Our Vacation Ends Now Back to Work

Margaret and I took a long driving vacation over the past three weeks.  We started a Margaret's family reunion in Alabama. Our next stop was to see my cousin in North Carolina. We continued our journey visiting one of Margaret's friends in Pennsylvania.  Next we went to visit with my cousins in New Hampshire. We left New Hampshire for our first visit to Niagara Falls on the Canada side to see some of our church snowbirds and friends. (Snowbirds visit sunny Florida in the winter and return home in the spring). Our final stop was in Kentucky to see family.  Our 4,200 mile driving vacation is over.  Did I say vacation, maybe I need to sleep for two weeks!  While we were away CMS continued to make changes such as reducing the Part D drug preauthorization for Hospice beneficiaries to only four categories of drugs, making changes to the Face-To-Face home health requirements, releasing a draft of OASIS-C1 guidance manual.  Other news includes a halt of OASIS related audits of New England home health agencies, Palmetto requiring agencies to submit the Face-To-Face documentation for all episodes (recertification episodes would require the original episode Face-To-Face documentation).  Yesterday CMS extended the Temporary Moratoria on Enrollment of Home Health Agencies and Ambulance Suppliers that was issued six months ago.  No additional areas have been added just a six month extension.  We will provide details of the above in future emails. I have working diligently since I returned to prepare for our Webinar "Understanding the Home Health PPS Rules and Rate Changes for 2015".  This proposed rule has generated numerous changes for home health providers.  I can assure you there are many changes that will impact your home health operations. Remember that this webinar is one price for your entire company and it will be recorded, meaning you can watch it live and some of your employees can watch the recording when their schedules permit. The webinar will be held live from 3:00 pm to 4:30 pm Thursday July 31st.  More information is below. Regards, Richard **********************************************

Understanding the Proposed Home Health PPS Rules and Rate for FY 2015

We have a Special Live and On Demand Webinar onThursday July 31, 2014 from 3:00 - 4:30 PM EDT.  This 90 Minute Webinar covered the following items.  1. Proposed Home Health PPS Payment Rates for FY 2015    2. Changes in Home Health Wage Index   3. Changes in Face-To-Face Encounter Narrative 4. Case-Mix Adjustment Variables and Scores for 2015     5. Clinical and Functional Thresholds for 2015 6. Case-Mix Payment Rates for 2015     7. Simplification of Therapy Supervision Timeframes   8. Update on Home Health Quality Reporting Program    9. Implementation Date for ICD-10 10. CMS views on Diabetic Patient's who cannot self inject   11. Update Home Health Value Based Purchasing Model This Webinar can be viewed at a later time because it was recorded.  Your registration fee is only $199 for your entire company.  The registration fee also will include handouts that you will receive via email when you register.    To attend the exciting new Webinar please download the Registration Form and fax it back to us at (888) 577-6932 We do accept all major credit cards.   You can register by phone by calling (321) 473-8561and asking to speak with Margaret. Registration Form

CMS Changes Case Mix Weights Again in Proposed PPS Rules for 2015

Every case mix weight has changed in the CMS Proposed PPS Rules for 2015.  They have adjusted the rates to include the latest paid claims available as of 12/31/2013.  They have also reweighted some of the impact of therapy.  We encourage you to review all of the new case mix weights to determine the potential impact on you individual home health agency.  We have listed a sample below for your review.

Code	Therapy Utilization	C, F & S	2015 Case Mix Weight	2014 Case Mix Weight	Increase / (Decrease)	% Increase /(Decrease)
10111	1st and 2nd Episodes, 0 to 5 Therapy Visits	C1F1S1	0.5984	0.6080	-0.0096	-0.0158
10112	1st and 2nd Episodes, 6 Therapy Visits	C1F1S2	0.7250	0.7273	-0.0023	-0.0032
10113	1st and 2nd Episodes, 7 to 9 Therapy Visits	C1F1S3	0.8515	0.8468	0.0047	0.0056
10114	1st and 2nd Episodes, 10 Therapy Visits	C1F1S4	0.9781	0.9661	0.0120	0.0124
10115	1st and 2nd Episodes, 11 to 13 Therapy Visits	C1F1S5	1.1046	1.0856	0.0190	0.0175
21212	1st and 2nd Episodes, 16 to 17 Therapy Visits	C2F1S2	1.5241	1.5021	0.0220	0.0146
21213	1st and 2nd Episodes, 18 to 19 Therapy Visits	C2F1S3	1.7307	1.6558	0.0749	0.0452
22113	3rd+ Episodes, 18 to 19 Therapy Visits	C1F1S3	1.6296	1.5328	0.0968	0.0632
40111	All Episodes, 20+ Therapy Visits	C1F1S1	1.8217	1.6745	0.1472	0.0879

We will have much more on the proposed home health payment rules and rates for 2015 in future email alerts.  We have scheduled a Home Health Webinar titled “Understanding the Proposed Home Health PPS Rules & Rates for 2015” for July 31, 2014 from 3:00 pm to 4:30 pm EDT.  The webinar will be held Live, but will be available later on demand because it will be recorded.

The proposed rules were published in the federal register on July 7, 2014.  The link to the proposed rule is http://www.gpo.gov/fdsys/pkg/FR-2014-07-07/pdf/2014-15736.pdf

Proposed Home Health Rates 2015

On Wednesday we published an Email Blast about the Proposed Home Health PPS Rates for 2015.  This is the second article about the Proposed PPS Rates.  Today we will list the actual episode payment rates, LUPA payment rates and Non Routine Medical Supply Rates.  Look for more Email Blast next week about the Proposed Home Health PPS Rules and Rates for 2015.

Proposed Base Urban Episode Rates Before Case Mix and Wage Index Adjustments
Description	2015	2014	Variance	% Variance
Standard Episode Payment Rate	$2,922.76	$2,869.27	$53.49	1.86%

Proposed LUPA Rates Urban Agencies Before Wage Index Adjustments
Description	2015	2014	Variance	% Variance
Skilled Nursing	$127.81	$121.10	$6.71	5.54%
Physical Therapy	$139.73	$132.40	$7.33	5.54%
Occupational Therapy	$140.68	$133.30	$7.38	5.54%
Speech Pathology	$151.85	$143.88	$7.97	5.54%
Medical Social Work	$204.87	$194.12	$10.75	5.54%
Home Health Aide	$57.88	$54.84	$3.04	5.54%

Proposed LUPA Add-On Payment Amounts Before Wage Index Adjustments
Description	Base 2015 Rate	Add-On Factor	Revised Rate 1st Visit
Skilled Nurse makes initial visit	$127.81	1.8541	$236.97
Physical Therapist makes initial visit	$139.73	1.6700	$233.35
Speech Pathologist makes initial visit	$151.85	1.6266	$247.00

Proposed Non-Routine Medical Supply Base Rate
Description	2015	2014	Variance	% Variance
Medical Supply Base Rate	$53.28	$53.65	($0.37)	(0.69%)

Proposed 2014 Non-Routine Medical Supply
Severity	Points	Relative Weight	Proposed NRS Payment Amount
1	0	0.2698	$14.37
2	1 to 14	0.9742	$51.91
3	15 to 27	2.6712	$142.32
4	28 to 48	3.9686	$211.45
5	49 to 98	6.1198	$326.06
6	99+	10.5254	$560.79

Remember that all rates must be adjusted for urban and rural home health agencies.  LUPA Rates and Episodes Rates must be adjusted by wage index.   Episode rates must be adjusted by wage index and case mix.  Home health agencies that do not submit quality data will receive an additional 2 percent cut in payments. 

We will have much more on the proposed home health payment rules and rates for 2015 in future email alerts.  We have scheduled a Home Health Webinar titled “Understanding the Proposed Home Health PPS Rules & Rates for 2015” for July 31, 2014 from 3:00 pm to 4:30 pm EDT.  The webinar will be held Live, but will be available later on demand because it will be recorded.

The proposed rule will be published in the Federal Register on July 7, 2014. We have a temporary link to the proposed rule below:

https://s3.amazonaws.com/public-inspection.federalregister.gov/2014-15736.pdf

CMS Proposes To Eliminate Face-To-Face Narrative with PPS Rates for FY 2015

The proposed rule changes home health payment rates for 2015, it updates home health wage index, case-mix rates, addresses the delay of ICD 10, changes some of the therapy reassessment timeframes, solicits comments on a Home Health Value Based Purchasing Program and make changes to the Face-To-Face narrative.  Most home health agencies are having difficulties with the Face-To-Face narrative.  CMS is proposing to eliminate the physician Face-To-Face narrative, but the physician must document that the encounter occurred and the date the encounter occurred.  In instances where the physician is ordering skilled nursing visits for management and evaluation of the patient's care plan, the physician will still be required to include a brief narrative that describes the clinical justification of this need as part of the certification/recertification of eligibility. Next CMS is proposing for medical review purposes to only consider medical records from the patient's certifying physician or discharging facility in determining initial eligibility for the Medicare home health benefit.  Finally CMS intends to deny the physicians Medicare claim for the Face-To-Face encounter if the home health claim is not covered because the patient is not eligible for the benefit. This portion of the proposed rule would be implemented in future regulations. The bottom line appears to still require the physician narrative in some cases and to utilize the physician medical records to justify home health certification. The home health industry will still be penalized based on the record-keeping of the physicians.   Penalizing a home health patients by disallowing their coverage due to poor record-keeping of the physician is a disgrace.  It appears that CMS is continuing to ration care to eligible Medicare beneficiaries by unclear and unfair rules and regulations.  We support the Lawsuit filed by the National Association of Home Care on home health Face-To-Face issues.  This proposed rule continues to show CMS lack of understanding of the issue and their need to restrict and deny Medicare patients their needed home health services. We will have much more on the proposed home health payment rules and rates for 2015 in future email alerts.  We have scheduled a Home Health Webinar titled "Understanding the Proposed Home Health PPS Rules & Rates for 2015" for July 31, 2014 from 3:00 pm to 4:30 pm EDT.  The webinar will be held Live, but will be available later on demand because it will be recorded. The proposed rule will be published in the Federal Register on July 7, 2014. We have a temporary link to the proposed rule below: Temporary Link    **********************************************

Understanding the Proposed Home Health PPS Rules and Rate for FY 2015

We have a Special Live and On Demand Webinar on Thursday July 31, 2014 from 3:00 - 4:30 PM EDT.  This 90 Minute Webinar covered the following items.  1. Proposed Home Health PPS Payment Rates for FY 2015    2. Changes in Home Health Wage Index   3. Changes in Face-To-Face Encounter Narrative 4. Case-Mix Adjustment Variables and Scores for 2015     5. Clinical and Functional Thresholds for 2015 6. Case-Mix Payment Rates for 2015     7. Simplification of Therapy Supervision Timeframes   8. Update on Home Health Quality Reporting Program    9. Implementation Date for ICD-10 10. CMS views on Diabetic Patient's who cannot self inject   11. Update Home Health Value Based Purchasing Model This Webinar can be viewed at a later time because it was recorded.  Your registration fee is only $199 for your entire company.  The registration fee also will include handouts that you will receive via email when you register.    To attend the exciting new Webinar please download the Registration Form and fax it back to us at (888) 577-6932 We do accept all major credit cards.   You can register by phone by calling (321) 473-8561 and asking to speak with Margaret. Registration Form