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  NAHC Report: Issue# 2720, 8/6/2015
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NAHC Lawsuit Challenging the Medicare Face-to-Face Rule Presented in Court
CMS Issues Clarifications, Corrections to Freestanding Hospice Cost Report Forms and Instructions
For Your Information: Four Quick Questions
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NAHC Lawsuit Challenging the Medicare Face-to-Face Rule Presented in Court

Counsel for the National Association for Home Care & Hospice (NAHC) presented oral argument before U.S. District Court Judge Christopher Cooper on August 6, 2015, regarding NAHC’s lawsuit challenging the validity of the physician narrative requirement in the physician face-to-face encounter rule. While Medicare rescinded the narrative requirement from its rule after NAHC filed its lawsuit last year, Medicare has not provided nearly $200 million in retroactive payments to home health agencies that were wrongfully denied claims because of the now-rescinded narrative requirement. NAHC brought litigation on the validity of the narrative requirement so that home health agencies that provided care to patients in good faith are paid for their inappropriately disallowed claims.

“We are trying to fix an injustice for the home health agencies that are stuck in limbo with nearly $200 million in unpaid claims because of the now-rescinded narrative requirement,” stated Val J. Halamandaris, President of NAHC. “Medicare rescinded its ill-conceived narrative requirement after we filed this lawsuit last year. However, we are still trying to clean up the mess the narrative requirement left behind—nearly $200 million in wrongful claim denials to home health agencies. These home health agencies provided services to Medicare patients in good faith, and they should receive payment for the nearly $200 million in claims that they were wrongfully denied.”

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CMS Issues Clarifications, Corrections to Freestanding Hospice Cost Report Forms and Instructions

Effective for cost reporting years starting on or after October 1, 2014, freestanding hospices are required to file the revised hospice cost report Form CMS-1984-14. The new freestanding hospice cost report significantly expands data collection requirements to supply greater detail related to hospice costs by level of care; data from the modified report may be used in future payment reform analyses by the Centers for Medicare & Medicaid Services (CMS).  Form CMS-1984-14 underwent a lengthy review and comment process and was made publicly available in late August 2014. CMS has continued to receive recommendations to modify CMS-1984-14 to promote greater clarity and accuracy of the documents.

CMS recently issued Transmittal 2:  New Cost Reporting Forms and Instructions -- Effective Date:  Hospice Cost Report changes effective for cost reporting periods beginning on or after October 1, 2014  (dated July 31, 2015) to its website; the transmittal makes clarifying and correcting revisions to the freestanding hospice cost reporting forms and instructions as follow:

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Four Quick Questions
The National Association for Home Care & Hospice is launching a new series of articles called “Four Quick Questions” highlighting education offerings at the 2015 Annual Meeting & Exposition. In each article, a lead faculty member provides answers to the same four questions regarding a specific education session.

Today, Mary K. Carr, BSN, MPH, Vice President for Regulatory Affairs at the National Association for Home Care & Hospice answers questions about Session 406: How to Deal with Current and Future Changes: The Home Health Regulatory Roundup

What current issues does the session address?

MKC: The session will address the revised face-to-face requirements, updates to the 2016 home health payment rates,  CMS’ Value Based Purchasing program for home health agencies, and what agencies can expect with the implementation of the IMPACT Act, to name a few.

What is the most important insight or skill that attendees will take away from the session?

MKC: Over the past several years, the regulatory environment for home health providers has been steadily evolving. Medicare certified agencies are continually being challenged with increased regulatory burdens, reimbursement changes, and increased oversight. This session will provide an overview of the most important regulatory and policy issues facing home health agencies. Participants will come away with a better understanding of the changing regulatory and policy environments and what they need to do to meet those challenges.

Who would this session most benefit?

MKC: The session will most benefit middle and upper management personnel in Medicare certified home health agencies.

How would you best describe your session in 140 characters or less?

MKC: The session will provide important insights on how to prepare for the ongoing regulatory and CMS policy changes.


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The Director executes direct administration of the Community Nurses Inc. System Home Health and Hospice departments, Adult Day Services and Support Services as evidenced by achieving results in clinical quality, service excellence, human resources management and financial management.  The Director assists in developing and implementing a strategic plan for the growth and development of Community Nurses Inc. services in collaboration with the AVP of Home Health/Hospice and other Penn Highlands Healthcare leadership.


  • Bachelors Degree in Nursing, Business Administration, or related field required; Masters Degree in Nursing, Business Administration, or related field preferred.
  • System management experience preferred.
  • Five years home health/hospice nursing experience preferred.
  • Two years management experience in home health/hospice setting required.
  • Demonstrates effective communication and collaboration skills with physician and all other members of the health care team
  • Progressive and successful work history
  • Specialty certification preferred

Interested candidates please submit a resume and cover letter for consideration. FAX:  814-788-8046 OR E-MAIL:


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