This message contains confidential information and is intended only for KHCA/KCAL membership. Dissemination, distribution or copying the contents of this email beyond this group is strictly prohibited. |
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Member Spotlight: Plaza West Healthcare & Rehab - Topeka, KS
Plaza West Healthcare & Rehab is a 151 bed Skilled Nursing Facility located in Topeka, KS. Plaza West staff and residents are excited about the upcoming holidays. Residents get out and about every Monday and Thursday this month to see the amazing lights all over Topeka. Residents and employee families are invited to see Santa and get their pictures with him on the 20th.
The Plaza West team is fully focused on their resident's needs... including the need for Christmas shopping! The team is planning several shopping trips for residents this month.
We are happy to have Plaza West in Membership!
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CMS Releases Managed Care Prior Authorization Proposed Regulation
The Centers for Medicare & Medicaid Services (CMS) has issued a proposed rule that would streamline processes related to prior authorizations (PA) for medical items and services. The proposed rule would also make information on plan PA performance – such as timeliness, as well as plan reasons for and methods of denials – public to providers and beneficiaries.
The proposed rule would apply to Medicare Advantage (MA) Plans, State Medicaid and Children’s Health Insurance Program (CHIP) agencies, Medicaid Managed Care Plans, CHIP Managed Care Plans, and Qualified Health Plan (QHP) issuers on the Federally-facilitated Exchanges (FFEs). CMS estimates that efficiencies introduced through these policies would save physician practices and hospitals, alone, over $15 billion over a 10-year period.
Key proposed provisions include:
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Address challenges with the PA process faced by providers and patients, including requirements for certain types of plans to include a specific reason when denying requests, as well as publicly report certain prior authorization metrics. Additionally, the proposed rule would require plans to send decisions within 72 hours for expedited (i.e., urgent) PA requests and seven calendar days for standard (i.e., non-urgent) requests, which is twice as fast as the existing Medicare Advantage response time limit. CMS also suggests shorter timeframes may be more appropriate such as 48 hours for urgent PA requests and five days for non-urgent PA requests.
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Provide improved access to health data contained in patient records to providers and beneficiaries to reduce fewer disruptions in care. These policies include expanding the current source of information about prior authorization decisions, allowing providers to access patients’ data by requiring plans to build and maintain more expansive patient databases accessible to providers, as well as to enable data exchange among plans to in-network providers.
These provisions would likely offer providers and beneficiaries helpful new information to understand plan PA processes and patterns of behavior.
AHCA/NCAL will release a more thorough summary in the coming days and work with membership to comment. The deadline to submit comments is March 13, 2023.
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Complete AHCA/NCAL’s State of the Industry Survey
AHCA/NCAL is asking providers (SNF, AL, ID/DD) to complete a 10-minute survey to gauge how the industry is faring in 2022. Providers will be asked about a few topics, including COVID-19, workforce, and finances.
Your participation will help AHCA/NCAL advocate for resources and common-sense policies for the profession. Please complete the survey by the end of the day on Wednesday, December 14.
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AHCA/NCAL’s Mark Parkinson Included In The Hill’s 2022 List Of Top Lobbyists
The Hill (12/7, Choi, 5.69M) reports on its list of "top lobbyists" for 2022, saying "lobbyists played a key role in shaping an avalanche of legislation" this year, "including Democrats’ Inflation Reduction Act and several bipartisan bills...that brought sharply divided lawmakers together." The Hill says the "list honors the corporate lobbyists, hired guns, association leaders and grassroots activists who leveraged their expertise and connections to make a difference in the nation’s capital this year." AHCA/NCAL President and CEO Mark Parkinson is included in the list.
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Healthcare worker vaccination mandate could end after a military vax withdrawal
Two national vaccine mandates, including the one affecting most nursing home workers, are under attack and could face reversal.
The Biden Administration is considering rescinding the military’s 2021 COVID-19 vaccine mandate as part of the National Defense Spending bill negotiations with Republicans, according to a report in the Washington Post.
If that occurs, it could spread to a rollback of the mandate for healthcare workers put in place by the Department of Health and Human Services in November 2021. The Supreme Court upheld both earlier this year. READ MORE
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TOMORROW! CMS Hosts SNF/LTC Open Door Forum on December 8
The Centers for Medicare & Medicaid Services is hosting an open forum (ODF) on Thursday, December 8 at 12:00 p.m. Central.
To participate by phone:
Dial: 1-888-455-1397 & Conference Passcode: 5109694
The call will cover:
Persons participating by phone do not need to RSVP. TTY Communications Relay Services are available for the Hearing Impaired. For TTY services dial 7-1-1 or 1-800-855-2880. A Relay Communications Assistant will help.
Instant Replay: 1-866-388-5331; Conference Passcode: No Passcode Needed
Instant Replay is an audio recording of this call that can be accessed by dialing 1-866-388-5331 Instant Replay begins 1 hour after the call has ended. The recording expires December 10, 2022, 11:59 PM ET.
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Free Webinar: Preparing for Respiratory Viruses featuring Dr. Ashish Jha
AHCA/NCAL is hosting a webinar for its members on Friday, December 9 at 2 p.m. CT. The webinar focuses on practical steps long term care facilities can take to prepare for the increase in respiratory viruses anticipated this winter. Dr. Ashish Jha, Coordinator of the White House COVID-19 Response team, will be joining this webinar to share his insights with participants
This webinar will also feature Dr. David Gifford, Chief Medical Officer, AHCA/NCAL, Steven M. Creasy, Pharm, Director, Clinical Services at Pharmerica, and Kenneth Daily, LNHA, President of the Elder Care Systems Group. These experts will share information and best practices on vaccines, treatments, and indoor air quality. Registration information and more details can be found at the link below.
The webinar will be recorded, and all registrants will receive an email when the recording is available.
Please email educate@ahca.org with any questions or if you need assistance registering.
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A Special Message from Pam Truscott, NCAL Director of Quality Improvement |
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Across the country, we are seeing increases in influenza, RSV, COVID-19, and other respiratory viruses often requiring hospitalizations. There are simple steps you can take to keep your residents, families, and ourselves safe during this cold and flu season - including getting your flu shot and COVID-19 bivalent booster, staying at home when you are sick, and following the core practices of infection control (such as washing your hands).
Please see this special message with more information on how you can do your part. And be sure to visit GetVaccinated for more resources and information.
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Where is your McKnight’s email?
Recently McKnight’s has made a change in their email distribution service which has created issues with delivery to many providers. If you are no longer receiving your daily trade publication of McKnight’s via email, please email Polly Berkley as we are working directly with McKnight’s to get the issue resolved.
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Webinar: The Proficient Infection Preventionist Series: Astute Survey Preparedness & Application of Infection Control Regulatory Requirements
12/20/2022 1:30PM-2:30PM
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Webinar: Deep Dive Into Federal Regulations in a Year: §483.10 Resident Rights Requirements
1/10/2023 1:30PM-3:00PM
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Webinar: 5-Star Work Plan A to Z: 5-Star Overview and Health Inspection Domain
1/18/2023 1:30PM-2:30PM
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Webinar: Mission Possible: SNF Department Head Briefing - Department Details for the DON
1/24/2023 1:30PM-2:30PM
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Webinar: 5-Star Work Plan A to Z: 5-Star Staffing Rating
1/25/2023 1:30PM-2:30PM
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Virtual Adult Care Home Operators Course
2/15/2023 9am 2/28/2023 3pm
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Looking for options for required Staff In-Service?
KHCA’s online learning platform is BACK! We’ve loaded the in-services for SNF and for AL first. Many more education sessions to come.
Questions about education can be directed to Polly Berkley VP of Operations and Education.
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Mark Your Calendar for these 2023 Dates! |
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Kansas Health Care Association and the Kansas Center for Assisted Living
1100 SW Gage Blvd. | PO Box 4770 | Topeka, KS 66604
PH: 785-267-6003 FAX: 785-267-0833
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