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:: NAHC Report
NAHC Report: Issue# 2282, 9/26/2013
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OIG Reviews Rhode Island Hospice GIP Claims Under Medicaid
Medicaid Home-Based Telehealth and Remote Patient Monitoring
For Your Information: LAST CALL FOR SURVEY ON HOSPICE PRESCRIPTION DRUG DATA ON CLAIMS!
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OIG Reviews Rhode Island Hospice GIP Claims Under Medicaid

The Office of the Inspector General (OIG) released a report based on a review that was completed of the Rhode Island Executive Office of Health and Human Services Office of Medicaid’s payments for hospice general inpatient services (GIP).  The purpose of the review was to determine whether the state agency made Medicaid payments for hospice GIP services in accordance with federal and state regulations. 

A prior OIG review found Medicaid overpayments to hospice providers that submitted and received reimbursement for claims that did not meet the requirements for GIP and should have been billed as routine home care. All of the unallowable services were provided in a nursing home setting.  The OIG has had GIP care and state Medicaid compliance with federal reimbursement requirements on its Annual Work Plan for several years and has had hospice care in nursing homes on the annual OIG work plan for several years, as well.

There are less than 10 hospice providers in Rhode Island - and the reviewed claims were from a single agency that has a 24-bed inpatient hospice facility where it provides GIP services. It also provides GIP care in contracted hospitals and skilled nursing facilities.  Directed by the OIG, the state Medicaid agency performed a review of 43 of the hospice’s GIP claims from 2007-2010.   The claims were for 25 hospice patients.  The OIG found that 15 of the 43 claims were paid for care that should have been billed at the routine home care level of care. 

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LAST CALL FOR SURVEY ON HOSPICE PRESCRIPTION DRUG DATA ON CLAIMS!

NAHC/HAA Survey Seeks Hospice Input on Prescription Drug Reporting on Claims

In July, the Centers for Medicare & Medicaid Services (CMS) released Change Request (CR) 8358, Additional Data Reporting Requirements for Hospice Claims. Mandatory reporting of these additional items begins with claims with dates of service on or after April 1, 2014, with voluntary reporting beginning January 1, 2014. 

CR 8358 requires - among other things - that hospices begin reporting injectable and non-injectable prescription drugs on their claims on a line-item basis per fill.  Hospices will also be required to report infusion pumps on a line-item basis for each pump order and for each medication refill. 

The National Association for Home Care & Hospice’s Hospice Association of America (HAA) is seeking additional information on industry concerns related to compliance with the reporting of prescription drug data on claims, and is making a brief survey available for response. 

All hospice stakeholders are encouraged to complete the questionnaire and submit their responses; the information we gather will be used in discussions with CMS related to the requirement.  

The extended deadline for completion of the survey is FRIDAY, September 27. 

If you have any questions or comments, please feel free to contact Katie Wehri (Katie@nahc.org) or Theresa Forster (tmf@nahc.org).

VENDORS PLEASE NOTE:  The survey was crafted from a provider perspective but we are VERY INTERESTED in hearing concerns and implementation questions from ALL stakeholders. 

Feel free to either respond to the survey and provide your comments at the end, or email your concerns to Katie and/ or Theresa at the emails listed above.

Many thanks to all who take the time to participate.

Visit the CARING Store online for the latest Resources

Medicaid Home-Based Telehealth and Remote Patient Monitoring
Report Discusses Best Practices

In July, the American Telemedicine Association (ATA) released a report titled State Medicaid Best Practice: Report Patient Monitoring and Home Video Visits (the Report). In the Report, the ATA profiles four states’ patient monitoring and home video visits programs and their outcomes.

Overview

The Report mentions that 17 states currently have some form of Medicaid telehealth program, either through a federal waiver, or through demonstration projects like Money Follows the Person (MFP). The seventeen states that currently have either video conferencing, remote monitoring, or both include: Alabama, Alaska, Arizona, Colorado, Indiana, Kansas, Kentucky, Minnesota, New Mexico, New York, Pennsylvania, South Carolina, South Dakota, Texas, Utah, Washington State, and Wisconsin. For a complete chart, see page 2 of the report, here.

For the Report, ATA surveyed state telehealth policies, and analyzed four “best practice models,” including those of Colorado, Kansas, New York, and Washington State. For the criteria that ATA used in assessing the policies, see page 3, here.

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Administrative Director
Adventist Health/Home Care Services, Portland, Oregon

Adventist Health is seeking an experienced Home Care Administrator to oversee a growing and busy mission driven service provider in the greater Portland, Oregon area. Scope of job responsibilities include Home Health, Hospice, Home Medical Equipment, Home Infusion Therapy, and Private Duty business lines. The Administrative Director is responsible to direct, supervise, monitor and evaluate all functions and activities for the Adventist Health/Home Care Services department of Adventist Medical Center (AMC). We are looking to the right individual who can lead in business growth and development, financial management, HR management, and conformity to policies, procedures, quality improvement and regulatory requirements. In addition, we are looking for the right individual to support and promote the mission, philosophy and the vision of our Adventist Health/Home Care Services department, creating an environment in which all Homecare staff can work together harmoniously and with coordinated effort in compliance with AMC’s Service Standards. Candidates must have previous health care and leadership experience; home care experience preferred. Bachelors’ degree in a healthcare field required, Master’s in Business preferred. Compensation Commensurate with Experience.

Please apply on our website for the Administrative Director/Home Care Services position:
http://www.adventisthealthnw.com/find-a-career/job-search


Home Care Administrator, RN
Asbury Methodist Village at Home, Gaithersburg, Maryland

Why work for us?

Excellent Community Setting & Work Environment, Unparalleled & Exciting Growth Opportunity, Strong Corporate Resources Available, Autonomy to Run a Successful Program

Asbury Methodist Village, located in Gaithersburg Maryland, is currently searching for an experienced administrator to manage its Private Duty home care agency. Experience in home and community based services and a passion for working with the elderly are a must. The ideal candidate has five years home care experience in all areas of agency operation.  We provide home care to residents of our retirement community with a growth strategy to provide service off campus in the greater community.  The ideal candidate has a network of professionals to tap into for new referral sources to accomplish our growth goals. 

This position is responsible for the full range of operations including: clinical, financial, marketing, human resources, and public relations. Strong networking skills and the ability to develop relationships with referral sources, i.e. physicians, hospitals, healthcare agencies, etc.  Candidate must possess excellent communication and customer service skills. Must be proficient with MS Office, computerized scheduling software and medical records.

Excellent benefits and salary based upon professional experience.

To apply, please forward resume, cover letter, and complete salary history to Human Resources Representative via e-mail: BPickhardt@asbury.org  or fax to 301.250.2110. EOE.

For information about placing an ad, contact Scott Baum at ads@nahc.org.

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