NAHC Report for July 30, 2020

Hospice PEPPER Available

The Hospice PEPPER, a data report that contains a single hospice’s claims data statistics (obtained from the UB-04 claims submitted to the Medicare Administrative Contractor (MAC)) for areas targeted by CMS as being at risk for improper Medicare payment, is now available.

Each Medicare certified hospice has access to a PEPPER (Program for Evaluating Payment Patterns Electronic Report), which contains statistics for these target areas, regardless of whether the hospice’s data are of concern. The report shows how a hospice’s data compares to national, MAC jurisdiction and state statistics for the three most recent years. Hospices must download their PEPPER via the PEPPER Portal.  

Hospices can also access a User’s Guide and other PEPPER resources from the PEPPER Resources webpage.

NAHC is planning for a Hospice PEPPER webinar to be held in the near future.

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Key CMS Updates for Hospice & Home Care in New Open Door Forum

The Centers for Medicare & Medicaid Services (CMS) held a Home Health, Hospice, & DME Open Door Forum (ODF) on July 29. This is the first ODF held since the current Public Health Emergency (PHE) began. A summary of this ODF is below.

Read Full Article

NAHC Report for July 29, 2020

Home care and hospice workers are on the front line of the fight against the spread of the COVID-19 pandemic and they face more risks to their own health than almost anyone. These heroes deserve more than our thanks – they deserve our support and protection. As Congress crafts additional legislative responses to the pandemic, it is imperative that a set of core principles be considered for an equitable, effective, and efficient deployment of programs. Tell Congress to give our front line workers in the home the protection and compensation they deserve. Take action now!

ForwardHealth Updates

The Wisconsin Department of Health Services (DHS) has released two new ForwardHealth Updates that explain Electronic Visit Verification (EVV) policy and training:

• ForwardHealth Update 2020-31, “Implementation of Electronic Visit Verification for Personal Care and Supportive Home Care Services”
• ForwardHealth Update 2020-32,“Electronic Visit Verification Training for Personal Care Services and Supportive Home Care Services”

Next Steps

Non-Medicaid-Enrolled Providers

The EVV soft launch starts November 2, 2020, in Wisconsin. To prepare, provider agencies that do not have a Medicaid ID will need to obtain a unique provider agency ID. This includes provider agencies that plan to use an alternate EVV system and those who operate a self-employed business.

• Learn how to obtain a unique provider agency ID.
• Start the process to obtain a unique provider agency ID.

The provider agency ID is generated in real time and will display once you have finished submitting your information.

Medicaid-Enrolled Providers

Review the email listed on the Mailing Address panel in the demographic maintenance tool in your secure ForwardHealth Portal account, and update the email address if necessary. DHS will use this provider agency email address for EVV communication with providers. DHS must have the correct email on file for the individual in your organization that is responsible for the administration of EVV.

Please complete the email verification by July 31, 2020, to ensure receipt of needed EVV information.

Training

For information about and to register for EVV training, go to the EVV Training webpage. Training begins mid-August and is required to access the DHS-provided EVV system.

The Wisconsin Association for Home Health Care joined a coalition of medical societies in Wisconsin that created an open letter to the people of Wisconsin on the importance of wearing masks and social distancing to help curb further spread of COVID-19. 

Read letter.

The Wisconsin Department of Health Services (DHS) invites you to attend a Medicaid Telehealth Expansion interactive webinar.

Agenda

This webinar will seek your response to DHS’s proposed launch of Wisconsin Act 56: Telehealth Expansion, which will significantly expand Wisconsin Medicaid’s permanent telehealth policy. The presentation will include the following items:

1.       General overview of telehealth expansion

2.       General policy information

3.       Wave 1 priority acute and primary service areas:

4.       Proposed services included in telehealth

5.       Proposed services excluded from telehealth

6.       Input from attendees

Following the presentation, DHS will take questions from attendees via the DHS telehealth mailbox.

How to join

Thursday, July 30, 10:30 am – 12:00 pm

Click this URL to join; Password: 07302020

Join by phone: 646-558-8656; Webinar ID #933 1403 1869

Friday, July 31, 2:00-3:30 pm

Click this URL to join; Password: 07312020.

Join by phone: 646-558-8656; Webinar ID #999 9957 0817

Wisconsin Association for Home Health Care Announces

2019-2020 “Friend of Home Health Care” Recipients

Designation bestowed on select group of legislators

(Madison, WI) – Today, the Wisconsin Association for Home Health Care (WiAHC) announced its 2019-2020 “Friend of Home Health Care” recipients. The designation is meant to publicly identify Wisconsin State Legislators that supported the expanded utilization of home health care as an effective, affordable option for post-acute care.

The 2019-20 “Friend of Home Health Care” recipients include the following legislators:

“These legislators were critical to our legislative success and championed our most important priorities,” said Lisa Kirker, Chair of the WiAHC Board of Directors. “Home health care agencies across Wisconsin are grateful for the support and partnership of these individuals.”

WiAHC was very active during the 2019-2020 legislative session in educating legislators on the workforce issues facing home health care agencies and how increasing MA reimbursement rates can alleviate financial burden as well as attract new staff. WiAHC was successful in advocating for the introduction of Assembly Bill 447/Senate Bill 416, which aimed to increase MA reimbursement rates by 10% for home health visits. The bill received a public hearing in the Senate Health Committee, and WiAHC is hopeful there will be continued interest in the legislation next session. WiAHC also successfully advocated for legislation that allowed all MA reimbursable services to be conducted via telehealth.

WiAHC is a membership-based association that represents home health care agencies and their staff. WiAHC helps to support the common interests of its members to promote home health care as a quality, cost-effective health care option in our state. Home health care services are not the same as personal care services. Home health care services are medical, skilled nursing services as opposed to personal care services administered by non-health care professionals.

Do you know a colleague who would be a great fit for the Board? Submit a nomination today!

WiAHC is run by a volunteer Board of Directors. Board members are elected annually to staggered three-year terms. Board members develop and manage affairs of the Association and are supported by Committee Chairs and staff. Positions include Chair, Vice-Chair, Secretary/Treasurer, Regional and At-Large Representatives. 

Positions serve a three-year term, starting January 2021. Those elected will also be invited to attend the final Board meeting of 2020. 

To be eligible, a nominee's home health agency must be a current member of WiAHC. 

How to Nominate

Nominating is easy, quick and simple! Submit a nomination using the form below. 

The deadline to submit nominations is August 20, 2020.

Click here

In a 6-0 decision, the Wisconsin Supreme Court reinstated a 2016 circuit court order prohibiting the Wisconsin Department of Health Services (DHS) from recouping Medicaid payments made to Medicaid providers “if the provider’s records verify that the services were provided and the provider was paid an appropriate amount for such services, notwithstanding that an audit identified other errors or noncompliance with [DHS] policies or rules.”

The Supreme Court labeled DHS’ recoupment policy for such services provided a “perfection policy” and held that such a policy was not consistent with Wisconsin’s Medicaid recoupment statute or administrative rules.

The case, Papa vs. Wisconsin Department of Health Services, involved the extent of DHS’ authority to require repayment from providers for previously paid claims based on failure to follow all documentation and other technical requirements contained in a confusing series of administrative rules in the Forward Wisconsin Provider Handbook, technical bulletins and other sources. In 2016, a Waukesha County Court found that DHS’ position that compliance with all technical and documentation requirements by providers as a prerequisite for payment amounted to a “Perfection Rule” that exceeded its authority to recoup payments otherwise properly made. However, the Wisconsin Court of Appeals overturned that decision in July 2019.

In today’s 6-0 decision, the Supreme Court reversed the Court of Appeals and restored the county court’s 2016 order limiting DHS’ authority to recoup payments, concluding that “so long as DHS can verify that a covered service was actually provided, the claim was appropriate, and the claim was accurate, DHS cannot recoup payments based on a record imperfection. A record imperfection alone is not an independent basis for recouping payments.” The decision provides clarity and greater certainty for physicians, who could otherwise face demands for repayment of thousands of dollars months or years after the fact based entirely on unintentional documentation errors.

Thursday, August 6, 2020
10:30 a.m. – 12:00 p.m. CST

Program Description:

Post-acute care is key for accelerating hospital throughput to ensure beds are available during potential Covid-19 surges and for providing critical rehabilitation services for patients with and without a Covid-19 diagnosis. But the epidemic has upended the role post-acute should play, particularly the transition patterns between acute and post-acute providers.

Learn how each post-acute setting fits into a hospital’s updated discharge strategy and find opportunities to optimize relationships and support post-discharge care.

Learning Objectives:

At the conclusion of the webinar, attendees will be able to:

• Describe how the COVID-19 pandemic has altered the role post-acute should play
• Describe how each post-acute setting fits into a hospital’s discharge strategy
• Identify the opportunities to optimize relationships and support post-discharge care

Intended Audience:

CMOs, CNOs, Quality Leaders, Skilled Nursing, and Home Health

Featured Presenters:

Jared Landis is the Executive Director over the Advisory Board’s post-acute research practice and a national spokesperson for the company—regularly presenting at industry conferences such as the American Health Care Association, National Association for Home Health and Hospice, and Leading Age. In 2010, he helped launch and continues to lead the Post-Acute Care Collaborative, which provides original research and dedicated resources to assist post-acute and long-term care providers, as well as hospital systems. Jared is a subject matter expert (SME) in post-acute market trends, post-discharge care management initiatives, and acute/post-acute alignment strategies. Jared is a 2005 graduate of Duke University with a Bachelor of Arts in Economics.

Questions:

For registration questions, contact Allison Taylor at ataylor@wha.org.

Fee:

There is no cost for this webinar.

Register Here!

On Monday, June 29, the Governor’s Task Force on Caregiving held a public listening session to gain input from stakeholders on the task force’s draft proposals. WiAHC members Leah Perras, , Executive Director of Transitions at Home, and Greg Von Arx, CEO of Recover Health testified at the listening session. Perras’ and Von Arx’s testimony was aimed at the task force’s failure to propose a Medicaid reimbursement rate increase for home health services despite previous testimony to the task force requesting such an increase.

“Wisconsin is lagging behind the nation in ensuring home health can adequately compete for staffing against other sectors of the healthcare industry despite growing demand for home health care services,” Perras said. “Due to Medicaid rates in Wisconsin, home health agencies pay below the state average for the same position across other sectors of the medical industry. As growth in the utilization of home health care services continue, today’s workforce challenges will only get worse.”

Perras explained that Wisconsin is well below the national average when it comes to RNs working in home health settings. RNs working in home health settings make up just 6% of the total nursing workforce in the state, according to the Wisconsin Center for Nursing. Nationally, RNs working in home health settings make up nearly 13% of the total nursing workforce, according to the Bureau of Labor Statistics. Unfortunately, home health agencies regularly lose highly skilled nurses to other sectors, mostly due to compensation potential.

According to CMS, patients’ homes are considered the ideal care setting, which is causing rapid growth in the industry, faster than most other health care categories since 2013. Increased utilization will also be necessary for the aging Baby Boomer generation.

“While healthcare inflation has grown 32.3% and Low Utilization Payment Adjustment (LUPA) rates, which are federally averaged Medicare rates, have increased by 26%, Wisconsin’s Medicaid reimbursement rate for home health services has increased 0% over the last ten years,” Von Arx told the task force.

During the 2019-20 legislative session, WiAHC worked with a large bipartisan group of lawmakers on legislation to increase the Medicaid home health visit rate by 10 percent. The bill, Senate Bill 416/Assembly Bill 447, received a public hearing in the Senate Health Committee and had considerable support in both the Senate and Assembly. WiAHC is hopeful a recommendation from the task force would assist in increasing awareness on the urgency of the issue facing Wisconsin’s home health agencies.

WiAHC lobbyists are also submitting a memo to the task force and will continue to advocate for including a rate increase in the task force’s final proposal.