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:: NAHC Report
 
NAHC Report: Issue# 2483, 8/6/2014
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ARTICLE ARCHIVES MEMBER RESOURCES eNEWSLETTERS CARING STORE
CMS Issues Several Change Requests Specific To Home Health Agencies
Hospice Legislative Action Alert
For Your Information: Legal & Regulatory Educational Sessions at NAHC’s Annual Meeting
NAHC/Home Care & Hospice Events
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CMS Issues Several Change Requests Specific To Home Health Agencies

The Centers for Medicare & Medicaid Services (CMS) has issued four Change Requests that provide guidance to the Medicare Administrative Contractors (MACs) on several home health policy and claims processing issues.

Change request 8699 - Preventing Duplicate Payments When Overlapping Inpatient and Home Health Claims Are Received Out of Sequence

CMS has instructed the MACs to implement edits that will prevent home health claims from processing with dates of service that overlap an inpatient stay. In response to a 2012 Office of Inspector General report that exposed claim vulnerabilities, CMS has identified two conditions where a home health claim could process that overlap with an inpatient claim: 

  • The edit that rejects home health claims when they have dates overlapping an inpatient stay - other than the admission date, discharge date, or a date during an occurrence span code 74 period indicating a leave of absence - does not consider inpatient stays in a swing bed (Type of Bill 018x), and
  • Medicare systems only identify overlaps with inpatient stays when the inpatient hospital or skilled nursing facility claim was received before the home health claim.

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Hospice Legislative Action Alert
Urge Support of H.R. 5383 to Mandate Frequency of Hospice Surveys 5393

While Medicare home health agencies must be surveyed, minimally, every 36 months and skilled nursing facilities must be surveyed, minimally, every 15 months, there is no set frequency in statute or regulation for hospice surveys.  As the result, CMS sets targeted frequencies for hospice surveys based on availability of funding and competing priorities.  As demands on limited administrative resources grow, hospice survey frequencies grow longer. 

This means that some hospices may not have been surveyed in the last 10 years or more, and many hospices have not been surveyed since significant revisions were made to the Hospice Conditions of Participation in 2008. For many years the National Association for Home Care & Hospice (NAHC) and other industry advocates have pushed for minimal hospice survey frequency requirements, and as recently as June 2014, in the wake of media concerns that less frequent hospice inspections may lead to lapses in care, NAHC President Val J. Halamandaris called on Congress and CMS to address this pressing need.

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Legal & Regulatory Educational Sessions at NAHC’s Annual Meeting
Pre-Conference on Saturday, October 18, 2014 at NAHC’s Annual Meeting

This year’s Annual Meeting features track-specific educational sessions, informative round table discussions and much, much more. Below are some of the sessions included in this year’s Legal & Regulatory Track:

  • How to Stay Informed: Medicare Updates and Reminders from CGS
  • How to Stay Informed: Medicare Updates by Palmetto GBA
  • How to Stay Informed on Medicare Regulations: Meet Your Medicare Contractor
  • How to Deal with Current and Future Changes:  Home Health Regulatory Roundup
  • How to Prepare for Medicare Audits and Compliance

Visit the NAHC website for full descriptions and to register for the conference!

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