In The News

A New Guide on Universal Screening for Health-Related Social Needs from the Accountable Health Communities Model

Participants in the Accountable Health Communities Model use the Accountable Health Communities Health-Related Social Needs Screening Tool to quickly identify health-related social needs, such as food insecurity, housing instability, and lack of access to transportation, among community-dwelling Medicare and Medicaid beneficiaries. The Screening Tool enables staff to take the next step of connecting beneficiaries with community resources that can address their unmet needs. A new user guide can help health care or social service providers in a wide range of clinical settings use the Screening Tool. The guide also provides key insights for implementing universal screening for health-related social needs based on the experiences of organizations participating in the Accountable Health Communities Model.

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HOME HEALTH AGENCIES DEALING WITH NEW COST REPORTING FORMS

From the Health Group, LLC 

The U.S. Centers for Medicare & Medicaid Services (“CMS”) have significantly revised the Home Health Agency Cost Report, now identified as Form 1728-20.  The new form is to be used for all cost reporting periods beginning on or after January 1, 2020.  Many agencies have already completed their filing using the new forms; however, many cost reports have not been completed.

The new cost report expanded cost centers including:

  • · Telecommunications Technology,
  • · Nursing Administration,
  • · Medical Records,
  • · LPN (previously included with RN),
  • · Physical Therapy Assistants (previously reported with physical therapists),
  • · Occupational Therapy Assistants (previously reported with occupational therapists),
  • · Telehealth,
  • · Advertising, and
  • · Fundraising.

While there are several changes, in addition to adding cost centers, the most significant change is the addition of Worksheet S-3, Part V which attempts to capture average hourly wage information, based on hours, for both employees and independent contractors.  Many agencies do not have hours for independent contractors who are paid on a method other than hourly, i.e., per-visit.  Agencies need to develop a process for securing hours from independent contractors to report accurate data.  This has already posed problems for many agencies that have already filed for the year ended December 31, 2020.

The new cost report (Form CMS-1728-20) and revised instructions can be secured at The Provider Reimbursement Manual - Part 2 | CMS.  Due to the date the changes were finalized, most agencies will incur significant effort to complete the 2020 filing appropriately.  Do not be unprepared for your 2021 filing.  Discuss the cost report changes with whoever is responsible for your cost report and prepare for 2021.

 

Home-based care expands for vulnerable Veterans in Southern Colorado

Dept. of Veteran Affairs

To improve intensive management and care coordination for Veterans, VA Eastern Colorado Health Care System expanded its home-based primary care program in Southern Colorado. An interdisciplinary team is now offering comprehensive primary care in Veterans’ homes.

Since 2014, the Southern Colorado home-based primary care team had a physician, registered nurse, nurse practitioner and social worker. In 2020, Dr. Karen Shea, a home-based primary care medical director, added another nurse practitioner, a registered dietitian and an occupational therapist. She formed a full patient-aligned care team to offer more Veterans personalized, whole-person care at home.

“There was a need down here to expand, to serve some of these Veterans who are vulnerable,” Dr. Shea said, about relocating to Pueblo in August 2019. “All of our team members come and see them in their home, and provide that care and that continuity. We see them so often they generally don’t have to go to the hospital or the emergency room. We’re able to consolidate their care and keep them in their home.”

Montez, 82, explains his watercolor works at his home in Pueblo County, Colorado.

Most patients are medically or socially complicated, or multiple medical problems make travel tough. Family members and caregivers of Veterans who need close monitoring get resources and education.

They learn about medications, advanced care planning and palliative care, which optimizes quality of life and mitigates suffering through serious illness.

“Our goal is to help them remain in their homes for as long as possible,” she added...

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CMS Extends Medical Review Dates

From NAHC

The Centers for Medicare & Medicaid Services (CMS) has announced that Medicare Administrative Contractors (MACs) may now begin conducting post-payment medical review for later dates of services.

On March 30, 2020 the Centers for Medicare & Medicaid Services (CMS) suspended most Medicare Fee-For-Service (FFS) medical review because of the COVID-19 pandemic.  On August 17, 2020 CMS resumed medical review but limited the time frame to claims with dates of service prior to March 1, 2020 (the beginning of the COVID-19 Public Health Emergency (PHE)).

The Targeted Probe and Educate program (intensive education to assess provider compliance through up to 3 rounds of review) will restart later. The MACs will continue to offer detailed review decisions and education as appropriate.

For any medical reviews for dates of service during the current PHE, providers will want to carefully examine the review decision to ensure that any PHE waivers and flexibilities were considered.  The most current waivers and flexibilities can be found here.

As a reminder the current post-payment review topics for each of the home health and hospice MACs are listed below.  CMS just announced the expansion of the dates eligible for review so these topics may be updated to reflect this and/or a change in topics.

 

CMS Bulletin: CMS Bolsters Payments for At-Home COVID-19 Vaccinations for Medicare Beneficiaries

As part of President Biden’s commitment to increasing access to vaccinations, the Centers for Medicare & Medicaid Services (CMS) today announced an additional payment amount for administering in-home COVID-19 vaccinations to Medicare beneficiaries who have difficulty leaving their homes or are otherwise hard-to-reach. There are approximately 1.6 million adults 65 or older who may have trouble accessing COVID-19 vaccinations because they have difficulty leaving home. To better serve this group, Medicare is incentivizing providers and will pay an additional $35 per dose for COVID-19 vaccine administration in a beneficiary’s home, increasing the total payment amount for at-home vaccination from approximately $40 to approximately $75 per vaccine dose. For a two-dose vaccine, this results in a total payment of approximately $150 for the administration of both doses, or approximately $70 more than the current rate.

More information on Medicare payment for COVID-19 vaccine administration – including a list of billing codes, payment allowances and effective dates – is available at https://www.cms.gov/medicare/covid-19/medicare-covid-19-vaccine-shot-payment.

More information regarding the CDC COVID-19 Vaccination Program Provider Requirements and how the COVID-19 vaccine is provided through that program at no cost to recipients is available at https://www.cdc.gov/vaccines/covid-19/vaccination-provider-support.html.

 
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