Palmetto GBA Home Health Face To Face Check List - 12/16/2015

We were quiet last week because Margaret and I took a long needed break by taking a 7 day cruise to Nassau, St Thomas and St Martin. It was a wonderful break, but now it is time to get back to work.  On December 9^th, Palmetto GBA issued a Home Health Face to Face Checklist.  We all know about the Probe Edits currently being conducted as we have discussed in our 11/16/2015 email update.  Using the Palmetto GBA Home Health Face To Face Checklist can help point out areas that need to be addressed in the Face To Face Documentation.

You can download the checklist here!

http://www.palmettogba.com/Palmetto/Providers.Nsf/files/Home_Health_Face_to_Face_Checklist.pdf/$File/Home_Health_Face_to_Face_Checklist.pdf 

Palmetto GBA Hospice Medical Audit Form - 12/2/2015

Yesterday we sent an email regarding a Home Health Audit Form from Palmetto GBA.  I researched their website and found a similar tool for hospice.  They have suggested that Hospices utilize this form or check list when gathering information to respond to ADRs or other Medicare claims review.  We believe hospices could utilize some of the items in this form along with some additional items to develop a great monthly billing and clinical check list.  We are currently working on this project and intend to include it in our hospice seminar Plug in to Win that will be held in Las Vegas on January 28th – January 29th. You can download the Palmetto GBA Form Here! http://www.palmettogba.com/Palmetto/Providers.Nsf/files/Hospice_Documentation_Audit_Tool.pdf/$File/Hospice_Documentation_Audit_Tool.pdf

Palmetto GBA New Home Health Medical Audit Form - 12/1/2015

On Monday November 23^rd Palmetto issued a new Home Health Medical Audit Form.  They have suggested that home health agencies utilize this form or check list when gathering information to respond to ADRs or other Medicare claims review.  We believe home health agencies could utilize some of the items in this form along with some additional items to develop a great end of episode billing check list.  We are currently working on this project and intend to include it in our home health seminar Plug in to Win that will be held in Las Vegas on January 28^th – January 29^th.

You can download the Palmetto GBA Form Here!

http://www.palmettogba.com/Palmetto/Providers.Nsf/files/Home_Health_Medical_Record_Audit_Form.pdf/$File/Home_Health_Medical_Record_Audit_Form.pdf

Last Day For Lowest Vegas Registration Rate - 11/30/215

We will be presenting our Annual Home Health Seminar and Annual Hospice Seminar in Las Vegas on January 28^th - January 29^th.  This year’s title for both seminars is Plug in to Win. We have reduced the seminar from three days to two days.  We have done this to reduce the amount of time our clients and attendees will have to spend away from home.  These seminars will concentrate on the areas our previous seminar attendees have requested. 

Home Health Topics

Home Health Update

Win With Value-Based Purchasing Model

ICD-10-CM Impact on Home Health Coding

Defending Medicare Claims – Legal

Supporting Medicare Claims – Clinical

See What Condition My Conditions Are In

Winning Financial Strategies

Business & Employment Relationship Issues

Hospice Topics

Hospice Update

Understanding Hospice Cost Report Changes

ICD-10-CM Impact on Hospice Coding

Defending Medicare Claims – Legal

Supporting Medicare Claims – Clinical

How to use Hospice Data to Improve Quality of Care at the End of Life

Winning Financial Strategies

Business & Employment Relationship Issues

Nationally recognized speakers are Richard K. Dixon, Robert Liles, and J’non Griffin.  We are adding Heather Calhoun as an additional speaker for the hospice program

The home health seminar will have 10 hours of home health administrator CEUs approved by Texas Department of Aging and Disability Services.  The hospice seminar will have 10 hours of hospice administrator CEUs approved by Texas Department of Aging and Disability Services. Both seminars will have 10 hours of Nursing CEU's provided by Corexcel and Dixon Healthcare Solutions, Inc.  

The lowest registration rate of $699 for the first registrant and $599 for each additional registrant expires today.  Beginning on December 1^st the rates will increase to $799 for the first registrant and $699 for each additional registrant.

OIG Work Plan 2016 - 11/20/2015

The Office of Inspector General of the Department of Health and Human Services has issued their Work Plan for Fiscal Year 2016.  This reports shows the OIG accomplishments for fiscal year 2015.  This report concerns all the OIG’s plans for 2016.

Under the section for hospice it shows they will focus on the use of general inpatient care to determine if it is being used appropriately by the hospice industry.  They also plan to continue to review if hospice claims to determine if they meet the Medicare eligibility requirements and if the hospice is providing the appropriate level of care to the patients.

Under the home health section they will focus on reviewing clinical documentation to determine if the Medicare claims meet the home health eligibility requirements.  Prior year OIG audits claimed that one in four home health agencies had questionable billing practices.  They will continue to review home health billing practices in 2016.

To review the entire OIG Work Plan for 2016 please follow this link.

http://www.oig.hhs.gov/reports-and-publications/archives/workplan/2016/oig-work-plan-2016.pdf

Adapt & Learn to Think Outside the Box - 11/19/2015

Yesterday I wrote an article for home health agencies.  Today’s article is for hospices.  Hospice seems to follow home health in the regulation development department.  This year we have new payment rates for the first sixty days of a patients hospice stay, reduced payment rates for the remaining days of a patient’s hospice day and a possibility of Services Intensity Add-on (SAI) Payment for the last seven days of a patient’s life.  This new rule alone is probably driving your IT and billing personnel nuts. 

These new variable routine home care payment codes will make it more difficult to determine where you stand with your annual hospice cap.  We also have ICD-10-CM coding up and running along with adding all the appropriate diagnosis codes to your hospice claims.  CMS made some last minute changes to some of the items in the new Hospice Medicare Cost Report that is in effect for all hospices with years beginning on or after October 1, 2014

I have been involved in the Medicare program for over 30 years and have seen tremendous amounts of change, but I have not seen so much change in such a short period of time.  Just think about Routine Home Care Payment Changes, New Hospice Medicare Cost Report,  Calculating your own Hospice CAP Report, ZIPCs, RACs, ICD-10-CM, New Wage & Hour Laws, and potential new hospice payment rates in the future. 

You will have the opportunity to obtain much of the information you need at our new “Plug in to Win” 2-Day Hospice Seminar at Bally’s in Las Vegas, NV January 28^th to January 29^th.  This seminar feature Richard Dixon, President of Dixon Healthcare Solutions, Inc.  It will also feature J’non Griffin one of the leading hospice coding and clinical experts in the country, Robert Liles one of the leading hospice attorney’s, and Heather Calhoun a leading clinical and quality improvement consultant.   You will have the opportunity for free 15 minute appointments with each speaker.  Over 99% of our previous attendees recommend and would attend a future Dixon Healthcare Solutions, Inc. seminar.  Learn to adapt and think outside the box so your home health agency can succeed.

Wake Up or Get Left Behind - 11/18/2015

I have been quite disappointed with the home health industry lately.  Medicare continues to make enormous changes to the rules and regulations and it appears either everybody is asleep at the switch or they just don’t care.  We had two one-day seminars regarding the Home Health Value-Based Purchasing Model and how to make the necessary changes for home health agencies to succeed.  I know it is fall and it was only a one-day seminar, but the attendance was lower than expected.  We held a seminar in Louisville, KY as a central point for Tennessee, Iowa, Kansas, Nebraska, and North Carolina.  We also held a seminar in Orlando, FL mainly for the state of Florida.

I was astonished that only one home health agency in Florida attended the meeting in Orlando, but we had people come from Arizona, Nebraska and many other states.  The Home Health Value-Based Purchasing Model program starts for 9 states effective on January 1, 2016, which is less than two months from today.  The states are Massachusetts, Maryland, North Carolina, Florida, Washington, Arizona, Iowa, Nebraska, and Tennessee. 

CMS is determined to have most of all future Medicare payments based on outcomes.  This Home Health Value-Based Purchasing Model will probably spread to all states by 2019 or 2020.  I know that most of are overwhelmed by all of the changes, but we must adapt to meet the changes or we will be forced out of business.

I have been involved in the Medicare program for over 30 years and have seen tremendous amounts of change, but I have not seen so much change in such a short period of time.  Just think about Face-To Face, ZIPCs, RACs, ICD-10-CM, New Wage & Hour Laws, and now Value-Based Payments. 

You will have the opportunity to obtain much of the information you need at our new “Plug in to Win”

2-Day Home Health Seminar at Bally’s in Las Vegas, NV January 28^th to January 29^th.  This seminar feature Richard Dixon, President of Dixon Healthcare Solutions, Inc.  I it will also feature J’non Griffin one of the leading home health coding and clinical experts in the country and Robert Liles one of the leading home health attorney’s.  You will have the opportunity for free 15 minute appointments with each speaker.  Over 99% of our previous attendees recommend and would attend a future Dixon Healthcare Solutions, Inc. seminar.  Learn to adapt and think outside the box so your home health agency can succeed.

http://dixonhealthcaresolutions.com/home-health/

http://dixonhealthcaresolutions.com/hospice/

Home Health Claims Probe & Educate - 11/16/2015

CMS Released MLN Matters Number SE1524 last week concerning a new home health claim probe and educate review.  You Medicare Administrative Contractor (MAC – PlamettoGBA, CGS or NGS) will request 5 claims from each Medicare certified home health agency.  This probe and educate review will concentrate on the area of reviewing to determine if the home health services provided to the patient meets the eligibility requirements.  The real focus will be on the compliance with the latest CMS interpretation of the face to face requirement that was issued in the final rules home health payment CMS-1611-F. 

Each home health agency will be required to submit documentation to support the 5 claims selected for review.  If MAC finds problems with one or fewer claims the agency will be classified into the category of “No or Minor Concerns”.  If the MAC finds problems with two or more of the claims the agency will be classified into the category of “Moderate/Major Concerns”. 

For your information please utilize the following link

https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/SE1524.pdf

Vegas January 2016 2-Day Seminars Plug in to Win All Meat No Potatoes - 11/6/2015

We have received many request to continue are annual home health and hospice seminars in Las Vegas.  A new 2-Day Seminar Program titled "Plug in to Win" has been developed for home health agencies and hospices.  Both seminars will be held in adjacent meeting rooms on January 28th - January 29th, 2016.  The seminars will be held at Bally's Las Vegas, on the strip in fabulous Las Vegas, NV. We have reduced the seminars from three days to two days.  It will provide an all meat program.  We have eliminated the potatoes.  The seminars will consist of 10 hours of class time over the two days.  You will still have the opportunity to meet one-on-one with each speaker for free. The home health seminar will have 10 hours of home health administrator CEUs approved by Texas Department of Aging and Disability Services.  The hospice seminar will have 10 hours of hospice administrator CEUs approved by Texas Department of Aging and Disability Services.  Both seminars will have 10 hours of Nursing CEU's provided by Corexcel and Dixon Healthcare Solutions, Inc.

Final Home Health Value-Based Purchasing Model Published

The Home Health Value-Based Purchasing Demonstration on January 1st 2016 for all home health agencies in the nine states they have selected.  They divided the 50 states into nine groups.   Group States Selected State 1 VT, MA, ME, CT, RI, NH Massachusetts 2 DE, NC, MD, PA, NY Maryland 3 AL, GA, SC, NC, VA North Carolina 4 TX, FL, OK, LA, MS Florida 5 WA, OR, AK, HI, WY, ID Washington 6 NM, CA, NV, UT, CO, AZ Arizona 7 ND, SD, MT, WI, MN, IA Iowa 8 OH, WV, IN, MO, NE, KS Nebraska 9 IL, KY, AR, MI, TN Tennessee CMS will use OASIS data, HHCHAPS data, paid claims data, and three new data elements for scoring.  Each state will be divided into large providers and small providers and their score will compared to their group for their state.  January 1, 2015 to December 31, 2015 will serve as the base year for the providers.   Scores Impacts Payment Rates Impact 1/1/16 to 12/31/16 1/1/18 to 12/31/18 + or -  3% 1/1/17 to 12/31/17 1/1/19 to 12/31/19 + or -  5% 1/1/18 to 12/31/18 1/1/20 to 12/31/20 + or -  6% 1/1/19 to 12/31/19 1/1/21 to 12/31/21 + or -  7% 1/1/20 to 12/31/20 1/1/22 to 12/31/12 + or -  8% If you are located in one of the 9 states listed above you have 60 days to be ready for HHVPM to begin.  We have two timely One Day Seminars that will give you the information you need to prepare for the changes.  They are titled Winning Strategies - Home Health Value Based Payments.  The first seminar will be held in Louisville, KY on November 10th.  The second seminar will be held in Orlando, FL on November 17th.  The seminar topics are: Understanding the Home Health Value-Based Purchasing Model How to Succeed Under Home Health Value Based Purchasing Review of Final Home Health Rules and Rates for 2016 SMART Marketing to Grow and Prosper We are pleased to offer $100 per person discount off the current rate because of a sponsorship by TurboQuisine.  The discounted rate including the $100 discount is $269 for the first person and $199 for additional people from the same agency.    Link to the Final Rule We developed a free 10 minute video that could help you to solve 5 major issues impacting your home health agency.  We have always tried to have our clients, seminar attendees and friends to learn to think outside the box.  This video really hits on that point.  Watch the video and let us know your opinion. LINK to Video **********************************************

Dixon Healthcare Solutions, Inc. One Day Seminar Winning Strategies

Home Health Value Based Payments One Day Seminar For Home Health Agencies Two location to choose from presented by  Dixon Healthcare Solutions, Inc. November 10, 2015 - Hampton Inn & Suites Louisville East, 1451 Alliant Avenue, Louisville, KY 40299 Hotel Phone (502) 809-9901 November 17, 2015 - Hampton Inn & Suites Orlando Airport, 5460 Gateway Village Circle, Orlando, FL 32812 Hotel Phone (407) 857-2830 **** Web Links - Winning Strategies **** Time 8:30 AM - 3:50 PM - Lunch Included Registrations Forms  Louisville  Orlando The Presenter Richard K. Dixon is President and CEO of Dixon Healthcare Solutions, Inc., a national healthcare consulting firm specializing in Home Health and Hospice.  His experience includes operations consulting, financial management consulting, budgeting, preparation of Medicare and Medicare Cost Reports, and reimbursement management consulting.  Mr. Dixon has 25 plus years of experience including VP of Finance for home health agencies with annual revenues in excess of $30 million.  He is a sought after speaker for state and national meetings. **** Thousands of people have attended his seminar presentation! "Great Speaker, Great Topics, Great Presentations" "Takes difficult topics and makes them easy to understand" Attendees will receive handouts and electronic media to take back to their home health agency We have applied and expect to receive 6 hours of home health administration continuing education credits from Texas Department of Aging & Disability  Services Program Topics Understanding the home health value based purchasing model How to succeed under home health value based purchasing Review final home health rules & rates for 2016 SMART marketing to grow and prosper Pricing If paid by October 8, 2015 - $269 for first person and $199 for second person If paid after October 8, 2015 - $369 for first person and $199 for second person ***********************************

PLUG IN TO WIN

Two Comprehensive Seminars Home Health - January 28-29, 2016 Hopsice - January 28-29, 2016 Balley's Las Vegas ******************************************

Preparation of Your  Medicare Cost Report

Dixon Healthcare Solutions, Inc. Prepares Medicare Cost Reports for a Flat Fee from $1,895 for Home Health Agencies and Hospices

If you would like for us to prepare your Medicare Cost Report please email  Richard@dixonhsi.com or call 321-473-8561 and ask for Richard.

Most of us like to know what it cost upfront before we purchase a product or service. We agree and offer flat fee cost report preparation so you know the price of the services in advance.  Our company strives to make the cost report preparation process as painless as possible.  We offer our cost report clients unlimited telephone consulting services to answer specific questions regarding how to gather the necessary information we need to prepare the cost report.    Our employees have over 30 years of experience preparing Medicare and Medicaid Cost Reports. We prepare cost reports for clients in over 20 different states.  Listed below are our flat fees for cost report preparation. Medicare Home Health Cost Report Preparation - from $1,895 Medicare Hospice Cost Report Preparation - from $1,895 Medicare Home Office Cost Report Preparation - from $2,495   Our Annual Cost Report Preparation Package includes: Medicare Cost Report  Medicare Cost Report Questionnaire  Financial Statements to accompany the Cost Report  *************************************

Final Home Health Episode Payment Rates 2016

Listed below are the National Standardized 60-Day Episode Payment Amounts.  Remember these rates will be adjusted for each home health agencies wage index and the individual Medicare patients case mix.

Urban Agencies that submit quality data - $2,965.12

Urban Agencies that do not submit quality data - $2,906.92

Rural Agencies that submit quality data - $3,054.07

Rural Agencies that do not submit quality data - $2,994.13

Listed below are the LUPA payment rates for episodes with four visits or less.  Remember these rates must be adjusted for wage index.

Discipline	Urban Agencies Submitting Quality Data	Urban Agencies Not Submitted Quality Data
SNC	$134.42	$131.79
PT	$146.95	$144.07
OT	$147.95	$145.05
SP	$159.71	$156.58
MSW	$215.47	$211.24
HHA	$60.87	$59.68

Discipline	Rural Agencies Submitting Quality Data	Rural Agencies Not Submitted Quality Data
SNC	$138.45	$135.74
PT	$151.36	$148.39
OT	$152.39	$149.40
SP	$164.50	$161.28
MSW	$221.93	$217.58
HHA	$62.70	$61.47

CMS has also finalized the Home Health Value-Based Purchasing Model.  The states that have been selected for the HHVP Model are Arizona, Florida, Iowa, Maryland, Massachusetts, Nebraska, North Carolina, Tennessee, or Washington you will be required to participate in the model beginning on January 1, 2016.  Actually they have already been collecting data for their base year which will be 2015.

If you are located in one of the 9 states listed above you have 60 days to be ready for HHVPM to begin.  We have two timely One Day Seminars that will give you the information you need to prepare for the changes.  They are titled Winning Strategies – Home Health Value Based Payments.  The first seminar will be held in Louisville, KY on November 10^th.  The second seminar will be held in Orlando, FL on November 17^th.  The seminar topics are:

Understanding the Home Health Value-Based Purchasing Model

How to Succeed Under Home Health Value Based Purchasing

Review of Final Home Health Rules and Rates for 2016

SMART Marketing to Grow and Prosper

 We are pleased to offer $100 per person discount off the current rate because of a sponsorship by TurboQuisine.  The discounted rate including the $100 discount is $269 for the first person and $199 for additional people from the same agency.  

We have a Temporary Link to the Final Rule because the final rule will not be published in the Federal Register until November 5^th.

https://s3.amazonaws.com/public-inspection.federalregister.gov/2015-27931.pdf

We developed a free 10 minute video that could help you to solve 5 major issues impacting your home health agency.  We have always tried to have our clients, seminar attendees and friends to learn to think outside the box.  This video really hits on that point.  Watch the video and let us know your opinion.

For more information please use the following link

https://youtu.be/NeU5PPcrqz4

Final Home Health PPS Rules & Rates for 2016 - 11/2/2015

CMS has issued the Final Home Health PPS Rules & Rates for 2016 late Thursday October 29^th.  This is the second of several email alerts that we will publish this week on the information contained in the proposed rules & rates for 2016.  Listed below are the national 60 day episode payment rates.  Remember these must be adjusted by wage index and case mix.

Description                                                        2016 Rates          2015 Rates          Decrease

Urban Rate Quality Data Submitted         $2,965.12             $2,961.38             $3.74

Urban Rate Quality Data Not Submitted                $2,906.92             $2,903.37             $3.55

Rural Rate Quality Data Submitted           $3,054.07             $3,050.22             $3.85

Rural Rate Quality Data Not Submitted   $2,994.13             $2,990.47             $3.66

CMS has also finalized the Home Health Value-Based Purchasing Model.  The states that have been selected for the HHVP Model are Arizona, Florida, Iowa, Maryland, Massachusetts, Nebraska, North Carolina, Tennessee, or Washington you will be required to participate in the model beginning on January 1, 2016.  Actually they have already been collecting data for their base year which will be 2015.

If you are located in one of the 9 states listed above you have 60 days to be ready for HHVPM to begin.  We have two timely One Day Seminars that will give you the information you need to prepare for the changes.  They are titled Winning Strategies – Home Health Value Based Payments.  The first seminar will be held in Louisville, KY on November 10^th.  The second seminar will be held in Orlando, FL on November 17^th.  The seminar topics are:

Understanding the Home Health Value-Based Purchasing Model

How to Succeed Under Home Health Value Based Purchasing

Review of Final Home Health Rules and Rates for 2016

SMART Marketing to Grow and Prosper

 We are pleased to offer $100 per person discount off the current rate because of a sponsorship by TurboQuisine.  The discounted rate including the $100 discount is $269 for the first person and $199 for additional people from the same agency.  

We have a Temporary Link to the Final Rule because the final rule will not be published in the Federal Register until November 5^th.

https://s3.amazonaws.com/public-inspection.federalregister.gov/2015-27931.pdf

We developed a free 10 minute video that could help you to solve 5 major issues impacting your home health agency.  We have always tried to have our clients, seminar attendees and friends to learn to think outside the box.  This video really hits on that point.  Watch the video and let us know your opinion.

For more information please use the following link

https://youtu.be/NeU5PPcrqz4

CMS Issues Final Home Health PPS Rules and Rate for 2016 - 10-30-2015

CMS has rolled full speed ahead ignoring letters from Senators, members of Congress, and others issuing the Final Home Health PPS Rules and Rates for 2016.  CMS estimates that home health payments will be reduced by 1.4% or $260 million.  The changes include the third year 2.4% reduction for rebasing payments, a .97% reduction for case mix creep, and a 1.4 percent inflation increase.  We will have more emails next week on payment rate specifics.

CMS has also finalized the Home Health Value-Based Purchasing Model.  They have reduced the number of process measures from 10 to 6; have 10 outcome measures; 5 HHCAHPS measures, and reduced the number of reporting measures from 4 to 3.  CMS has made some adjustments to the payment amounts by lowering the first year to a plus or minus 3 percent.  The fifth year will be plus or minus 8 percent. 

If your home health agency is located in Arizona, Florida, Iowa, Maryland, Massachusetts, Nebraska, North Carolina, Tennessee, or Washington you will be required to participate in the model beginning on January 1, 2016.  Actually they have already been collecting data for their base year which will be 2015.

If you are located in one of the 9 states listed above you have 63 days to be ready for HHVPM to begin.  We have two timely One Day Seminars that will give you the information you need to prepare for the changes.  They are titled Winning Strategies – Home Health Value Based Payments.  The first seminar will be held in Louisville, KY on November 10^th.  The second seminar will be held in Orlando, FL on November 17^th.  The seminar topics are:

Understanding the Home Health Value-Based Purchasing Model

How to Succeed Under Home Health Value Based Purchasing

Review of Final Home Health Rules and Rates for 2016

SMART Marketing to Grow and Prosper

 We are pleased to offer $100 per person discount off the current rate because of a sponsorship by TurboQuisine.  The discounted rate including the $100 discount is $269 for the first person and $199 for additional people from the same agency.  

We have a Temporary Link to the Final Rule because the final rule will not be published in the Federal Register until November 5^th.

https://s3.amazonaws.com/public-inspection.federalregister.gov/2015-27931.pdf

We developed a free 10 minute video that could help you to solve 5 major issues impacting your home health agency.  We have always tried to have our clients, seminar attendees and friends to learn to think outside the box.  This video really hits on that point.  Watch the video and let us know your opinion.

For more information please use the following link

https://youtu.be/NeU5PPcrqz4

CMS Establishes New G Codes For Home Health and Hospice - 10/21/2015

On October 16, 2015 CMS issued MLN Matters Number MM9369.  It has added two new codes for RN and LVN/LPN visits.  This will retire the HCPCS code G0154 and replace it with new RN Code G0299 and the new LVN/LPN code G0300 for episodes that begin on or after 1/1/2016.  This change is taking place because of the change in the reimbursement payment amount for the Hospice Service Intensity Add-On payment for skilled visits provided by an RN or MSW in the last seven days of a patients life.

For more information please use the following link

https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM9369.pdf