CMS Expands Home Health Moratoriums

CMS has issued a six month moratorium on new Medicare Home Health Agencies located in the following areas:

City                                        Counties

Fort Lauderdale, FL           Broward

Detroit, MI                           Macomb, Monroe, Oakland, Washtenaw & Wayne

Dallas, TX                              Collin, Dallas, Denton, Ellis, Kaufman, Rockwall & Tarrant

Houston, TX                         Brazoria, Chambers, Fort Bend, Galveston, Harris, Liberty, Montgomery & Waller

CMS has extended the moratorium for another six months for Medicare Home Health Agencies located in the following areas:

City                                        Counties

Chicago, IL                            Cook, DuPage, Kane, Lake, McHenry & Will

Miami, FL                              Miami-Dade & Monroe

For more information please utilize the following link:

http://www.gpo.gov/fdsys/pkg/FR-2014-02-04/pdf/2014-02166.pdf

CMS Reverses Hospice Patient Vaccine Restrictions

CMS issued Transmittal 1339 on February 6, 2014 to reverse its previous rule that restricted payment for hospice beneficiary vaccines.  In the previous rule only the hospice would be eligible to receive payment for vaccines for hospice patients.  They have determined that this enforcement is too restrictive.  This removes the previous rule Change Request 8098.  Any provider will now be allowed to furnish and receive payment for vaccines to hospice beneficiaries.

For more information please utilize the following link:

http://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R1339OTN.pdf

Affordable Care Act Delayed Again

The Obama administration announced Monday afternoon that it is delaying the employer mandate for businesses with between 50 and 99 employees until January 2016.  It also made a change to businesses that have 100 or more employees.  They will still be required to cover their employees beginning on January 2015, but the percentage of employees covered by employer health insurance has dropped to 70%.

We will publish a link when the final rule is published

Palmetto Specific HIPPS Code Claim Review

Palmetto GBA will be performing service-specific prepay probe reviews on claims billed for selected Home Health HIPPS codes. Based on identified CERT errors, OIG and Med PAC reports, internal analysis and prioritization, as well as past experience, selected HIPPS codes have been identified as major risk services for J11.Palmetto GBA will be setting five service-specific probe medical review edits for HIPPS code 5CHK* (variable last digit of HIPPS Codes.) These edits will be set to select 100 claims from each of the following states: Florida, Illinois, Louisiana, Texas; and 100 claims from all the remaining 12 states within the jurisdiction.

Palmetto GBA will also be setting four service-specific probe medical review edits for HIPPS Code 5CGK* (variable last digit of HIPPS Codes.) These edits will be set to select 100 claims from each of the following states: Florida, Texas; 100 claims from the following state grouping: Illinois, Louisiana, Mississippi; and 100 claims from all the remaining 11 states within the jurisdiction.

Palmetto GBA will be setting four service-specific probe medical review edits for HIPPS code 5BHK* (variable last digit of HIPPS Codes.) These edits will be set to select 100 claims from each of the following states: Florida, Texas; 100 claims from the following state grouping: Illinois, Louisiana, Mississippi; and 100 claims from all the remaining 12 states within the jurisdiction.

For more information please utilize the following link:

http://www.palmettogba.com/palmetto/providers.nsf/ls/Jurisdiction%2011%20Home%20Health%20and%20Hospice~9FFNBY3126?opendocument&utm_source=J11HHHL&utm_campaign=J11HHHLs&utm_medium=email

CMS Post New Guidance for Homebound Status

CMS published MLN Matters Number SE1405 on January 13, 2014.  This report concerned information related to the requirements for the Face-To-Face Encounters.  It also laid out a brief description on the homebound status that would be required for patients to receive home health care.  It is very important for all home health agencies to carefully document homebound status. 

SE1405 actually listed the narrative requirements to document homebound status including some examples.  This publication will be a good reference for you and your staff.

To download the information please utilize the following link:

https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/SE1405.pdf

Temporary Hold on Home Health LUPA Claims

Medicare contractors have identified an incorrect payment calculation affecting home health claims that would be paid low utilization payment adjustments (LUPAs). To prevent these claims from paying incorrectly, Medicare contractors will hold all home health LUPA claims with "Through" dates on or after January 1, 2014 until Medicare systems are corrected. This correction should occur in early February, 2014.

Time is Running out for Home Health Agencies

Time is running out to register for our latest home health seminar!

Stepping Up For Home Health

February 3^rd to 5^th, 2014

Monte Carlo Hotel & Casino

Las Vegas, NV

The Hotel Will Release Room Block on January 6, 2014

Are you ready for ICD-10?  Do you understand the State of OASIS and Coding Now and in 2014?  Have you developed an approach to Financial Management to improve your operations?  Are you ready to prepare proper documentation to obtain Medicare payments for your patients?  Do you have a plan to respond to audits by RACs or ZPICs?  Has your agency prepared for the Medicare reimbursement changes for 2014?   Do you understand how to work with Accountable Care Organizations?  Are you ready to lead your agency through the various changes?  Have you developed a plan to grow your home health agency?  Do you understand how Developing Your Inner Game can lead you to success?  Have you implemented all the changes required by the HIPPA/HITECH Act?