You're receiving this email because of your relationship with the Office of Inspector General, Division of Health Care. Thank you for your continued commitment to serving the citizens of our Commonwealth!
Cabinet for Health & Family Services
Office of Inspector General
Division of Health Care
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Home Health Agency Newsletter
August 2019
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HHAs: CY 2020 and 2021 New Home Infusion Therapy Benefit and Payment and Policy Changes
On July 11, CMS issued a proposed rule [CMS-1711-P] that proposes routine updates to the home health payment rates for CY 2020, in accordance with existing statutory and regulatory requirements. This rule will also include:
- Proposal to modify the payment regulations pertaining to the content of the home health plan of care
- Proposal to allow therapist assistants to furnish maintenance therapy
- Proposal related to the split percentage payment approach under the Home Health Prospective Payment System (PPS)
- Proposals related to the implementation of the permanent home infusion therapy benefit in 2021
This proposed rule sets forth implementation of the Patient-Driven Groupings Model (PDGM), an alternate case-mix adjustment methodology, and a 30-day unit of payment as mandated by the Bipartisan Budget Act of 2018 (BBA of 2018). CMS projects that Medicare payments to Home Health Agencies (HHAs) in CY 2020 will increase in aggregate by 1.3 percent, or $250 million, based on proposed policies. The increase reflects the effects of the 1.5 percent home health payment update percentage ($290 million increase) mandated by BBA of 2018. It also reflects a 0.2 percent decrease in aggregate payments due to reductions made by the new rural add-on policy mandated by the BBA of 2018 for CY 2020 (i.e., an estimated $40 million decrease in rural add-on payments). The rate updates also include adjustments for anticipated changes with implementation of the PDGM and a change to a 30-day unit of payment, the use of updated wage index data for the home health wage index, and updates to the fixed-dollar loss ratio to determine outlier payments.
In addition, the proposed rule includes:
- Proposed payment rate changes for home infusion therapy temporary transitional payments for CY 2020
- Payment proposals for new home infusion therapy benefit for CY 2021
- Regulatory burden reduction – Patients over paperwork and enhance and modernize program integrity
- Paraprofessional roles – Improving access to care
- Home Health Quality Reporting Program – Support MyHealthEData Initiative
- Home Health Value-Based Purchasing model
For More Information:
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Register for an iQIES Account - Action Required
Dear Home Health Agency (HHA):
The Quality Improvement and Evaluation System (QIES), which providers and vendors use to submit assessment data, is being upgraded to make the system more reliable, scalable, secure, and accessible. The enhancements will occur in phases (by provider type) and began with Long- Term Care Hospitals (LTCHs) in March 2019, to be followed by Inpatient Rehabilitation Facilities (IRFs) in October 2019 and Home Health Agencies (HHAs) in January 2020. The enhanced system is referred to as the Internet Quality Improvement and Evaluation System (iQIES).
The initial rollout of iQIES will not change how providers or vendors submit data. However, iQIES will require a new user management system because virtual private network (VPN) and CMSNet are no longer needed to access this system. All users will have to create an account and establish credentials in the Healthcare Quality Information System (HCQIS) Access, Roles and Profile system (HARP). HARP is a secure identity management portal that the Centers for Medicare & Medicaid Services (CMS) provides.
Click
HERE
to view full instructions...
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Blueprint for OASIS Accuracy is Coming to a City Near YOU!
Did you know that OASIS Answers' signature training event is offered throughout the country this fall? Make plans now to register early and secure the best rate!
Experience the comprehensive and nationally acclaimed two-day Blueprint for OASIS Accuracy workshop and learn to confidently teach, audit and collect OASIS items accurately. Through guided, expert instruction and participation in problem-solving discussions and application scenarios, achieve mastery of the OASIS items, conventions and the latest data collection rules.
Click
HERE
for registration details.
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OASIS Answers Home Health Training Webinars
The OASIS Answers, Inc. (OAI) "Just in Time" monthly home health training webinars are designed to provide the most innovative training to your clinicians, clinical leaders, quality improvement teams and auditors. These sessions will ensure that you are aware of and know how to apply the most recent, most relevant, and most accurate CMS home health information. Monthly topics are based on the issues that are most pertinent to agencies for the month and will be driven by CMS updates or changes that are critical to agency success.
Upcoming sessions are available in either a Live or Recorded format. Previously aired webinars are offered as a recording only. Take a peek and see how the OASIS Answers' webinar series can supplement your organization's training!
Click
HERE
for to reserve your spot!
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Home Health Quality Reporting Program Measure Calculations and Reporting User's Manual - Version 1.0
The Centers for Medicare & Medicaid Services (CMS) Home Health (HH) Quality Reporting Program (QRP) has posted the first version of the of the HH QRP Measures Calculations and Reporting User’s Manual. This manual presents the methods used to calculate the quality measures (QMs) that are included in the HH QRP and reported on the
Home Health Compare website
. It comprises detailed information for each QM, including definitions, inclusion and exclusion criteria, and QM calculation specifications. A complete version of the HH QRP QM User’s Manual may be found on the
HH QRP Quality Measures page
.
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Interested in Serving on an IDR Panel?
Kentucky requires one member of the IDR panel to be "a person currently engaged in the provision of Home Health Agency services who has no affiliation with the provider disputing a deficiency." Typically, a Home Health Agency Director is on each IDR panel. There is no payment or travel reimbursement for a Director serving on a panel. Directors will be rotated. If a
Home Health Agency Director
is interested in serving on a panel, a confidentiality statement must be signed prior to the participation in the first IDR panel.
Chrystal Daugherty, IDR/IIDR Coordinator
Office of Inspector General
116 Commerce Ave.
London, KY 40744
Fax: (606) 330-2054
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Home Health Agency Questions and Answers
Home Health Agency (HHA) Providers can access the Home Health and OASIS Q&As and other reference manuals on the
HHA Providers Reference site
.
These Questions and their responses have been developed over many years of experience training OASIS coordinators and are currently used as part of the Home Health Agency Surveyor Training program. They can and should be used by home health agency providers in training new staff on the basics of OASIS and also as a refresher for existing staff.
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OASIS Answers, Inc.
is a team of experienced nursing and therapy professionals who concentrate their skills, experience and passion to meet the needs of clients at the state association, federal government, quality improvement organization, private industry, and individual provider levels.
Click here
for the latest information on their webinars.
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OASIS CONTACT INFORMATION
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Chrystal Daugherty
Assessment/Coding Questions
Rhonda Littleton-Roe
Transmission or Technical Questions
Sam Crossfield
HHA Licensing or Regulation Questions
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Please note:
Do not send any identifiable patient information through e-mail. This includes patient names, SSNs, dates of birth or any other data items considered identifiers or Protected Health Information (PHI) under HIPAA. Please redact any PHI prior to sending.
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OASIS Data Specifications
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KARES
To enroll in KARES voluntarily, please click the icon above and follow the self-directed enrollment process.
For additional information about the program, please contact the help desk at (502)564-2159 or
via email
.
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Click here
to visit the website or
click here
for guidance on how to verify and update home health demographic data.
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Reporting Complaints
Email addresses have been established for use by patients and the general public to report possible violations of regulatory requirements.
Click Here
for the email addresses and additional contact information based on the facility's location.
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Which Branch
is Serving You?
To provide the highest level of service, the Division of Health Care operates through four regional offices. Knowing the appropriate Branch to contact with questions and concerns will ensure you receive maximum service in minimum time. Review links below for detailed information.
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CMS Survey and Certification memoranda, guidance, clarifications and instructions to State Survey Agencies and CMS Regional Offices.
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Medicare Learning Network
Let the Medicare Learning Network (MLN) be your home for Centers for Medicare & Medicaid Services (CMS) education, information, and resources.
Visit the
Medicare Learning Network
for free educational materials for health care professionals on CMS programs, policies, and initiatives.
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ISTW: Integrated Surveyor Training Website
This CMS website provides training information to include the preceptor manual, the State Operations Manual and other documents. As always, the survey and certification process is a collaborative effort between CMS and providers. This website will allow providers the opportunity to take the same courses as surveyors.
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Want to Know the Top 10 Citations for Home Health Agencies?
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Sign Up for This Newsletter
If you have received a copy of this newsletter from a friend or co-worker, you can click on the Sign Up button to enter your information and join our mailing list.
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Employment Opportunities
To search and apply for positions within the Office of Inspector General, please visit the Kentucky Personnel Cabinet's web page by clicking the sign above.
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DHC Leadership Team:
Inspector General
V
acant
Deputy Inspector General
Director
Assistant Director
Assistant Director
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Commonwealth of Kentucky | Office of Inspector General | 275 East Main St., Frankfort, KY 40621
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The Office of Inspector General is the regulatory and licensing agency for all health care, day care and long-term care facilities and child adoption/child-placing agencies in the commonwealth.
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