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:: NAHC Report
NAHC Report: Issue# 2314, 11/13/2013
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ARTICLE ARCHIVES MEMBER RESOURCES eNEWSLETTERS CARING STORE
NAHC Members Urged to Contact their Elected Officials During Ongoing Budget Conference Committee Negotiations and Congressional Efforts to Fix Medicare Physician Payment Formula
Date Set for Implementation of HIPPS Codes on Medicare Advantage Claims Delayed Again
For Your Information: Hospice Webinar – Additional Data Reporting on Claims: Register Now for this December 4 Session
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NAHC Members Urged to Contact their Elected Officials During Ongoing Budget Conference Committee Negotiations and Congressional Efforts to Fix Medicare Physician Payment Formula

A Congressional budget conference committee is currently attempting to negotiate discretionary spending levels for next year, with a deadline of December 13 to report back to Congress.  As part of these discussions, suggestions have been made to substitute some mandatory spending cuts, such as from Medicare and Social Security, for some of the discretionary spending cuts under the sequester.  There is, however, significant opposition to this idea, and continues to be talk of some “grand bargain” of long term mandatory spending cuts. A grand bargain seems unlikely in the current impasse between Republicans vowing not to raise taxes and Democrats vowing not to do any grand bargain without some new revenues. 

Concurrent with these budgetary developments, work continues on fixing the flawed Medicare physician payment formula, known as the sustainable growth rate or SGR.  Estimates for a permanent fix range from $139 billion to $175 billion over ten years.  Finding offsets from Medicare for this level of spending is very daunting - with most betting that Congress will do another one year patch, which is estimated to cost between $20 to $30 billion, depending on how much is spent on extending other policies such as the therapy cap exceptions process. 

Last year nursing homes and hospital payments were cut to help pay for a one-year physician fix -- home health care and hospice were spared.  Congress must take action on the physician fix by year’s end, or shortly thereafter, to prevent a 25 percent cut in physician payments.

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Hospice Webinar – Additional Data Reporting on Claims: Register Now for this December 4 Session

Since release of Change Request (CR) 8358 (Additional Data Reporting Requirements for Hospice Claims) in July 2013, hospices and hospice industry stakeholders have been wrestling with how to capture the newly required data on the claim. Given the amount and type of data that must be reported beginning April 1, 2014, it’s not too early for hospice programs to begin tackling the significant challenges associated with CR 8358 compliance.  The National Association for Home Care & Hospice’s Hospice Association of America is hosting a webinar on Wednesday, Dec. 4 at 1 p.m. EASTERN on this important topic. The registration fee per site is $125; a recorded version of the webinar will also be available for purchase. CEs will be provided.

12/4/13 Online registration form: 
http://online.krm.com/iebms/reg/reg_p1_form.aspx?oc=10&ct=0018682&eventid=20996

12/4/13 Product registration form
http://online.krm.com/iebms/reg/reg_p1_form.aspx?oc=10&ct=0018682P&eventid=20996

This webinar will provide the following to participants:

  • Review the four categories of additional data
  • Review the six data elements required
  • Discuss the many outstanding questions
  • Provide practical tips to be used in meeting the new requirements 

Faculty will focus on the data elements that are required in order to have a 5010 compliant claim but that are not necessarily evident in the CR, with special emphasis on the drug reporting requirements.  A review of questions submitted to CMS and their answers, as we have them at the time of the webinar, will be provided. 

Webinar Faculty:  M. Aaron Little, CPA, Managing Director, BKD, LLP
A CPA and leading national home care and hospice consultant, Aaron has over 15 years of experience with BKD, LLP and specializes in revenue cycle outsourcing and consulting services, as well as compliance and routinely consults with providers and legal counsel on home care and hospice billing compliance matters. Nationally recognized for his home care and hospice expertise, Aaron serves on the Home Care & Hospice Financial Managers Association (HHFMA) Workgroup.  He chairs HHFMA's Young Financial Professionals Committee and is an active member of its subcommittee on revenue cycle matters.  He routinely presents for the National Association for Home Care & Hospice (NAHC), HHFMA, Visiting Nurse Associations of America and numerous other regional and state industry organizations and is frequently quoted in industry periodicals. Aaron's professional affiliations include the HHFMA, American Institute of Certified Public Accountants and Missouri Society of Certified Public Accountants.

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Date Set for Implementation of HIPPS Codes on Medicare Advantage Claims Delayed Again

The Centers for Medicare & Medicaid Services (CMS) has delayed, once again, the edit to reject Medicare Advantage (MA) plan claims that do not have a health insurance prospective payment system (HIPPS) code for home health services. The edits will not be activated until July 1, 2014. MA plans and the HHAs have until that time to make the necessary system adjustments.

CMS initially intended to require that MA plans include a HIPPS code on all home health encounters beginning July 1, 2013. The National Association for Home Care & Hospice (NAHC) contacted CMS in June to discuss concerns regarding the failure of the health plans to communicate this directive with the provider community. Several weeks after our call, CMS announced that were delaying the edit until December 1, 2013. 

In a letter to the MA plans, CMS again announced delaying the edit for HIPPS codes on home health and skilled nursing facility encounters until July 1, 2014.

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