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NAHC Report: Issue# 2395, 3/19/2014
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CMS Issues Guidance to Surveyors on Alternative Sanctions for Home Health Agencies
MedPAC Issues its Report to Congress
For Your Information: Private Duty Education Sessions Announced for this Year’s March on Washington
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CMS Issues Guidance to Surveyors on Alternative Sanctions for Home Health Agencies

The Centers for Medicare & Medicaid Services (CMS) has issued guidance to State Survey Agency Directors on the implementation of new alternative sanctions for home health agencies that was finalized in the November 8, 2012 Federal Register notice. Alternatives sanctions provide CMS with alternatives to program termination for agencies found to be not in “substantial compliance” with the conditions of participation.

CMS now has the authority to impose alternative sanctions of civil money penalties (CMPs), directed in-service training, directed plans of correction, suspension of payment for new admissions, and temporary management on HHAs that are found to have condition level deficiencies. The guide instructs on the implementation, basis for, and notification requirements for the individual sanctions, in addition to, the process for an informal dispute resolution (IDR), and the formal appeals process for when CMPs sanctions are imposed.

The guidance provides instructions on enforcement actions for deficiencies that pose either immediate jeopardy or no immediate jeopardy situations. In cases where deficiencies pose immediate jeopardy to patient safety, CMS will terminate an agency’s provider agreement no later than 23 days from the last day of the survey, unless immediate jeopardy is removed. CMS may also impose sanctions in cases of immediate jeopardy. In non-jeopardy cases, agencies that are noncompliant with conditions of participation and repeat noncompliance with condition and standard-level deficiencies may also be subject to termination and/or imposition of sanctions.

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MedPAC Issues its Report to Congress
Recommendations include a per episode home health copayment, elimination of market basket updates and program integrity measures for home health services; elimination of the update of hospice payment rates and changes to the Medicare payment system for hospices more generally

The Medicare Payment Advisory Commission (MedPAC) recently issued its annual Report to Congress, which it is required to do by law. The report makes recommendations on payment policies for traditional fee-for-service Medicare (Parts A and B), as well as Medicare Advantage plans (Part C) and prescription drug plans (Part D).

Below are the key recommendations for home care and hospice services that were included in MedPAC’s report:

Home Health Agencies

  • The Congress should direct the Secretary to reduce payments to home health agencies with relatively high risk-adjusted rates of hospital readmission.
  • The Secretary, with the Office of the Inspector General, should conduct medical review activities in counties that have aberrant home health utilization. The Secretary should implement the new authorities to suspend payment and the enrollment of new providers if they indicate significant fraud. (First recommended in March 2011).

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Private Duty Education Sessions Announced for this Year’s March on Washington

The Home Care and Hospice community is at a critical point as new rules are being considered on Capitol Hill that could affect how home care and hospice organizations operate and pose a significant challenge to the mission to serve America’s aged, disabled, and ill.

Join NAHC, your peers and colleagues at this year’s March on Washington to make home care and hospice the center of health care in our country.

Along with legislative meetings and advocacy, this year’s March on Washington will have compelling educational sessions to provide home care and hospice advocate with the tools, skills and information that they need to make the strongest case possible for preserving access to quality home care and hospice services for all who need them.

This year’s Educational Tracks include:

  • Medicare Home Care
  • Medicare Hospice
  • Medicaid Home Care, and,
  • Private Duty

Some of the Educational Sessions for the Private Duty track include:

  • Employer Mandates under the Affordable Care Act: Status Report
  • The Companionship Services Exemption under the FLSA: Compliance and Ongoing Advocacy Efforts

To view all of the Private Duty tracks, please click here.

To register to attend this year’s March on Washington, please click here.

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