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NAHC Report: Issue# 2449, 6/13/2014
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CMS Will Not Require Medicare Advantage Plans to Apply the Medicare Face-to-Face Requirement for Home Health Services
Texas Signs Memorandum of Understanding with CMS: Becomes Twelfth State to Adopt Medicare-Medicaid Dual Eligibles Initiative
For Your Information: HHFMA Announces Speakers for Financial Management Conference
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CMS Will Not Require Medicare Advantage Plans to Apply the Medicare Face-to-Face Requirement for Home Health Services

The Centers for Medicare & Medicaid Services (CMS) has reversed its position requiring Medicare Advantage plans (MA) to apply Medicare Fee-for-Service face-to-face certification requirements to home health services. This reversal is seen as a major victory for NAHC, who has been advocating for such a change, and the home health community as a whole.

CMS, in the final call letter for the 2015 rates for the MA plans, “clarified” that the MA plans were to apply the same certification requirements as fee-for-service (FFS) Medicare to plan members who receive home health services. This directive would also require that the plans apply the F2F encounter requirement. 

The National Association for Home Care & Hospice (NAHC) had serious concerns with this directive and took those concerns to officials at CMS. NAHC questioned the rationale behind the requirement in light of the fact that the MA plans have a preauthorization process that would negate the need to follow Medicare FFS certification requirements. NAHC also expressed its interpretation of the regulations to require that MA plans offer the same scope of benefits to its members as Medicare, but does not require that the plans apply the same certification criteria as Medicare. 

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Texas Signs Memorandum of Understanding with CMS: Becomes Twelfth State to Adopt Medicare-Medicaid Dual Eligibles Initiative

On May 23, the Centers for Medicare and Medicaid Services (CMS) and the Texas Health and Human Services Commission (the State of Texas) signed a Memorandum of Understanding (MOU) establishing the Medicare-Medicaid Alignment Initiative (MMAI) in a capitated model for beneficiaries eligible for both Medicare and Medicaid, or “dual eligibles.” The new demonstration (the Demonstration) will begin no earlier than March 1, 2015, and continue until December 31, 2018. 

Texas’ MOU marks the twelfth MMAI MOU, after Massachusetts, Washington State (fee-for service), Ohio, Illinois, California, Virginia, New York, South Carolina, Washington State (capitated), Colorado, and Michigan. As of this writing, five other states have active proposals submitted to CMS. The MMAI is a joint federal and state project which seeks to improve care and reduce costs associated with dual eligibles. Minnesota has signed a dual eligibles demonstration independent of the MMAI.

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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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