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NAHC Report: Issue# 2413, 4/16/2014
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Certifying Physicians Edits for Home Health Agencies (HHAs)
Medicaid Council Attends MACPAC Meeting
For Your Information: CMS Issues an Update Regarding the Upcoming OASIS C-1 Webinar
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Certifying Physicians Edits for Home Health Agencies (HHAs)

CMS has issued a special edition Medicare Learning Network® article which confirms that both the certifying physician and the attending physician will be subject to the Provider Enrollment, Chain and Ownership System (PECOS) edit when listed on the claim.

Effective July 1, 2014, HHAs are required to report the NPI of the physician who certifies/re-certifies the patient’s eligibility (Certifying Physician). This is in addition to reporting the NPI and name of the physician who signs the patient’s plan of care (Attending Physicians) when the attending physician is not the same physician who certified/recertified the patient’s eligibility to receive services under the Medicare home health benefit. This will occur when the acute or post acute care physician is the physician who documents the face to face encounter, certifies the patient for home health services, and hands off the patient to the community physician who will sign the plan of care.

Therefore, for episodes that begin on or after July 1, 2014, the certifying physician and the attending physician must be enrolled in PECOS or have validly opted out.

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Medicaid Council Attends MACPAC Meeting

On April 10, 2014, National Council on Medicaid Home Care (the Council) policy director, Michelle Martin, attended the public meeting of the Medicaid and CHIP Payment Access Commission (MACPAC). During the meeting, the Commissioners heard a presentation on a draft chapter, intended for the June 2014 report to Congress, on long term services and supports (LTSS).

Authors of the draft chapter and MACPAC senior analysts, Angela Lello and Molly McGinn-Shapiro, explained the contents of the chapter which is intended to provide a foundation on LTSS to members of Congress. The chapter does not include any recommendations but instead lays out the fundamentals of Medicaid LTSS and the how the variation in state policy influences LTSS.

The Commissioners had an opportunity to comment and ask questions on the draft chapter. The majority of the comments and questions centered on ways to make the topic of LTSS easier for readers of the future report to Congress to comprehend. Whether the suggested changes will be made in time for the LTSS chapter to be included in the June 2014 report to Congress is currently unknown.

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CMS Issues an Update Regarding the Upcoming OASIS C-1 Webinar
CMS is Delaying its April 30 Webinar Until Further Notice

ICD-10 Delay – The Centers for Medicare & Medicaid Services (CMS) is examining the implications of the ICD-10 provision in the recently enacted Protecting Access to Medicare Act of 2014 and will provide guidance to providers and other stakeholders soon on the implementation of OASIS-C1.  Until that time, the Division of Continuing Care Providers, in conjunction with the training department, will not be providing the OASIS-C1 implementation webinar originally scheduled for April 30, 2014.  Once a decision is made about OASIS-C1, we will determine if it is appropriate to reschedule the webinar.

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