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  NAHC Report: Issue #3001, 9/28/2016
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Legislation Introduced to Congress Would Delay Pre-Claim Review for One Year
NAHC & Allies Send Letter Urging Congress to Stop Medicare Cost Increase
For Your Information: Former SouthWest CEO to Address NAHC on the Most Powerful Rule for Business Success
Job Corner: Corporate Compliance and Privacy Officer, Evangelical Lutheran Good Samaritan Society; Director of Patient Services — Home Care & Hospice, Long Island, NY
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Legislation Introduced to Congress Would Delay Pre-Claim Review for One Year

A bill introduced on September 28 by Reps. Tom Price (R-GA-6) and James McGovern (D-MA-2) would impose a one year moratorium on the Pre-Claim Review Demonstration (PCR) and requires the Center for Medicare and Medicaid Services (CMS) to report to Congress on the impact of the project on patients, home health agencies, physicians, and Medicare spending.

PCR began in Illinois on August 3, 2016 and almost immediately created chaos in the state’s home health agencies (HHA) and their patients. Problems included a 60-80 percent non-affirmed rate, burdensome and time-consuming paperwork, an inefficient electronic system that cannot process the documentation, physician unfamiliarity with what is needed for PCR due to poor education from CMS and their contractor, and considerable cash flow problems at agencies. At least one Illinois HHA has closed due to PCR. This led to HHAs withholding the start of care to patients until a favorable decision is received, resulting in longer hospital stays. 

As Rep. Price wrote in a “Dear Colleague” letter to his fellow members of Congress, PCR “is creating barriers to care and forcing providers to incur significant unnecessary burdens to support an overly broad, untargeted, and ineffective demonstration.”

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NAHC & Allies Send Letter Urging Congress to Stop Medicare Cost Increase

The National Association of Home Care & Hospice and a group of about 75 health care and employee groups sent a letter to Congress on September 27 urging lawmakers to prevent an increase in out-of-pocket health care costs for some Medicare recipients in 2017.

According to the 2016 Medicare Trustees Report, Part B premiums are currently scheduled for a big increase in 2017, from $121.80/month this year up to $149/month, a bump of 22 percent. The trustees also estimate the Part B deductible will rise from $166 to $204 next year for all enrollees.

The increase is happening because of a “hold harmless” provision that forbids Medicare Part B premium increases from being larger, in dollar amount, than the beneficiary’s Social Security cost-of-living-adjustment (COLA). This rarely matters because Social Security benefits are much larger than a beneficiary’s Part B premium. However, last year there was no COLA at all and this year the COLA is expected to be about 0.2 percent. Therefore, the hold harmless provision may be triggered and leave about 30 percent of beneficiaries with a substantial increase in their Medicare Part B premium and deductible. That 30 percent would have to foot the bill for a premium increase that would normally be spread among all Medicare beneficiaries.

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Former SouthWest CEO to Address NAHC on the Most Powerful Rule for Business Success
NAHC 2016 Annual Meeting Conference and Exposition, October 23–25, 2016 in Orlando, Florida

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NAHC’s 2016 Annual Meeting & Exposition is sponsored by:

Point Click Care
Homecare Homebase
Ability Network
Benefits in a Card

We’ve got three days of impressive keynote speakers, amazing educational sessions and engaging networking opportunities. All of this will leave you excited, energized and ready to put into practice what you learned when you return home.

From the NAHC stage, former SouthWest Airlines CEO Jim Parker will talk about why doing the right thing by your employees and customers doesn’t only “feel good,” it's the most powerful rule for business success. He says if you develop a respect and appreciation for your employees, they’ll do the same for your customers. He’ll share personal insights explaining that it’s really not that hard to do the right thing no matter what industry sector you’re in.

Parker, author of the book Do the Right Thing, led Southwest Airlines during the wake of 9/11 and was faced with a disastrous situation that threatened to ruin not only their airline but the entire airline industry. His leadership approach was: no layoffs, no pay cuts and no-hassle ticket refunds. The result, Southwest remained profitable and was the only major airline to protect the jobs of all its employees.

Jim Parker speaks at Sunday’s General Session at NAHC 2016.

To learn more about the conference educational opportunities, keynote speakers, the home care & hospice expo and much more, click here.

We’ll see you in Orlando!

Corporate Compliance and Privacy Officer — The Evangelical Lutheran Good Samaritan Society, Sioux Falls, South Dakota
Full Time

The Evangelical Lutheran Good Samaritan Society (Society), the nation’s largest not-for-profit, faith-based provider of senior housing and services, seeks a Corporate Compliance and Privacy Officer for its fast-growing Home & Community Based Services (HCBS) business enterprise. 

This leader directs planning, development, implementation, training, and monitoring of all regulatory compliance and HIPAA privacy programs for Home Health and Hospice services and Services@Home/Private Duty across the enterprise, including the Society’s subsidiary operations. This position is located in Sioux Falls, South Dakota; however, a telework arrangement may be considered.

Compliance: Broad knowledge of healthcare and business operations gained through a four-year degree in business, management or healthcare; prefer advanced degree applicable to the duties and responsibilities of the position, a minimum of 5 years’ experience in healthcare industry and at least three years’ experience in compliance/quality for a healthcare organization or equivalent.  Must have knowledge and experience in payment, reimbursement and clinical documentation requirements for home-health related services - especially for the Medicare program.

Privacy: Certified in Healthcare Privacy (CHPS) or Registered Health Information Administrator (RHIA) designation preferred; knowledge/experience in electronic medical records in healthcare; ability to learn/develop high proficiency in computerized records systems.

To apply, visit the Society’s career website at:

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