Attention Hospices: Registration For National Provider Call Now Open

The Hospice Quality Reporting Program National Provider Call scheduled by CMS is on June 17, 2015, from 1:30 p.m. to 3:00 p.m. EST.

During this call, CMS will discuss the new Hospice Item Set (HIS) Manual (V1.02), with a focus on updates that were made to the HIS Manual from V1.01 to V1.02 and provide clarifications of HIS definitions and expectations for use. Providers should review V1.02, which will be available on the HIS website prior to the call.

Click here to register.

Additional information:

Event:  Hospice Quality and Hospice Item Set Manual V1.02

Topic:  Hospice Quality Reporting Program

When:  Wednesday, June 17, 2015

Time:  1:30 PM – 3:00 PM Eastern Time

Click here for more info.

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MedPAC Calls For Cancellation Of Medicare Pay Raise For Nursing Homes

In a proposed rule published in the April 20 Federal Register, CMS said it is seeking a 1.4% net hike in the nursing home Medicare payment rate. The rate increase would reflect a market basket increase of 2.6% and two deductions, including a 0.6% cut for productivity adjustment and a 0.6% cut as a forecast error adjustment. However, in a letter to CMS, MedPAC has said that it believes no update is warranted because “Medicare’s current level of payments appears more than adequate to accommodate cost growth, even before any update.”

MedPAC argues that the aggregate Medicare margin for freestanding nursing homes in 2013 was 13.1%, the 14th consecutive year it exceeded 10%. However, the American Health Care Association is now shooting back at MedPAC’s decision, claiming MedPAC’s own research shows that nursing homes operate at an overall margin of only 1.9%.

MedPAC is now calling for CMS to move toward value-based purchasing and quality reporting programs. Additionally, MedPAC has recommended that Congress eliminate the market basket update, revise the prospective payment system, and rebase payments beginning with a 4% reduction to the base rate. Comments to CMS’ proposed rule are due on June 19.

Click here to read more.

CMS Reissues Hospice CR 9114

CMS has rescinded Change Request 9114 (originally issued April 3) and has posted a replacement CR 9114. Additionally, a related Medlearn Matters article has also been posted.

CMS’ action is in response to concerns that the original issuance on April 3 was inconsistent with statements issued as part of the final hospice payment rule for FY 2015 relating to requirements surrounding designation of the attending physician. The final rule that was published in August 2014 suggested that in clearly identifying the attending physician the election statement should include the physician’s name, address or NPI. The April 3 CR indicated that the physician’s name and NPI must be included on the election statement.

In the reissued CR 9114, CMS “has revereted to the language included in the final rule. Because the new attending physician requirements were effective October 1, 2014 and the new language is reflective of what was included in the final payment rule, the effective date of changes in the revised CR9114 is October 1, 2014.”

NAHC has included two excerpts from the new CR 9114 on the attending physician designation to represent language that will be incorporated in Chapter 9 of the Medicare Benefit Policy Manual.

Click here to read more from NAHC.

Legislation Introduced To Expand Access To Remote Monitoring & Telehealth

Bipartisan legislation has recently been introduced to the House that would expand access to remote monitoring and telehealth. The Telehealth Enhancement Act of 2015 would make significant changes in federal laws pertaining to remote monitoring and telehealth. The legislation builds off a previous bill, the Telehealth Enhancement Act of 2013, which sought to adjust Medicare home health payments to account for remote patient monitoring and to expand coverage to all critical access and sole community hospitals.

The major provisions in the bill include the following:

  • Incentives for Medicare’s hospital readmission reduction program;
  • Ensuring the use of telehealth in health homes and medical homes;
  • Allow flexibility in ACO coverage of telehealth; and
  • Add additional sites to be considered originating sites for purposes of payments for telehealth services under Medicare such as a ‘home telehealth site.’

Click here to read more.

New Legislation Introduced To Refine Hospice F2F Requirements

New legislation (HR 2208, The Hospice Commitment to Accurate and Relevant Encounters ACT – Hospice CARE) has been introduced to address “key issues related to the requirement that hospice providers conduct a face-to-face encounter with patients entering their third or subsequent benefit period to gather information that helps support documentation for continuing eligibility for hospice care.” The legislation would make the following changes into law:

  • It would allow any of the following practitioners to conduct the hospice face-to-face encounter: hospice physician, nurse practitioner, clinical nurse specialist, or physician assistance, or other health professional as designated by HHS.
  • In cases of a new readmission to hospice care where exceptional circumstances exist, it would allow the face-to-face encounter occur no later than seven calendar days after the individual’s election of services.

Click here to read more.

DOL Proposes Changes To Overtime Exemption For Salaried Workers

On May 5, 2015, the U.S. Department of Labor submitted a proposed rule for review by the Office of Management and Budget (OMB) to modify the standards of the application of overtime exemptions for professional and executive personnel who are paid on a salary basis. Although the details of the rule are not yet available, it is expected that the rule change will raise the minimum salary level required for an application of the exemptions and tighten the standards for determining whether an employee is a “professional” or an “executive.”

Currently, the minimum salary necessary to qualify for exemptions is $455 per week. In March of last year, President Obama stated that he wanted the standards to be updated an ordered the Department of Labor to begin revising the rules.

Although there are many speculations on the content of the proposed rule, many observers expect the minimum salary level for qualification for the exemptions will likely double. The proposed rule is expected to be released by OMB in a matter of weeks.

Click here to read more.

OSHA Revises Guidelines For Preventing Workplace Violence

The Department of Labor, Occupation Safety and Health Administration (OSHA) has issued a revised version of their Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers. It has been updated from OSHA’s 1996 and 2004 voluntary guidelines.

The new guidelines state that healthcare and social service workers face a significant risk of job-related violence. The Bureau of Labor Statistics (BLS) show that 27 out of 100 fatalities in healthcare and social service settings that occurred in 2013 were due to assaults and violent acts. Between 2011 and 2013, workplace assaults ranged from 23,540 and 25,630 annually, with 70 to 74% occurring in healthcare and social service settings.

The new guidelines are based on industry best practices and feedback from stakeholders, and provide recommendations for developing policies and procedures to eliminate or reduce workplace violence in a range of settings.

Click here to see OSHA’s revised guidelines.

Click here for more info on preventing workplace violence.

Click here to read more.