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NAHC Report: Issue# 2295, 10/16/2013
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President Obama Signs Legislation to Reopen the Government and Raise the Debt Limit
Supplemental Comparative Billing Report for Hospices
For Your Information: NAHC Needs Your Help and Participation in its Face-to-Face Encounter Documentation Denials Survey
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President Obama Signs Legislation to Reopen the Government and Raise the Debt Limit
Bill Includes Provision for Negotiations on a Broader Budget Framework, which should be Underway during NAHC’s Annual Meeting in Washington

Late Wednesday night, Senate Majority Leader Harry Reid (D-NV) and Senate Minority Leader Mitch McConnell (R-KY) reached a deal that would reopen the Federal Government and lift the debt ceiling, thereby avoiding the United States defaulting on its financial obligations for the first time in history. The Senate passed the legislation 81-18 followed by House passage by a vote of 285 – 144. 

President Obama signed the measure into law after the bill’s passage, stating that, “We’ll begin reopening our government immediately, and we can begin to lift this cloud of uncertainty and unease from our businesses and from the American people.”

The agreement reached by Senators Reid and McConnell reopens the government and ensures that it remains open through January 15, lifts the debt ceiling through February 7, and requires a bicameral budget conference committee by December 13. While the agreement achieves the goals of reopening the government – which was in its third week of a partial shutdown – and prevents the government to default, it also sets up another round of contentious budget negotiations between Democrats and Republicans, which will coincide with home care and hospice advocates coming to Washington, DC to attend NAHC’s Annual Meeting. 

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NAHC Needs Your Help and Participation in its Face-to-Face Encounter Documentation Denials Survey

Recently two of the CMS contractors a have announced widespread audits of home health providers with a key focus on compliance with the face-to-face (F2F) encounter documentation requirements.

The documentation requirements have become more stringent recently with contractors now expecting physicians to write detailed descriptions of the patient’s condition in order to support the need for skilled services and homebound status.

NAHC has heard that one contractor has denied 399 claims out of 801 within an 11-day period related to the revised guidelines for the F2F documentation.    

NAHC once again needs to present the case to CMS that home care agencies are in an untenable position with the more stringent F2F requirement guidelines.

Before making such a case, however, NAHC needs to gather solid data to present to the regulators. NAHC has developed a survey with specific questions regarding the number and reasons for F2F denials, and asks its members to take a few moments to offer their insight.

The following survey should only take a few minutes to complete and will provide us with valuable information.

Please click here to access the survey. Your feedback is very important.

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Supplemental Comparative Billing Report for Hospices

SafeGuard Services released Supplemental Report for CBR027:  Hospice Services Findings from a Retrospective Cohort Study.  For this report, the claims data of 15,797 hospice patients who died over a seven day period in May 2013 was analyzed for the type of services utilized, the diagnosis at time of death and the length of stay. 

In June 2013, a Comparative Billing Report (CBR) was disseminated to 3,459 hospice agencies in the country.  The report compared individual hospice utilization data to regional and national utilization measures.  The CBR study, however, did not provide data on overall length of stay in hospice per beneficiary or the top diagnoses among hospice patients. Moreover, according to the report, Centers for Medicare & Medicaid Services (CMS) hospice subject matter experts (SMEs) indicated that General Inpatient Care (GIP) might be insufficiently offered by hospice agencies. This supplemental report takes a look at these areas of hospice care delivered to Medicare patients. 

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