Free Webinar about Colorado Home Care Benefit Programs

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Care Managers and Social Workers Earn 1 CEU Credit

Open the attached flyer to see upcoming dates and registration QR codes or, for a different time, RSVP to [email protected]

What You Need to Know to Prepare for the End of the COVID-19 Public Health Emergency (From NAHC)

The Centers for Medicare & Medicaid Services (CMS) is providing partners with guidance and resources as they plan for the eventual end of the COVID-19 Public Health Emergency (PHE) and the Medicaid continuous coverage condition established under the Families First Coronavirus Response Act. In line with that commitment, CMS will be communicating early and often with states and other partners to support planning and coordination of this unwinding process.

KEY RESOURES

CMS has created a new Unwinding homepage with additional tools and resources.

• On this page, you can find the new Communications Toolkit and graphics to help partners begin reaching out to Medicaid and Children’s Health Insurance Program (CHIP) enrollees so that they are prepared for the upcoming renewal, along with several other unwinding resources.
• The toolkit and graphics are available in both English and Spanish.

IN CASE YOU MISSED IT

On March 3, 2022, the CMS provided states with additional guidance and tools as they plan for whenever the COVID-19 Public Health Emergency (PHE) does conclude. When the PHE does eventually end, states will be required, over time, to redetermine eligibility for all people enrolled in Medicaid and CHIP. The recently released guidance will help states keep consumers connected to coverage by either renewing individuals’ Medicaid or CHIP eligibility or transferring them to other health insurance options.

WHAT PARTNERS CAN DO NOW

Right now, partners can help prepare for the renewal process by educating people with Medicaid and CHIP coverage about the upcoming changes. People with Medicaid & CHIP coverage should:

1. Update their contact information with their State Medicaid or CHIP program; and
2. Look out for a letter from their state about completing a renewal form.

Key Messages for Partners to Share

There are three main messages that partners should focus on now when communicating with people that are enrolled in Medicaid and CHIP.

1. Update your contact information – Make sure [Name of State Medicaid or CHIP program] has your current mailing address, phone number, email, or other contact information. This way, they’ll be able to contact you about your Medicaid or CHIP coverage.
2. Check your mail – [Name of State Medicaid or CHIP program] will mail you a letter about your Medicaid or CHIP coverage. This letter will also let you know if you need to complete a renewal form to see if you still qualify for Medicaid or CHIP.
3. Complete your renewal form (if you get one) – Fill out the form and return it to [Name of State Medicaid or CHIP program] right away to help avoid a gap in your Medicaid or CHIP coverage.

Hospice Payment Rate Update Proposed Rule — Comment by May 31

On March 30, CMS issued their 2023 proposed rule for Hospice (CMS-1773-P), which  would provide routine updates to hospice-based payments and the aggregate cap amount for fiscal year (FY) 2023. “This proposed rule proposes to establish a permanent mitigation policy to smooth the impact of year-to-year changes in the hospice payments related to changes in the hospice wage index.”

National rates, before geographical calculation of the wage component, are as follows:

Routine home care (days 1-60)                    $    209.14

Routine home care (days 61+)                     $    165.25

Continuous home care (daily maximum)    $ 1,505.61

Inpatient respite care                                     $    486.88

General inpatient care                                  $ 1,098.88

The following is from the CMS announcement:  

Proposed Medicare Hospice Payment Policies

This proposed rule proposes a permanent, budget neutral approach to smooth year-to-year changes in the hospice wage index. Specifically, we are proposing a permanent cap on negative wage index changes greater than a 5% decrease from the prior year (regardless of the underlying reason for the decrease) for hospices in the FY 2023 proposed rule.

Routine Annual Rate Setting Changes

As proposed, hospices would see a 2.7% ($580 million) increase in their payments for FY 2023. The proposed 2.7% hospice payment update for FY 2023 is based on the estimated 3.1% inpatient hospital market basket update reduced by the productivity adjustment (0.4 percentage point). Hospices that fail to meet quality reporting requirements receive a 2-percentage point reduction to the annual market basket update for FY 2023.

The hospice payment update includes a statutory aggregate cap that limits the overall payments per patient that is made to a hospice annually. The proposed cap amount for FY 2023 is $32,142.65 (FY 2022 cap amount of $31,297.61 increased by 2.7%.

Hospice Quality Reporting Program

This rule provides an update on the development of a patient assessment instrument, titled HOPE, which would contribute to a patient’s plan of care when adopted. This includes an update on the BETA testing and derivatives that will be achieved during this phase of testing, such as burden estimates and timepoints for collection, as well as additional outreach efforts that will be conducted during and after BETA testing and during our future plans for adoption. CMS also discusses potential future quality measures within the HQRP based on HOPE and administrative data, including HOPE-based process measures and hybrid quality measures, which could be based upon multiple sources that include HOPE, claims, and other data sources.

This rule announces a potential future update to the CAHPS Hospice Survey, which is used to collect data on experiences of hospice care from primary caregivers of hospice patients. In particular, CMS is providing an update on a mode experiment whose goal was to test the effect of adding a web-based mode to the CAHPS Hospice Survey. 

In this proposed rule, we are seeking information on our Health Equity Initiative within the HQRP by describing our current assessment of health equity within hospice. We are also seeking input on a potential future structural measure as well as responses to specific questions that would further inform future efforts. 

More Information:

• Proposed rule: We’ll accept public comments until May 31, 2022
• Hospice Center webpage

Provider Relief Fund Payment Reports Past-Due – Consequences Already Being Enforced

As reported previosuly by HHAC to our members, health care providers who received Provider Relief Fund payments exceeding $10,000 total between July 1 and Dec. 31, 2020, should have reported to the Health Resources and Services Administration by March 31 on how they used those funds. The following is an article by Bloomberg Law about providers that are already facing enforcement actions such as repayment or exclusion from receiving or retaining future PRF payments due to not having reported on the use of funds. 

Doctors Asked to Repay $100 Million in Covid Aid Absent Reports                                   

Bloomberg Law

The Department of Health and Human Services is clawing back as much as $100 million in pandemic assistance from health-care providers who didn’t comply with the agency’s reporting requirements.

Physician practices and clinics that received notices from HHS say they didn’t know there were strings attached to the money. Initial tranches of Covid-19 funds were deposited in some providers’ accounts without them asking for it.

Reminder emails about reporting requirements went to some facilities’ spam folders or to staffers who initially accepted the money but ended up leaving their jobs, according to the Medical Group Management Association, which represents health-care practices and providers.

The HHS’s Health Resources and Services Administration sent notices to non-compliant facilities on March 10, giving them 30 days to return the funds.

“If you do not return the funds, HRSA will initiate the recovery of all funds not reported on” during the first reporting period. Those providers will also be excluded from future payments, HRSA said, according to a sample letter obtained by Bloomberg Law. HRSA confirmed that the letters went out.

Roughly 10,000 recipients of the Provider Relief Fund are being asked to return anywhere from $30,000 to $250,000 by April 10, said Claire Ernst, MGMA’s director of government affairs. Meanwhile, they’re dealing with “everything from the highest inflation that we have seen in 40 years and potential variants down the line,” Ernst said.

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