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NAHC Report: Issue# 2461, 7/7/2014
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CMS Releases its 2015 Home Care Proposed Payment Rule
Governor Scott Signs Two Bills into Law to Help Disabled Children
For Your Information: CMS Announces its Next Open Door Forum for Home Health, Hospice and DME
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CMS Releases its 2015 Home Care Proposed Payment Rule
Includes 2015 Payment Rates, Face-to-Face Physician Encounters Reform and Much More

The Centers for Medicare and Medicaid Services (CMS) issued a proposed rule late Tuesday, July 1, that includes the usual annual payment rate update along with significant and positive changes to the documentation requirements in the face-to-face physician encounter requirements (F2F) and a host of other proposals that range from the mundane to the dramatic.

The CMS proposal on the F2F would eliminate the daunting, if not impossible, requirement that physicians provide a narrative explaining the patient’s homebound status and need for skilled care. Over recent months, a scourge of audits triggered wholesale retroactive claim denials nationwide based on allegations of insufficient narratives. The arbitrary claim denials triggered a lawsuit by the National association for Home Care & Hospice challenging the validity of the CMS requirement and its application to individual claims. While it can be expected that the issuance of a final rule dropping the narrative requirement will be forthcoming, NAHC continues to seek relief from the thousands of retroactive claim denials suffered by home health agencies.

The proposed rule includes:

  • 2015 Home Health Prospective Payment System rates
  • Face-to-Face Physician Encounter rule modifications
  • Significant change to the requirement for professional therapy reassessments
  • A new standard for the submission of OASIS to avoid payment rate reductions
  • Modifications of the standards for qualification of speech-language pathologists under the CoPs
  • The introduction of possible new coverage standards on the administration of insulin injections
  • The unveiling of a likely model for Value Based Purchasing
  • Clarifications of the requirements for imposition of alternative Civil Money Penalty sanctions for CoP violations
  • Changes to recertification requirements

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Governor Scott Signs Two Bills into Law to Help Disabled Children

Gov. Rick Scott (R-FL) recently signed a bill into law that could begin to give voice to children long rendered voiceless - HB 561 – that requires the appointment of an attorney for dependent children with special needs. The law took effect July 1 of this year.

The Florida Legislature set aside $4.5 million to pay attorneys willing to represent disabled and medically needy children in the court system, said a statement from the advocacy group Florida’s Children First. Attorneys may also provide their services pro bono.

“It’s been our mission since 2002 to enact a law like this because disabled children are the most vulnerable children to come into our child welfare system,” said Howard Talenfeld, president of Florida’s Children First. “Unfortunately, they have to face a maze of bureaucratic hurdles in order to obtain the benefits they need to be safe and to survive in the foster care system.”

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CMS Announces its Next Open Door Forum for Home Health, Hospice and DME

CMS has just put out notice for the July 9 Open Door Forum for Home Health, Hospice and DME.  

Please note: CMS has included on the agenda issues hospice providers have been having with billing of pumps on claims as the result of CR8358 requirements.

The next Home Health, Hospice & DME Open Door Forum is scheduled for Wednesday, July 9, 2014 at 2:00 PM Eastern Time (ET).

Please call at least 15 minutes prior to the forum start time.

Open Door Participation Instructions:

This call will be Conference Call Only.

To participate by phone:

Dial: 1-800-837-1935 & Reference Conference ID: 44430036.

Persons participating by phone do not need to RSVP. TTY Communications Relay Services are available for the Hearing Impaired.  For TTY services dial 7-1-1 or 1-800-855-2880. A Relay Communications Assistant will help.

 **This Agenda is Subject to Change**

I. Opening Remarks
Chair – Randy Throndset, Center for Medicare
Moderator – Jill Darling (OC)

II. Announcements & Updates
Hospice Reporting of DME Items
OASIS Software Vendors
Hospice CAHPS Survey
Home Health Survey

III. Open Q&A

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