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:: NAHC Report
 
NAHC Report: Issue# 2406, 4/4/2014
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ARTICLE ARCHIVES MEMBER RESOURCES eNEWSLETTERS CARING STORE
Implementation of ICD-10 Delayed for One Year
Home Care Medicaid Fraud Developments in Florida, Massachusetts, and Illinois
For Your Information: CMS Hosts Special Open Door Forum on Medicare Part D and Hospice On Tuesday, April 8, 2014
NAHC/Home Care & Hospice Events
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Implementation of ICD-10 Delayed for One Year

Last week Congress voted, and the President signed into law, a temporary fix to Medicare's sustainable growth rate formula (HR 4302) that includes a one-year delay to the ICD-10 compliance deadline. The ICD-10 implementation will not go into effect until October 1, 2015. Response to the news from the home care and hospice community has been mixed – with some in the industry expressing disappointment, while others are relieved.

Despite the mixed response to the news of a delay, the National Association for Home Care & Hospice (NAHC) strongly encourages providers and training partners to continue to prepare for the ICD -10 diagnosis coding transition with the same vigor as if the deadline was still October 1, 2014.

While there are some negative implications associated with the delay, the extra time should be viewed as an opportunity for home health and hospice providers to gain expertise in applying the ICD-10 codes - as well as thoroughly examining and preventing pitfalls related to the transition. Unfortunately, the Centers for Medicare & Medicaid Services has not released its plans regarding the delay, which includes plans for the Outcome and Assessment Information Set (OASIS) C1. 

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Home Care Medicaid Fraud Developments in Florida, Massachusetts, and Illinois

The National Council on Medicaid Home Care – a NAHC affiliate - reports on recent developments in home care Medicaid fraud and abuse, including: 1) alleged caregiver fraud in Florida; 2) alleged and convicted personal care services fraud in Massachusetts; and 3) convicted personal care services fraud in Illinois. 

Florida

As reported by the Florida Attorney General’s office, on April 1, Julia Privis and Alla Privis were arrested for allegedly billing over $18,000 of Medicaid services not rendered.  The services included bathing and skin care, range of motion exercises, and urine tests.  The Privises were employees of Ultimate Home Care, Inc.—one was a home health agency administrator and the other was a home health aide.

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CMS Hosts Special Open Door Forum on Medicare Part D and Hospice On Tuesday, April 8, 2014

The Centers for Medicare & Medicaid Services (CMS) has announced opportunities for hospice providers and other stakeholders to gain additional insight into recently finalized policies related to Part D and hospice.

Below is more information about this CMS-sponsored session:

Part D and Hospice — Special Open Door Forum (ODF)
Tuesday, April 8, 2014
1 – 2:00 pm Eastern Time
Call in:  1-800-837-1935
Conference ID: 25598571

This call will be conference call only

Slides for this ODF are located in the “Spotlight” section of the Hospice Center Webpage here.

This Special ODF will provide an opportunity to allow hospices and other interested parties to ask questions of CMS subject matter experts on the “Part D Payment for Drugs for Beneficiaries Enrolled in Hospice—Final 2014 Guidance” issued on March 10, 2014.

On December 6, 2013, CMS issued a memorandum seeking to clarify the criteria for determining payment responsibility under the Part A hospice benefit and Part D for drugs for hospice beneficiaries. Based on these clarifications CMS suggested revised expectations for Part D sponsors to prevent duplicate payments for drugs covered under the hospice benefit or waived through the beneficiary’s hospice election.

CMS sought stakeholder review and comment as part of the memorandum.  The final March 10 guidance is available here.

Questions on the Final 2014 Guidance may be sent to PARTDPOLICY@cms.hhs.gov. When submitting questions to this mailbox related to this guidance, please include “Hospice” in the subject line.

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