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NAHC Report: Issue# 2322, 11/25/2013
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NAHC President Comments on CMS’ Final Rule on Rebasing
CMS Issues Revisions To Proposed Hospice Cost Report
For Your Information: NAHC Will Host Additional Teleconference on the Medicare Rate Rebasing Rule
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NAHC President Comments on CMS’ Final Rule on Rebasing
CMS Turns A Deaf Ear to the Pleas of Aged, Infirm, Disabled and Dying Americans

Val J. Halamandaris, president of the National Association for Home Care & Hospice (NAHC) took “sharp exception” to a final rule published last Friday, November 22, 2013 by the Centers for Medicare and Medicaid Services (CMS). The final rule, for the most part, confirmed a proposed rule, issued in July, which will cut the Medicare home health benefit by $22 billion over the next four years.

“Congress asked CMS,” Halamandaris said, “to do a comprehensive evaluation of the home health benefit, to isolate what works and what needs improvement, how to increase access and efficiency, and how to reduce costs while improving the quality of care. CMS did none of this. Instead, all they did was look to impose the largest possible cut —3.5 percent a year — on the Medicare home health benefit. This adds up to 14 percent over the next four years, or a total of $22 billion.”

The National Association for Home Care & Hospice has produced studies showing that the Medicare home health benefit has already endured more than its fair share of cuts. The benefit has been cut a disproportionate $78 billion since 2009. Add in the newly imposed cut and $100 billion in cuts will have been taken from the most popular and most-needed Medicare program. And as a result of these cuts by the end of 2017, 75 percent of Medicare-certified agencies will be forced under water with profit margins of zero or less.

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NAHC Will Host Additional Teleconference on the Medicare Rate Rebasing Rule
November 26 will Focus on Scope of the Rule and Recommended Business Strategies; December 2 will Focus on Scope of the Rule and Legislative, Regulatory and Legal Solutions

What: In additional to the Monday, December 2 teleconference at 1:00 PM EST, NAHC has added a teleconference on Tuesday, November 26, at 1:00 PM EST.

The National Association for Home Care & Hospice (NAHC) will host a free teleconference on November 26, 2013 at 1:00 PM – 2:00 PM EST to provide an in-depth explanation of the Medicare home health rate rebasing rule issued late Friday. The teleconference will include a presentation on the steps home health agencies should begin to take to address the reimbursement rate changes.

The second free teleconference on December 2 at 1:00 PM – 2:00 PM EST will also focus on the new payment rule along with highlighting other issues of critical importance for the home care and hospice community. This teleconference will present the strategic plan to secure improvements in the Medicare rule through legislative, regulatory, and legal solutions.

When: The conferences will take place on:

Tuesday, November 26, 2013 from 1:00 PM to 2:00 PM EST. The number to call in is 1-800-216-6327; Passcode 585731

Monday, December 2, 2013, from 1:00 PM to 2:00 PM EST. Details on this teleconference have been previously sent to all members.

Note that these are two separate calls with separate content. You can participate in both calls.

Why: The final rule for the Medicare home health prospective payment system (HHPPS) was issued late on Friday, November 22, 2013. The purpose of the calls is to help NAHC members prepare for the impact of the final rule. The rule establishes four consecutive annual cuts of 3.5% in the Medicare payment rate.

In light of the new rule, NAHC and its allies plan to address the following issues:

November 26, 2013

  • What are the payment rate changes that take effect on January 1, 2013
  • How did CMS calculate these new payment rates
  • What should home health agencies consider doing to address the issues created through these new rates:
    • Addressing other payers
    • Achieving improved efficiencies
    • Examining visit utilization options

Who is conducting the seminar on November 26: Val J. Halamandaris, President of NAHC; Bill Dombi, Vice President for Law; Robert Simione, Chair, Home Care and Hospice Financial Management Association.

Who is conducting the seminar on December 2: Val J. Halamandaris, President of NAHC; Jeff Kincheloe, Vice President for Government Affairs; Bill Dombi, Vice President for Law; Richard Brennan, Vice President for Technology Policy and Government Affairs; Theresa Forster, Vice President for Hospice Policy and Programs; Colin Roskey, JD, Cozen O’Connor, NAHC Counsel; and, Mary B. Langowski, JD, Partner, DLA Piper, NAHC Counsel.

Who may participate: NAHC members will receive priority, but the conference is open to all.

For the November 26th teleconference. The first 300 callers will be accepted. We encourage you to have multiple people in your organization connect through a single line.

Will questions be allowed: Yes. Questions from participants will be received 24-hours in advance or submitted while the teleconference is live on the date of the broadcast. Send questions to Mike Wittke at

Will the teleconference be recorded: Yes, there will be a recording of the teleconference. Highlights of the event will also appear in NAHC Report, NAHC’s daily electronic newsletter, and in CARING, its monthly magazine.

Visit the CARING Store online for the latest Resources

CMS Issues Revisions To Proposed Hospice Cost Report

Very late last Friday, the Centers for Medicare & Medicaid Services (CMS) posted revisions to the proposed hospice cost report that was made public for comment in April. The new revisions are subject to a 30-day comment period. CMS provides a crosswalk and list of changes to assist with review.

While it initially appears that CMS did not make many of the changes that hospice stakeholders recommended, a more thorough analysis is under way and additional details will be available in the near future.

The National Association for Home Care & Hospice (NAHC) and its Hospice Association of America (HAA) will be gathering a group of experts to discuss the new version of the proposed cost report for its impact on the hospice industry and to assist in development of the industry’s response.

If this version is finalized, the instructions indicate that it will become effective for cost reporting years beginning on or after October 1, 2014.

Please note that these changes apply to freestanding hospices only. CMS will issue comparable changes at a later date for facility-based hospices. The revisions are posted online here.

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National Director Private Duty/Managed Care

Responsible for execution of all private duty operational matters for Intrepid. Oversee total operations of the Private Duty Division. Responsible for the successful opening, licensing and certification of all private duty agencies. Ensures that each private duty agency has adequate staffing to meet licensing and certification requirements.

Education: R.N., Bachelors degree; Master’s preferred; not a pre-requisite with proven performance experience and results.

Experience: Minimum five years experience in managerial, leadership and business management positions; private duty related preferred.

Special Skills: Strong negotiation skills, budget management experience, regulatory knowledge, strategic planning experience and analytical skills. Leadership and management experience in effective team building and continuous quality improvement programs. Working knowledge and experience in cross-functional business segments and their integrated influences and relationships. Effective and experienced in motivating and mentoring others who may or may not be in a direct reporting relationship. Strong and effective verbal and written communication skills. Working knowledge of email programs, word processing, etc.

If you are interested in this position please contact Ursala Isom at 214-445-3758 or send your resume to

Mercy Home Care Job Opportunities in Oklahoma

Mercy Home Care, Oklahoma provides the same high-quality medical services you’ve come to expect from Mercy Hospital and our network of primary-care and specialty clinics.  Our team of home-health professionals provides the compassionate health care you need from the comfort of your own home.

Job Opportunities in Oklahoma:
Clinical Supervisor – FT/Ardmore
Physical Therapy Asst – PRN/Ardmore
Regional Director – FT/Oklahoma City
RN – FT/Oklahoma City
LPN – FT/Oklahoma City
Physical Therapist – FT/El Reno
Occupational Therapist – PRN/El Reno
RN – FT/El Reno
RN Case Manager - FT/El Reno
Nursing Asst – FT & PT/El Reno

For more information and to apply online, visit:

For information about placing an ad, contact Scott Baum at

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