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:: NAHC Report
NAHC Report: Issue# 2581, 1/8/2015
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Issue in Focus: Getting Ready for Hospice Self-Reporting of the Aggregate Cap
MedPAC Poised to Recommend Zero Update for Hospice for FY2016
For Your Information: NAHC and HHNA’s Nurse Recognition Program Now Seeking 2015 Nominations for the Home Care & Hospice Nurse of the Year
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Issue in Focus: Getting Ready for Hospice Self-Reporting of the Aggregate Cap

The Fiscal Year 2015 Final Hospice Payment Rule directs that, beginning with cap year 2014 each hospice must self-calculate and report its aggregate cap (along with any applicable overpayment) by not later than 5 months following the close of the cap year (March 31).  Further, the self-calculation may not be completed earlier than 90 days following the close of the cap year (Jan. 31).  As part of the final rule the Centers for Medicare & Medicaid Services (CMS) indicated that it would be providing by way of the Medicare Administrative Contractors (MACs), a pro-forma spreadsheet for calculation of the cap and instructions on how to calculate the cap.  The calculation made by the hospice will be an interim calculation and the MACs are expected to make a final cap liability calculation at some later date.

CMS has not yet released a copy of the spreadsheet or instructions on self-calculation of the aggregate cap, but there are steps that hospices can take now to be ready for this obligation.

First, hospices must ensure that they are in active status with the Individuals Authorized Access to CMS Computer Services (IACS) system so that they will have no difficulties accessing the appropriate Provider Statistical and Reimbursement (PS & R) reports that will be required to self-calculate the aggregate cap.

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MedPAC Poised to Recommend Zero Update for Hospice for FY2016

The Medicare Payment Advisory Commission (MedPAC) met in late December to discuss Medicare payment policy recommendations for inclusion in its forthcoming annual March Report (Report) to Congress. In making recommendations, the Commission uses a standard framework to assess payment adequacy, including provider access to capital, financial margins, access to care - including numbers and growth in providers, as well as growth in utilization - and quality.  In addition to preliminary approval that the Report recommend elimination of the update for hospice payments in Fiscal Year (FY) 2016, Commissioners supported reprinting of previous MedPAC recommendations that have not yet been implemented.

Specifically, those recommendations state that the hospice payment system be reformed to better reflect the costs of hospice care over the course of the episode and that the Centers for Medicare & Medicaid Services (CMS) conduct medical review of hospice providers that have a high proportion of long-stay patients.  It should be noted that the latter recommendation (related to medical review) had not been implemented by CMS due to a legislative drafting error; that error was corrected as part of the IMPACT Act, which was signed into law in October.

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NAHC and HHNA’s Nurse Recognition Program Now Seeking 2015 Nominations for the Home Care & Hospice Nurse of the Year

NAHC and its affiliate the Home Healtcareh Nurse’s Association is seeking nominations for the 2015 Nurse of the Year. NAHC runs the Home Care & Hospice Nurse of the Year campaign to further recognize a nurse who stands for the highest standards of care. The top 10 nurses chosen by the selection committee will be eligible for the Nurse of the Year award. Then the final decision falls to NAHC members and the public. Voting begins this summer on the NAHC website, and the winner will be announced at the 2015 NAHC Annual Meeting in October.

Eligibility Requirements

Any registered nurse currently employed by a NAHC member agency is eligible for the Nurse Recognition Program. The nominated nurse should embrace the program’s spirit and exhibit the following attributes:

  • Does the nurse’s story paint a positive picture of home care and hospice?
  • Does the story show that the nurse provided exceptional care?
  • Does the applicant demonstrate excellence in nursing through credentials, awards, and honors?
  • Did the applicant make a difference in their patients’ lives?
  • Did the applicant inspire us to be our best?

Special Cases

Agencies may nominate telemonitoring nurses who do not visit patients or hospice nurses whose patients are deceased. In these cases, it may not be possible to obtain a photo that depicts the nurse with the patient. If so, agencies may submit separate photos of the patient and the nurse, but photo release forms are still required for a nurse’s story to appear in CARING. If the patient is deceased, or if they are a minor, an adult family member may complete and sign the release form.

Online Application

Each nomination must be submitted using the online form available on the NAHC and HHNA websites. Use the online form to provide background information on the nurse, along with contact information for the agency and the nurse. Please provide separate contact information for nurses who do not work out of the agency’s central office.

For more information on the Nurse of the Year program and submission guidelines, please click here.

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