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NAHC Report: Issue# 2448, 6/12/2014
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NAHC, Other Advocacy Organizations Urge Halt to CMS Part D/Hospice Prior Authorization Guidance
HHS Releases Study Showing HCBS Wait List Effects on Costs, Institutionalization
For Your Information: HHFMA Announces Speakers for Financial Management Conference
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NAHC, Other Advocacy Organizations Urge Halt to CMS Part D/Hospice Prior Authorization Guidance

Expressing concern about the placement of undue burden on hospice patients due to CMS’ Part D/ hospice prior authorization guidance, the National Association for Home Care & Hospice (NAHC) joined with 26 other advocacy organizations in sending a letter to Centers for Medicare & Medicaid Services (CMS) Administrator Marilyn Tavenner urging that she put a, “halt to [CMS’ March 10 Guidance -- Part D Payment for Drugs for Beneficiaries Enrolled in Hospice—Final 2014 Guidance] until a workable alternative is developed that does not place the burden of resolving payment disputes squarely on the shoulders of terminally ill Medicare beneficiaries.” 

The letter to Administrator Tavenner is the latest effort in recent months by NAHC and others to bring attention to the many problems arising out of CMS’ requirement that Part D plans implement a beneficiary-level prior authorization requirement on drugs prescribed for hospice-enrolled beneficiaries.

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HHS Releases Study Showing HCBS Wait List Effects on Costs, Institutionalization

The U.S. Department of Health and Human Services (HHS) recently released a study titled Impacts of Waiting Periods for Home and Community-Based Services on Consumers and Medicaid Long-Term Care Costs in Iowa (the Study). The Study sought to examine the extent waiting for Home and Community-Based Services (HCBS) impacts nursing home stays, hospitalizations, and overall Medicaid long-term services and supports (LTSS) spending. HHS chose Iowa for the Study as ample waiver application data was available, and this data included waiting periods ranging from 3 to 25 months.


According to sources cited in the Study, 1915(c) HCBS waiver enrollment has increased at a rate of 6 percent each year; by 2009, there were 3.3 million 1915(c) HCBS enrollees. However, by 2011, “a little over half a million people” were on waiting lists nationally, with an average wait time to receive services at approximately two years.

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HHFMA Announces Speakers for Financial Management Conference

The National Association for Home Care & Hospice (NAHC) and its affiliate Home Care & Hospice Financial Managers Association (HHFMA) are pleased to announce the speakers for the 2014 Financial Management Conference & Exposition on July 13-15 in Chicago.

“We are honored and delighted to have some of the best financial experts and thought leaders in the field join us at the conference,” said NAHC President Val J. Halamandaris. “This year’s speakers and faculty include noted experts from the home care and hospice industry and financial management consultants.”

On Monday, July 14, two general session panels will be held at the conference. The first general session, “HHFMA Leadership Panel — the Future Belongs to Home Care and Hospice” will include:

  • William J. Simione, Jr., BS, CPA, FHHA, CGMA, Founder, Simione Healthcare Consultants, LLC
  • William Bassett, BS, Chief Marketing Officer, Procura
  • Arnie Cisneros, PT, President, Home Health Strategic Management
  • Dexter Braff, MBA, MS, BS, President, The Braff Group
  • Marcylle Combs, RN, BS, CHCE, President, Foundation Management Services

The second general session, “The Views of Health Care Industry Stakeholders,” will include:

  • Moderator: Robert J. Simione, BS, Managing Principal, Simione Healthcare Consultants, LLC
  • Tami Johnson, BS, MS, Division Vice President of Case Management Services, Nursing Center Division, Kindred Healthcare
  • Michael Murphy, BS, MBA, MSCEP, Managing Partner, Durango Health Partners
  • Joel J. Reich, MD, FACEP, MMM, Senior Vice President for Medical Affairs/Chief Medical Officer, Eastern Connecticut Health Network
  • Michael Swarzman, MA, MBA, Vice President, Clinical Services and Business Development, Assistant Professor, Graduate School of Public Health, University of Illinois at Chicago

“Medicare Advantage and Managed Care” a special closing general session on Tuesday, July 15, will include:

  • Pat Laff, CPA, Managing Principal, Laff Associates
  • Paul Giles, BS, Director of Home Health Finance, Dignity Health Care
  • Christopher Attaya, MBA, FHFMA, Vice President of Business Intelligence, Strategic Healthcare Programs
  • Dawn Michelizzi, BS, Controller, VNA of Greater Philadelphia

The conference will address the opportunities and challenges ahead for the industry. With key features of the Affordable Care Act starting to take effect, there has never been a more important time to learn about the best financial management moves. Avariety of educational sessions and drill-down workshops will boost your skills in arenas that range from cost controls to revenue enhancement and strategic planning.

Attendees will earn continuing education credits while industry leaders share what has worked for them and give advice on navigating the future landscape of home care. This year, conference attendees can hear from the best in four targeted tracks; home health, hospice, leadership, and changing health care delivery. They’ll learn how to boost their bottom line despite tighter reimbursement, pick up the latest information on home health cost containment strategies, and get tools to forecast their strategic planning needs.

Attendees can also expand their knowledge in two pre-conference sessions. At the Hospice Summer Camp, they can hone the skills needed to manage hospice operations, and at the Home Health Summer Camp, they can explore the diverse world of home care finance.

Click here for more information on the Financial Management Conference and for a list of faculty members and speakers.

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