{"id":6714,"date":"2021-05-28T01:57:41","date_gmt":"2021-05-28T07:57:41","guid":{"rendered":"https:\/\/staging.amityhealthcaregroup.com\/?p=6714"},"modified":"2022-04-24T15:20:42","modified_gmt":"2022-04-24T21:20:42","slug":"may-28th-2021","status":"publish","type":"post","link":"https:\/\/staging.amityhealthcaregroup.com\/?p=6714","title":{"rendered":"Issue date: May 28th, 2021"},"content":{"rendered":"

Here are some home health related updates for this week:\u00a0<\/span><\/p>\n\n\n\n\n
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Join Amity Healthcare Group and ACHCU as we review regulatory requirements associated with the competency program, as well as discuss the impact of an effective competency program on clinical personnel, patients, and leadership. We will also discuss what makes a successful competency program.<\/span><\/p>\n

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REGISTER NOW<\/span><\/b><\/a><\/b><\/p>\n<\/td>\n

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NATIONAL NEWS<\/span><\/u><\/b><\/p>\n

Next CMS Administrator\u00a0 is Confirmed<\/span><\/u><\/b><\/p>\n

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On May 25, 2021, the United States Senate confirmed Chiquita Brooks-LaSure<\/b> to be the next administrator of the Centers for Medicare & Medicaid Services (CMS.) <\/span><\/p>\n<\/div>\n

Home Health Notice of Admission (NOA)<\/span><\/u><\/b><\/p>\n

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As we discussed in our last newsletter, CMS will be replacing Home Health Requests for Anticipated Payment (RAPs) with a Notice of Admission (NOA). On May 20, 2021 CMS issued a new MLN Matters Article MM12256 on replacing RAPs with NOAs. <\/span><\/h3>\n

The article covers updates to Chapter 10 of the Medicare Claims Processing Manual to include instructions for submitting Home Health (HH) NOAs instead of RAPs on and after January 1, 2022. Please make sure your billing staffs are aware of these manual updates.<\/span><\/p>\n

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For a complete MLN article, please go to <\/u><\/span>https:\/\/www.cms.gov\/files\/document\/mm12256.pdf<\/span><\/a><\/p>\n

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OIG <\/span><\/u><\/b>Home Health Claims Audit <\/span><\/u><\/b>Report <\/span><\/u><\/b><\/h3>\n

The Office of Inspector General published an audit report that includes findings that Medicare improperly paid some claims for home health services with 5-7 visits in a payment episode. The primary objective of the audit was to determine whether payments for home health services with five to seven visits in a payment episode complied with Medicare requirements.<\/span><\/p>\n

The audit covered $1.25 billion in Medicare payments to HHAs for claims for home health services provided in 2017 (audit period). OIG selected a random sample of 120 HHA claims with 5, 6, or 7 visits in a payment episode. An independent medical review contractor determined whether the services met medical necessity and coding requirements.<\/span><\/p>\n

The OIG determined that not all payments to HHAs for home health services with five to seven visits in a payment episode complied with Medicare requirements. Of the 120 sampled claims OIG reviewed during the audit, 91 complied with requirements, and for 4 claims there was no documentation available to make a compliance determination. However, the remaining 25 claims did not comply with requirements. As a result, Medicare improperly paid HHAs for a portion of the payment episode (14 claims) and for the full payment episode (11 claims), totaling $41,613. According to OIG, \u201cthese improper payments occurred because the Medicare administrative contractors (MACs) did not analyze claim data or perform risk assessments to target for additional review those claims with visits slightly above the LUPA threshold of four visits. On the basis of the sample results, OIG estimated that Medicare overpaid HHAs nationwide $191.8 million for our audit period.\u201d<\/span><\/p>\n

Based on the findings, OIG\u00a0 recommends that CMS: (1) direct the MACs to recover the $41,613 in identified overpayments made to HHAs for the sampled claims; (2) require the MACs to perform data analysis and risk assessments of claims with visits slightly above the applicable LUPA threshold and target these claims for additional review; and (3) instruct the MACs to educate HHA providers on properly billing for home health services with visits slightly above the applicable LUPA threshold, which could have saved Medicare as much as $191.8 million during our audit period.<\/span><\/p>\n

CMS concurred with all of the recommendations and established actions to be taken to address the recommendations.<\/span><\/p>\n

For a complete report, please go to: <\/span>https:\/\/www.oig.hhs.gov\/oas\/reports\/region9\/91803031.pdf<\/span><\/a><\/p>\n

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Cost Report Filing Extension<\/span><\/u><\/b><\/p>\n

Due to the COVID-19 public health emergency, the Centers for Medicare & Medicaid Services delayed the cost report filing deadlines for all provider types with a fiscal year ending March 1, 2020 through December 31, 2020.\u00a0 The following provides the extended due dates. <\/span><\/p>\n<\/div>\n\n\n\n\n\n\n
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Cost Reporting <\/span><\/strong>
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Initial Due Date<\/span><\/strong><\/p>\n<\/td>\n

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Extended Due Date<\/span><\/strong><\/p>\n<\/td>\n

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10\/31\/2020<\/span><\/p>\n<\/td>\n

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03\/31\/2021<\/span><\/p>\n<\/td>\n

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06\/01\/2021<\/span><\/p>\n<\/td>\n

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11\/30\/2020<\/span><\/p>\n<\/td>\n

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04\/30\/2021<\/span><\/p>\n<\/td>\n

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06\/30\/2021<\/span><\/p>\n<\/td>\n

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12\/31\/2020<\/span><\/p>\n<\/td>\n

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05\/31\/2021<\/span><\/p>\n<\/td>\n

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08\/02\/2021<\/span><\/p>\n<\/td>\n

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COLORADO NEWS<\/span><\/u><\/b><\/p>\n

American Rescue Plan of 2021-Impact on Home Health and Home Care<\/span><\/u><\/b><\/h1>\n

As a part of the American Rescue Plan Act (ARPA), the Department of Health Care Policy & Financing (the Department) expects to receive an additional infusion of short-term funds to increase access to home and community-based services (HCBS) <\/span>\u00a0and other long term support programs for Medicaid beneficiaries<\/span>. <\/span><\/p>\n

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Per the <\/span>guidance from the Centers for Medicaid and Medicare Services<\/span><\/a>, in order to be eligible for these funds, the state must:<\/span><\/p>\n