APDA Update

APDA News & Covid-19 Updates July 2020

Topics for today's Newsletter

July 21, 2020 HHS Announces National COVID-19 Testing Implementation Forum
July 17, 2020 SNFs dealing with false positive Covid 19 results
July 14, 2020 Trump Administration announces initiative for more & faster Covid 19 testing in nursing homes
July 13, 2020 HHS & OIG phone #s used in spoofing scam
Reminder to start using the new ABN form by 8/31/2020
Failure to perform a HIPAA Risk Assessment can be costly!
July 13, 2020 CMS continues to monitor fraud & abuse - Longwood Management to pay $16.7M in false claims & Consulate Healthcare-owned by Formation Capital is to pay $250M in false claims & up-coding
Confused about Covid 19 symptoms? CDC creates a Self Checker.

APDA & Industry News

The Nursing Home Industry and interested parties are watching.... .

As APDA and NASL work with CMS and Novitas fighting for fair and equal Transportation reimbursement for Portable X-ray providers- the rest of the long term industry is watching. McNights Long Term Care News has written an article " Nursing homes in 11 states may soon see reduction in transportation rates for portable X-ray suppliers" emphasizing concern for the possibility of decreased or loss of access to portable x-ray services-causing the SNF to send their elderly residents to the Emergency room.

Stay tuned for more information about APDA's Fall Annual Conference and Expo!

Should we head to Austin, TX? or Should we have a Virtual Conference in October?

Due to Covid 19, APDA is considering a Virtual vs a live Fall Conference this year.

The APDA conference committee is diligently working on behalf of its members and industry partners in an effort to bring everyone a most unique and informative conference - whether that be Virtual or Live ......we would like to get your opinion...please write us at membership@apdahealth.com

CMS Continues to monitor Fraud and Abuse:

According to Skilled Nursing News, Longwood Management Corporation, (a California based company) along with 27 individual affiliated skilled nursing facilities, will pay $16.7 million to settle federal allegations of rehabilitation billing fraud, the Department of Justice announced Monday.

"The settlement also covers false claims the government says were submitted between January 2006 and October 2014..." "The government accused the Los Angeles-based firm of pressuring therapists to hit predetermined targets for rehab minutes under the Ultra High category, which provided the greatest Medicare reimbursements under the since-retired Resource Utilization Group (RUG) payment system."

Consulate Health Care faces $250M fraud judgement. According to Naples News, An appeals court last week affirmed part of a jury’s finding that Consulate Health Care, which operates a tenth of all Florida nursing homes, systematically defrauded the government by providing medically unnecessary treatments to patients." The chain – a network of related businesses – is owned by Atlanta-based private equity firm Formation Capital, which manages $3.5 billion in assets, according to a Senior Housing News report. " The company owns & controls 150 NH and ALFs in the southeast and mid Atlantic states. " The whistleblower lawsuit against Consulate was filed in 2011 by Angela Ruckh, a nurse who worked at two North Florida nursing homes that are part of the chain that purchased Consulate and took its name." "In the lawsuit, she accused the company of up-coding patients on Medicare to make them look as if they needed more care and services than they actually did. They then provided patients with unnecessary and sometimes harmful therapies so the company could bill the government more."

Fraud Alert: HHS OIG Phone numbers used in Scam

HHS and OIG have "confirmed that official HHS OIG telephone numbers are being used as part of a spoofing scam targeting individuals throughout the country. These scammers represent themselves as HHS OIG employees and can alter the appearance of the caller ID to make it seem as if the call is coming from HHS OIG phone numbers found on its public website."

Don't Forget...Start using New ABN form on 8/31/2020.

The Advance Beneficiary Notice of Noncoverage (ABN), Form CMS-R-131, is issued by providers (including independent laboratories, home health agencies, and hospices), physicians, practitioners, and suppliers to Original Medicare (fee for service - FFS) beneficiaries in situations where Medicare payment is expected to be denied. The ABN is issued in order to transfer potential financial liability to the Medicare beneficiary in certain instances. Guidelines for issuing the ABN can be found beginning in Section 50 in the Medicare Claims Processing Manual, 100-4, Chapter 30 (PDF) .

The Failure to Conduct a HIPAA Risk Assessment Can be Costly

Do you know how and when to conduct a HIPAA risk Assessment? Do you know that the fines for not recognizing or performing a Risk Assessment following a breach can be higher than the breach itself? " ... since the start of the second round of HIPAA audits, fines have also been issued for potential breaches of PHI. These are where flaws in an organization´s security have not been uncovered by a HIPAA risk assessment, or where no assessment has been conducted at all. In March 2016, North Memorial Health Care of Minnesota paid more than $1.5 million to settle related HIPAA violation charges." " Conducting a HIPAA risk assessment on every aspect of an organization´s operations – no matter what its size – can be complex. This is particularly true for small medical practices with limited resources and no previous experience of complying with HIPAA regulations. Consequently, in 2014, OCR released a downloadable Security Risk Assessment (SRA) tool that helps small and medium sized medical practices with the compilation of a HIPAA risk assessment."

Covid-19 Updates

Comments, Questions? Please send them to Rosie (in the subject line) at: membership@apdahealth.com

July 17, 2020 False Positive Covid 19 results with Antigen Testing?

Christopher Laxton, the executive director of AMDA — The Society for Post-Acute and Long-Term Care Medicine, stated as per Skilled Nursing News...“Truthfully, the biggest question and concern we have is the false positive rate , and the reliability and sensitivity — especially sensitivity — on the antigen test,” he said. “Do they actually pick up COVID, or are they picking up anything — any kind of coronavirus, or corona-like virus?”

July 14, 2020 Trump Administration Announces Initiative for More and Faster COVID-19 Testing in Nursing Homes

As per HHS.gov, Nursing Homes will have access to rapid point of care testing. Both the Quidel Sofia and Sofia 2 Instruments and BD Veritor Plus Systems use antigen tests that can quickly detect fragments of proteins found on or within the virus by testing samples collected from the nasal cavity using swabs, providing results in minutes. Antigen tests will play a critical role in the fight against COVID-19 and will be essential to reach the Nation’s goal of testing millions of Americans each day.

Distribution will begin next week with nursing homes prioritized by Centers for Medicare & Medicaid Services (CMS) in their continuing effort to protect older adults. Each nursing home will receive one diagnostic test instrument and associated tests. Following initial distribution, nursing homes can procure additional tests directly from the respective manufacturers. Nursing homes must have the capability to screen and test residents, and test staff on a weekly basis or according to specific guidance by the state and local health departments. This procurement will also enable testing of visitors if appropriate for that facility.

Confused about Covid 19 Symptoms? Do you think you have Covid 19? Should you get tested?

The CDC has a convenient Self Checker on their website. The Self Checker is a personalized Q&A to help you determine what to do if you suspect yourself, an employee or co-worker may have Covid 19.

More on Guidance for Cleaning & Disinfecting - CDC recommends employers develop, implement, update and revise their cleaning & Disinfecting processes .

Read about EPA approved disinfectants and disinfectants when approved ones are not available-along with recommended cleaning processes.

The Value of APDA Membership

APDA is the only association representing the Portable Diagnostic industry.

This industry needs your support........

A strong membership is key to fighting for your issues, reimbursement and representation. Learn More

Empower your business with benefits for APDA Members only

Not a Member? Don't wait! - There has never been a better time to be a member

-Discounts on conference registration fees

-Access to Industry Vendor special pricing

-Special emails and Updates on the latest news and policy developments dedicated to Portable Diagnostic Providers sent to Members Only

-Receive a MEMBERS ONLY complete edition of APDA's Monthly e-News

-Quarterly Webinars - FREE to members only

-Unmatched opportunities to network with fellow Portable Diagnostic Providers

Renew or Join Here

APDA WELCOMES NEW MEMBERS!

Maven Imaging - A California based company specializing in portable x-ray pacs & cloud imaging sharing

UltraX Imaging - A Portable x-ray & Ultrasound company based in Michigan and Ohio

APDA Thanks & Appreciates Its Members and their Staff for the Hard work and contributions they make everyday as essential workers-caring for and keeping our elderly patients safe during this Covid Pandemic!

Questions or comments? We would like to hear from you!

Please contact Rosie Crawford - membership@apdahealth.com

We Are Social: