In The News

Process Revisions for Changes of Information for Medicare Certified Providers (From NAHC)

The Centers for Medicare & Medicaid Services (CMS) recently released revised instructions (Transmittal 10975/Change Request (CR) 12386) for processing of Medicare-certified provider information,  transitioning certain functions from the  Survey & Operations Group (SOG) Locations (formerly known as Regional Offices) to the Medicare Administrative Contractors (MACs) and the Provider Enrollment & Oversight Group (PEOG), which is part of the Center for Program Integrity. 

HHAC Members Click to Read Full Article

 

Public Opinion Supports the Choose Home Care Act

The Partnership for Quality Home Healthcare (PQHH) recently released the results of a new poll conducted by Morning Consult, which underscores the popularity of home health and the importance of passing the Choose Home Care Act of 2021.  

86% of adults, including 94% of Medicare beneficiaries, expressed support for the Choose Home Care Act. The poll also demonstrated wide bipartisan support, with 83% of Republicans and 92% of Democrats showing support for the legislation. 

The results of the poll are highly in favor of increasing patient choice for post-hospital care. Here are several resources regarding the poll for your use:

 

HCBS Funding Is Now in the Congressional Crosshairs

Home Health Care News / By Robert Holly
 
The $400 billion that the Biden administration wanted for strengthening the nation’s home- and community-based services (HCBS) infrastructure is likely in the crosshairs of Congress.
 
Currently, President Joe Biden and senior Democrats are working to figure out what’s included in the large spending legislation they hope to pass through the budget reconciliation process. Early estimates had a $3.5 trillion package touching on health care, education and climate change.
 
In order to pass the domestic investment plan via reconciliation, Democrats need the support of their entire party in the Senate. Yet some Senators, including Joe Manchin of West Virginia, have expressed a desire to get the spending legislation closer to $1 trillion to $1.5 trillion.
 
“Instead of rushing to spend trillions on new government programs and additional stimulus funding, Congress should hit a strategic pause on the budget-reconciliation legislation,” Manchin wrote in a recent Wall Street Journal op-ed. “A pause is warranted because it will provide more clarity on the trajectory of the pandemic, and it will allow us to determine whether inflation is transitory or not.”
 
In addition to the package’s overall price tag, Machin has expressed specific concerns about the plan to spend hundreds of billions of dollars on in-home care, according to a Tuesday report from Axios.
 
Other members of Congress have pushed back against investments in “soft” infrastructure as well.
 
Due to the lack of full-party support at the moment, funding for HCBS, which would likely be carved into the spending legislation through the recently introduced Better Care Better Jobs Act, may end up closer to $150 billion. Sens. Bob Casey of Pennsylvania and Ron Wyden of Oregon are among the key backers of the Better Care Better Jobs Act, along with Rep. Debbie Dingell of Michigan in the House.
 
Another Axios report from Friday [September 10th] said the House Ways and Means Committee was looking to invest $190 billion into HCBS.
 
Even if $400 billion is ultimately reduced to $190 billion, that would be a historic increase for HCBS providers, which for years have struggled with lackluster Medicaid rates and dire labor shortages.
 
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Vaccine Mandates: What they Mean for Home Care (Presented by NAHC)

Monday, September 20, 2021 (12:00 - 2:00 p.m. Mountain)

Home Care Vaccine Mandate Discussion with Industry Leaders and Legal Experts

Free to everyone

REGISTER NOW

 

HHS Announces the Availability of $25.5 Billion in COVID-19 Provider Funding

Combined application for American Rescue Plan rural funding and Provider Relief Fund Phase 4 will open on September 29

The Biden-Harris Administration announced today that the U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), is making $25.5 billion in new funding available for health care providers affected by the COVID-19 pandemic. This funding includes $8.5 billion in American Rescue Plan (ARP) resources for providers who serve rural Medicaid, Children's Health Insurance Program (CHIP), or Medicare patients, and an additional $17 billion for Provider Relief Fund (PRF) Phase 4 for a broad range of providers who can document revenue loss and expenses associated with the pandemic.

"This funding critically helps health care providers who have endured demanding workloads and significant financial strains amidst the pandemic," said HHS Secretary Xavier Becerra. "The funding will be distributed with an eye towards equity, to ensure providers who serve our most vulnerable communities will receive the support they need."

Consistent with the requirements included in the Coronavirus Response and Relief Supplemental Appropriations Act of 2020, PRF Phase 4 payments will be based on providers' lost revenues and expenditures between July 1, 2020, and March 31, 2021. As part of the Biden-Harris Administration's ongoing commitment to equity, and to support providers with the most need, PRF Phase 4 will reimburse smaller providers—who tend to operate on thin margins and often serve vulnerable or isolated communities—for their lost revenues and COVID-19 expenses at a higher rate compared to larger providers. PRF Phase 4 will also include bonus payments for providers who serve Medicaid, CHIP, and/or Medicare patients, who tend to be lower income and have greater and more complex medical needs. HRSA will price these bonus payments at the generally higher Medicare rates to ensure equity for those serving low-income children, pregnant women, people with disabilities, and seniors.

Similarly, HRSA will make ARP rural payments to providers based on the amount of Medicaid, CHIP and/or Medicare services they provide to patients who live in rural areas as defined by the HHS Federal Office of Rural Health Policy. As rural providers serve a disproportionate number of Medicaid and CHIP patients who often have disproportionately greater and more complex medical needs, many rural communities have been hit particularly hard by the pandemic. Accordingly, ARP rural payments will also generally be based on Medicare reimbursement rates.

"We know that this funding is critical for health care providers across the country, especially as they confront new coronavirus-related challenges and respond to natural disasters," said Acting HRSA Administrator Diana Espinosa. "We are committed to distributing this funding as equitably and transparently as possible to help providers respond to and ultimately defeat this pandemic."

In order to expedite and streamline the application process and minimize administrative burdens, providers will apply for both programs in a single application. HRSA will use existing Medicaid, CHIP and Medicare claims data in calculating payments. The application portal will open on September 29, 2021. To help ensure that these provider relief funds are used for patient care, PRF recipients will be required to notify the HHS Secretary of any merger with, or acquisition of, another health care provider during the period in which they can use the payments. Providers who report a merger or acquisition may be more likely to be audited to confirm their funds were used for coronavirus-related costs, consistent with an overall risk-based audit strategy. 

To promote transparency in the PRF program, HHS is also releasing detailed information - PDF (PDF - 175 KB) about the methodology utilized to calculate PRF Phase 3 payments. Providers who believe their PRF Phase 3 payment was not calculated correctly according to this methodology will now have an opportunity to request a reconsideration. Further details on the PRF Phase 3 reconsideration process are forthcoming.

Additionally, in light of the challenges providers across the country are facing due to recent natural disasters and the Delta variant, HHS is announcing today a final 60-day grace period to help providers come into compliance with their PRF Reporting requirements if they fail to meet the deadline on September 30, 2021, for the first PRF Reporting Time Period. While the deadlines to use funds and the Reporting Time Period will not change, HHS will not initiate collection activities or similar enforcement actions for noncompliant providers during this grace period.

For more information about eligibility requirements, the documents and information providers will need to complete their application, and the application process for PRF Phase 4 and ARP Rural payments, visit: https://www.hrsa.gov/provider-relief/future-payments.

Announcement posted on: https://www.hhs.gov/about/news/2021/09/10/hhs-announces-the-availability-of-25-point-5-billion-in-covid-19-provider-funding.html

 
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