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NAHC Report: Issue# 2526, 10/13/2014
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NAHC Files Brief in the Face-to-Face Physician Encounter Lawsuit
President Obama Signs the IMPACT Act into Law
For Your Information: Just Confirmed – General Session Speaker!
Adam Darkins, MD, MPHM, FRCS
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NAHC Files Brief in the Face-to-Face Physician Encounter Lawsuit

NAHC’s lawsuit challenging the validity and administration of the Medicare face-to-face physician encounter rule is advancing in federal court. On October 10, 2015, NAHC filed a brief in opposition to the Motion to Dismiss submitted by the US Department of Justice on behalf of the Medicare program. That brief argues that the court has the full power to hear the case now rather than forcing beleaguered home health agencies to pursue individual administrative appeals through an already over-clogged system.

The NAHC lawsuit specifically challenges the part of the rule that requires physicians to compose a narrative explaining why a patient is homebound and in need of skilled nursing or therapy services. Medicare contractors have issued tens of thousands of claim denials on the basis that the physician narrative is “insufficient.” While Medicare has a proposed rule that would eliminate the narrative requirement prospectively, that proposal does not address the harm the narrative requirement has already caused. NAHC expects that the proposed rule will be finalized before the end of October. NAHC is continuing the litigation in hopes of reversing the past findings of “insufficient narratives.”

In its brief, NAHC argues that the court can waive any requirement that administrative appeals be fully exhausted because it would be futile to appeal given that administrative contractors and ALJs cannot invalidate a federal regulation and that CMS has issued its final decision upholding that rule. The NAHC brief also sets out that home health agencies face irreparable harm caused by the massive number of retroactive claim denials and demands for repayments.

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President Obama Signs the IMPACT Act into Law
NAHC’s President, Val J. Halamandaris, participated in the White House Signing Ceremony

Last week, President Obama signed into law the Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act of 2014). Val J. Halamandaris, NAHC’s President, participated in the signing ceremony at the White House.

Mr. Halamandaris has emphasized NAHC’s support for the IMPACT Act previously by saying:

“Overall, NAHC is very supportive of the goals behind the IMPACT Act and fully supports the development of a uniform patient assessment and discharge planning process. The approach taken in the IMPACT Act to achieve these goals is a well-balanced, step-by-step method. It recognizes the need to provide a general direction and timeline for the reforms while channeling responsibilities to the Secretary of Health and Human Services and her Medicare administrator, the Centers for Medicare and Medicaid Services. We also appreciate…the strengthening of standards to avoid duplication of data requirements and the inclusion of stakeholder inputs in the patient assessment tools”

The IMPACT Act requires the Centers for Medicare & Medicaid Services (CMS) to survey hospices at least as frequently as every three years for the next 10 years.  For many years, the National Association for Home Care & Hospice (NAHC) and its Hospice Association of America (HAA) have supported greater frequency in hospice surveys.  Prior to the IMPACT Act, there was no set time frame for frequency of hospice surveys, and the average length of time between surveys for hospice providers is six to eight years – with some hospices not having been surveyed in over a decade.  More frequent surveys are a step toward helping ensure hospice provider compliance with regulations and proper administration of the hospice benefit. 

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Just Confirmed – General Session Speaker!
2014 NAHC Annual Meeting & Exposition
Phoenix Convention Center, Phoenix, Arizona
October 19 – 22, 2014

Adam Darkins, MD, MPHM, FRCS, Senior Director, Enterprise Technology Solutions, Medtronic, Inc. will address the attendees at NAHC’s Annual Meeting and Exposition on Wednesday, October 22 at 8:30am.

Learn from a leading physician about the convergence of medical devices and connected care technologies and the role it can play in improving patient management. Dr. Adam Darkins will give his unique perspective on the future of healthcare with enhanced patient management facilitated by technology-enabled solutions. It’s a subject on which Dr. Darkins has extensive expertise since he leads the development of Medtronic’s Enterprise Health Service strategies pioneering work in this area. He serves as the executive thought leader and is responsible for Integrated Health Services strategy development and execution.

Dr. Darkins is the former leader of the National Telehealth Programs for US Department of Veterans Affairs (VA). Under his leadership VA developed the clinical, technology and business underpinnings to successfully implement and sustain enterprise-wide telehealth-based services that have demonstrably improved access to care for patients, reduced utilization of health care resources and are associated with very high levels of patient satisfaction. His work resulted in over 600,000 patients receiving telehealth-based care annually on dedicated national platforms, making VA a recognized national/international leader in the field. He envisioned VA's clinical enterprise videoconferencing network, a national telehealth platform with over 4,500 clinical videoconferencing end points providing services linking 151 VA hospitals, 600 community based outpatient clinics and offering IP-based video services directly into patient's homes.

To register for the Annual Meeting, click here.

To review General Session Speakers, click here.

Registered Nurses and Hospice Staff

Renown Health, based in Reno, Nevada, is looking for experienced, supportive Registered Nurses and hospice staff.

In keeping with our commitment to providing compassionate and continuum care at every stage of life, we are opening Renown’s first-ever hospice program and we're looking for experienced RNs and hospice staff with at least two years of prior hospice experience.

Renown Health is northern Nevada’s largest integrated health network and a nationally recognized healthcare leader. Based in Reno, Renown serves a 17-county region comprised of northern Nevada, Lake Tahoe and northeast California. The Reno-Tahoe region holds a range of lifestyle options that spans from downtown Reno to the shores of Lake Tahoe. With over 300 days of sunshine annually, it’s easy to understand why so many people choose to explore the natural beauty of our region. Experience as much or as little as you want as you thrive in our small-town feel and friendliness and all the financial benefits that come from a state with no state income tax.

Learn more at: or contact Anne Larson, Recruiter, at 775-982-6306. EEO/M/F/V/D


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