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:: NAHC Report
 
NAHC Report: Issue# 2546, 11/10/2014
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ARTICLE ARCHIVES MEMBER RESOURCES eNEWSLETTERS CARING STORE
Office of Medicare Hearings and Appeals Seeks Input on Ways to Reduce Medicare Appeal Backlog
U.S. Department of Health and Human Services, Office for Civil Rights Releases a Bulletin on HIPAA Privacy in Emergency Situations
For Your Information: Webinar: NAHC and CMS Explain the Proposed Home Health Conditions of Participation
NAHC/Home Care & Hospice Events
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Office of Medicare Hearings and Appeals Seeks Input on Ways to Reduce Medicare Appeal Backlog

The Office of Medicare Hearings and Appeals (OMHA) has published a “Request for Information” regarding the Administrative Law Judge (ALJ) Program for Medicare Claim Appeals. The Request follows a recent OMHA Medicare Appellant Forum held in Washington, D.C. where OMHA officials detailed the ever-increasing appeal backlog along with its initiatives to bring greater efficiencies and productivities into the ALJ appeal process.

Nearly 900,000 ALJ level appeals are awaiting assignment and processing.  The assignment of appeals to ALJs has been suspended since July 2013 due to the volume of pending appeals. The majority of the backlogged appeals involve hospital challenges to retroactive claim rejections by a Recovery Audit Contractor. The second highest volume involves Durable Medical equipment appeals, primarily because of the monthly rental billings method. It is estimated that there are approximately 30,000 home health and hospice ALJ appeals pending, many of which stem from state Medicaid program appeals involving dual-eligibles.

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U.S. Department of Health and Human Services, Office for Civil Rights Releases a Bulletin on HIPAA Privacy in Emergency Situations
Bulletin comes as part of the government’s ongoing response to the Ebola threat

 In light of the Ebola outbreak and other events, the U.S. Department of Health and Human Services (HHS), Office for Civil Rights (OCR), is providing a bulletin to ensure that HIPAA covered entities and their business associates are aware of the ways in which patient information may be shared under the HIPAA Privacy Rule in an emergency situation, and to serve as a reminder that the protections of the Privacy Rule are not set aside during an emergency.

 The HIPAA Privacy Rule protects the privacy of patients’ health information (protected health information) but is balanced to ensure that appropriate uses and disclosures of the information still may be made when necessary to treat a patient, to protect the nation’s public health, and for other critical purposes.

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Webinar: NAHC and CMS Explain the Proposed Home Health Conditions of Participation
Tuesday, November 18, 2014, 1:00 PM – 2:30 PM EASTERN

The Centers for Medicare & Medicaid Services (CMS) announced new conditions that home health care providers must meet to participate in Medicare. The proposed rule will modernize home health regulations for the first time since 1989. The rule has been posted and home health agencies will have 60 days to submit comments. Home health agencies must meet the Medicare home health conditions of participation (HH CoPs) in order to participate in the Medicare program. Agencies that fail to meet any of the HH CoPs are at risk, at a minimum, for the imposition of several sanctions and, at worst, for program termination. 

Over the years, CMS has made several significant revisions to the HH CoPs, but many of the current CoPs have remained unchanged since their inception. In 1997, CMS attempted to revise the HH CoPs through a proposed rule that focused on patient-centered, outcome-oriented quality standards. CMS did not publish a final rule within the required three years time frame, so a new proposed rule had to be issued. (Please note: This event will not be recorded.)

Objectives:

  • Provide an overview of the proposed rule on home health conditions of participation for Medicare-participating home health agencies
  • Discuss the key changes associated with the proposed conditions of participation
  • Discuss rationale for changes to the proposed conditions for participation 

Faculty:

  • Danielle Shearer, Technical Advisor, Center for Clinical Standards and Quality, Clinical Standards Group, Centers for Medicare & Medicaid Services, Baltimore, MD
  • Mary Carr, RN, MPH, Vice President for Regulatory Affairs, National Association for Home Care & Hospice, Washington, DC

Recording: This event will not be recorded.

Registration: Registration for this NAHC event is being handled by KRM information services, inc. Register online.

Webinar Registration Fee:

  • $125.00 NAHC Members
  • $225.00 Non-Members

Continuing Education Credits Offered to Nurses Only: Maryland Nursing Association (MNA), our continuing education provider, will offer continuing education credits (1.5 CNE for 90 minutes) to nurses only for this webinar. All other attendees (non-nurses) who view the webinar in its entirety can obtain a certificate of attendance. Each attendee wanting a CNE or attendance certificate must enter their name in the event site roster and complete a participant feedback form.

If you have difficulty retrieving your certificate, contact KRM at custserv@krm.com or call 800.775.7654.

Cancellation: No refunds or substitutions will be allowed after Friday, November 14, and a $10.00 administrative cancellation fee will be charged. All cancellations must be made in writing to custserv@krm.com.

Questions about Registration or Technical Support: If you have questions, please contact KRM at custserv@krm.com or call 800.775.7654 to have a representative assist you.

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