these services are not separately billable. Examples given of such services include health information technology services, strategic planning, billing and accounting, staff training, and human resources.

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Vote for Modern Healthcare’s 100 Most Influential People in Healthcare

Voting is now underway for Modern Healthcare's 12th annual 100 Most Influential People in Healthcare program. Of the nearly 28,000 nominations submitted, the publication’s editors selected the top 300 names for the final ballot. Included on the final ballot is NAHC President Val J. Halamandaris.

Voting is open now until June 14, and people can vote for their top five candidates. Their votes will count for 50 percent of the outcome; the other 50 percent will be based on the expert opinions of senior editors at Modern Healthcare.

The combination of readers' votes and editors' choices will determine the final ranking of the 100 Most Influential People in Healthcare, to be published in Modern Healthcare on August 26.

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Advocates for the Disabled in Kansas Show Mixed Feelings towards Governor’s Initiatives

Last week, advocates for the disabled - including the Kansas Developmental Disabilities Policy Group - expressed support for Governor Sam Brownback’s proposal to pay for in-home services with planned Medicaid savings. Advocates also praised the Governor’s plan to reduce the number of people on waiting lists for Medicaid home and community based services by 600. That said, advocates continue to protest the Governor’s plans to eventually include long-term supports for the developmentally disabled in KanCare. A rally on May 10 brought 1,100 people to the statehouse.

Governor Brownback has called for taking $8 million from the “KanCare dividend,” or money saved from transferring beneficiaries from Medicaid to managed care, and $10.5 million in federal funds, to move 600 people off the waiting lists by the end of the next fiscal year. In Kansas, a disabled child can wait years to receive in-home services.

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