October 30, 2014 - In This Issue: Using Medicare Payment Models

October 30, 2014 - In This Issue:
VA To Pay Non-Contract Providers
Using Medicare Payment Models
Administration Announces New
Executive Actions To Improve
Quality Of Care For Medicare
Beneficiaries
CMS Announces 2015 Medicare
Premiums & Deductibles
Updated HIS Q + A
Home Health & Hospice News
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CDC Issues
Stronger Safety
Standards For
Healthcare
Workers Dealing
With Ebola
The CDC has issued more robust
standards to better protect healthcare
workers who come into contact with
Ebola and other deadly infectious
diseases. The previous
recommendations, which were first
issued in 2008 and last updated this
VA To Pay Non-Contract Providers
Using Medicare Payment Models
According to NAHC, the Department of Veterans Affairs (VA) has
started issuing notices to inform home health providers of the VA's
revised payment methodology for SNF services. Starting on October
1, 2014, the VA will require an Outcome and Assessment
Information Set (OASIS) to be completed to generate a health
insurance prospective payment system (HIPPS) code to reimburse
non-contracted home health agencies for skilled home health
services using the Medicare home health prospective payment
system (HHPPS). The VA will continue to pay a per diem rate for
non-contracted hospice providers.
Click here to read more from NAHC.
Administration Announces New
Executive Actions To Improve
Quality Of Care For Medicare
Beneficiaries
The Obama Administration announced new executive actions and
the President signed into law legislation that will improve the quality
of care for nursing home and home health patients. The President
signed the Improving Medicare Post Acute Care Transformation Act
past August, did not work in the case
of Texas Health Presbyterian Hospital
Dallas, where two nurses were
infected while treating an infected
patient. The updated protocols
recommend workers to wear personal
protective equipment that covers the
entire body and leaves no skin
exposed. Other recommendations
include wearing two sets of gloves
and wearing boot covers that are
waterproof and go to at least mid-calf
or cover the legs.
of 2014 (IMPACT Act), bipartisan legislation that puts in place new
and streamlined quality measures for nursing homes, home health
agencies, and other post-acute care providers. The Administration
took two additional steps to improve care for nursing homes and
home health patients through new executive actions that will:
Click here to read more.
Click here for more information.
Click here to see the updated CDC
guidelines.
The IMPACT Act also includes provisions that create greater
oversight and increased transparency within the hospice
community. The provisions that affect hospice providers
include mandated surveys of Medicare certified hospice
providers at least every three years for the next ten years
minimum; medical reviews for hospice programs with soon to
be determined percentage/number of patients receiving care
for more than 180 days; and hospice aggregate financial cap
that will be aligned with hospice reimbursement using a
common inflationary index that will not change hospice
reimbursement for providers.
Click here for specific guidance and
protocols for home health and
hospice agencies in preparation for
Ebola.
Proposed Rule On
Conditions Of
Participation For
Home Health
Agencies
CMS has issued a proposed rule to
improve Medicare's Home Health
Agency Conditions of Participation to
ensure safe delivery of quality care to
home health patients. The proposed
rule reflects the most current home
health agency practices by focusing
on the care provided to patients and
the impact of that care on patient
outcomes.
The proposed rule focuses on key
changes in the home health industry,
including promotion and protection of
patient rights, enhancing the process
for care delivery and coordination of
services, streamlining regulatory
requirements and building a
foundation for ongoing, data-driven,
agency-wide quality improvement.
To see the full text of the rule,
click here.
Expand and strengthen Medicare's widely-used Five Star
Quality Rating System for Nursing Homes, also known
as Nursing Home Compare.
Improve quality home health care received by Medicare
beneficiaries through a proposed rule that strengthens patient
rights, improves communication, and focuses on patient wellbeing.
CMS Announces 2015 Medicare
Premiums & Deductibles
The Medicare Part A deductible for inpatient hospital, skilled nursing
facility and home healthcare services will increase by $44 in CY
2015 to $1,260. The monthly Part A will decrease by $19.
Medicare part B monthly premiums and deductibles will remain as
is. CMS announced the CY 2015 rates last week. Click here to see
them.
Daily Medicare coinsurance amounts will be $315 for days 61-90 of
hospitalization in a benefit period, $630 for lifetime reserve days and
$157.50 for days 21-100 of extended care services in a skilled
nursing facility in a benefit period.
The Part A premium will decline by $19 in CY 2015, to $407.
The base Part B monthly premium and annual deductible for
physician and hospital outpatient services, certain home healthcare
services, durable medical equipment and other items will be
unchanged for CY 2015 at $104.90 and $147. The base Part B
premium is adjusted upward for higher income beneficiaries.
Click here to read more.
Updated HIS Q & A
The new Q + A document is available on the Hospice Item Set
portion of the HQRP webpage. The document contains frequently
asked HIS-related questions received on the Help Desk JulySeptember 2014.
Click here to access it.
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