Amity Healthcare Group Weekly Newsletter Issue date: July 15th, 2022

Issue date: July 15th, 2022

Hello, Everyone!


Did you know that…

Amity Healthcare Group provides ICD-10 coding and documentation review as follows:

  • ICD – 10 Coding
  • OASIS Review + ICD – 10 coding
  • OASIS Review + POC (Plan of Care) Review
  • OASIS Review + ICD – 10 Coding + POC (Plan of Care) Review
  • Episodic documentation review
  • Quality Trends Analysis and QAPI Development

Take advantage of the optimal reimbursement with the precise ICD-10 coding, accurate documentation, and improved quality scores.

For more information or a free trial, please contact us at 303-690-2749 or email at
Amity Healthcare Group is excited to announce its participation in Home Care Association of Florida 33rd Annual Home Care Conference – The Roaring Twenties that will be held in Orlando, Florida July 19-22, 2022.

Please join, Irina Gorovaya, Owner and President of Amity Healthcare Group, for a presentation – Telehealth in the “Rumble” Seat: New Norm, New Opportunity – on July 20, 2022, from 3:30 pm to 4:30 pm at Citron West room.

Irina will discuss current trends and potential opportunities for telehealth in home health and review existing regulations and legislature directing the use of telehealth in home health and hospice, as well as telehealth reimbursement. Irina will also discuss recommended American Telemedicine Association (ATA) standards for telehealth and provide guidance related to the successful deployment of a telehealth program in home health, including policies, documentation, staff education, and telehealth solutions.

Please also join, Lourdes Wiley, home health consultant and clinical educator, for a presentation – Compassion Fatigue & Burnout: New Perspectives for Health Care Providers, Teams, and Organizations – on July 22, 2022, from 10:35 am-11:55 am at Sunburst room.

Lourdes will discuss the effect of burnout and compassion fatigue on the entire organization as well as the patients served. This presentation is intended to give clinicians and non-clinicians alike a new perspective on how to care for themselves, each other, and take ownership of creating a welcoming and healthier workplace for all.


The CY2023 Proposed Rule

Since June 17th, the most talked about home health industry-related topic has been the CY2023 Proposed Rule. The proposed rule has generated a strong reaction from the National Association for Home Care and Hospice (NAHC), industry leaders, and providers. “The stability of home health care is at risk,” said NAHC President William A. Dombi, in reaction to the release of the CY2023 home health proposed payment update rule. “What we see in the proposed rule is the equivalent of a declaration of war against home health agencies and the more than three million patients they serve.”

The CY2023 proposed rule addressed multiple areas, including:

  • rate updates and revisions to components of the PDGM model;
  • payment updates to the home infusion therapy services;
  • changes to the expanded HHVBP demonstration and HHQRP programs;
  • collection of telecommunications data;
  • request for information on health equity in the HHQRP and the future approach for health equity in the expanded HHVBP model;

However, the proposed rate reduction has been in the center of attention. CMS estimates that Medicare payments to HHAs in CY 2023 would decrease in the aggregate by -4.2%, or -$810 million compared to CY 2022, based on the proposed policies. This decrease reflects the effects of the proposed 2.9% home health payment update percentage ($560 million increase), an estimated 6.9% decrease that reflects the effects of the proposed prospective, permanent behavioral assumption adjustment of -7.69% ($1.33 billion decrease), and an estimated 0.2% decrease that reflects the effects of a proposed update to the fixed-dollar loss ratio (FDL) used in determining outlier payments ($40 million decrease).

To familiarize yourself with the key points of the proposed rule, please go HERE, for a complete proposed rule, please go to the Federal Register.

Please remember, that the public comment period is open until August 16 at 11:59 PM ET. Instructions on how to submit comments are available on the Federal Register.

HHS Issues Guidance on HIPAA and Audio-Only Telehealth

In March 2020, in response to the COVID-19 public health emergency (PHE), the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) issued the Telehealth Notification to assist the health care industry’s response to the PHE and to expand the use of remote health care services.

One of the flexibilities that OCR exercised during the PHE was its enforcement discretion to not impose penalties for non-compliance with the HIPAA Rules in connection with the good faith provision of telehealth using such non-public facing audio or video communication products during the COVID–19 nationwide public health emergency. In addition, the use of an audio-only modality was also allowed.

On June 13, 2022, the U.S. Department of Health and Human Services (HHS), through its Office for Civil Rights (OCR), issued guidance on how covered health care providers and health plans can use remote communication technologies to provide audio-only telehealth services when such communications are conducted in a manner that is consistent with the applicable requirements of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy, Security, and Breach Notification Rules, including when OCR’s Notification of Enforcement Discretion for Telehealth is no longer in effect.

With a belief that audio-only telehealth, especially technologies that do not require broadband availability, can help address the needs of the individuals who otherwise have limited access to care, OCR provided additional guidance describing in what circumstances, audio-only telehealth is permissible under the HIPAA Rules.

For a complete guide, please go to HERE

Additional comments: The list below includes some vendors that represent that they provide HIPAA-
compliant video communication products and that they will enter into a HIPAA BAA.

  • Skype for Business I Microsoft Teams
  • Updox
  • VSee
  • Zoom for Healthcare
  • Google G Suite Hangouts Meet
  • Cisco Webex Meetings I Webex Teams
  • Amazon Chime
  • GoToMeeting
  • Spruce Health Care Messenger

“Organization Deactivation Project 2022”

In addition to HH CY2023, CMS deactivation of Medicare billing privileges was capturing attention this week as well. The National Association for Home Care and Hospice (NAHC) has noted that NAHC become aware of a project titled “Organization Deactivation Project 2022” initiated by the Centers for Medicare & Medicaid Services (CMS).

According to the Code of Federal Regulations, Title 42, 424.540 Deactivation of Medicare billing privileges.

CMS may deactivate the Medicare billing privileges of a provider or supplier for any of the following reasons:
The provider or supplier does not submit any Medicare claims for 12 consecutive calendar months. The 12-month period will begin the 1st day of the 1st month without a claims submission through the last day of the 12th month without a submitted claim.

  1. The provider or supplier does not report a change to the information supplied on the enrollment application within the applicable time period required under this title.
  2. The provider or supplier does not furnish complete and accurate information and all supporting documentation within 90 calendar days of receipt of notification from CMS to submit an enrollment application and supporting documentation or resubmit and certify to the accuracy of its enrollment information.
  3. The provider or supplier is not in compliance with all enrollment requirements in this title.
  4. The provider’s or supplier’s practice location is non-operational or otherwise invalid.
  5. The provider or supplier is deceased.
  6. The provider or supplier is voluntarily withdrawing from Medicare.
  7. The provider is the seller in an HHA change of ownership under § 424.550(b)(1).

At this time, NAHC indicated that some Medicare certified home health agencies have received a notice from their Medicare Administrative Contractor (MAC) notifying them that they have not submitted a Medicare claim in the past 12-13 months and their billing privileges and Medicare certification are being terminated. In addition, NAHC stated that “we also understand that the termination process for Medicare certification could be triggered from a Medicare survey when a Medicare-certified agency has not served any Medicare patients in the past year. We believe the project is targeting providers that appear to not be actively utilizing their Medicare certification as indicated by Medicare claims submissions and/or Medicare patients served.”

NAHC has reached out to CMS and is gathering additional information on this Project and will provide updates as they are received. We will continue monitoring the matter as well and will keep you updated.

Expanded HHVBP Model

Just a couple of updates as related to the Expanded HHVBP Model.

1. June FAQs are Now Available: the June edition of the Expanded HHVBP Model Frequently Asked Questions (FAQs) is now available to assist home health agencies (HHAs) in understanding common terms used in the expanded Model and requirements under HH CY22. The document is available for viewing and download on the Expanded HHVBP Model webpage.

2. Expanded HHVBP Model YouTube Playlist Launched: this playlist includes podcasts, instructional videos, and on-demand recordings to help HHAs understand the expanded Model, as well as strategies for improving care delivery in home health. Subscribe to the CMS HHS YouTube channel to receive updates when new videos are posted. Links to videos included in the playlist are also available on the Expanded HHVBP Model webpage.

Three (3) podcasts designed to support home health quality improvement efforts and care delivery are now available on the Expanded HHVBP Model YouTube playlist. Links to these podcasts are also accessible on the Expanded HHVBP Model webpage.

  • The Patient with Declining Memory: The “Keys” to Safe Mobility
  • Infection Prevention and Control: Home Health Patient Care and Communication
  • Managing Chronic Illness through Home Health Care

3. Sample Interim Performance Report (IPR) and Annual Performance Report (APR): for learning purposes only, CMS will publish two sample reports in July – one for the IPR and one for the APR. The intent of these sample reports is to orient HHAs to the content and format of the performance feedback reports and help HHAs understand how CMS will assess HHA performance under the expanded HHVBP Model. These sample reports will be available via iQIES and will not include actual HHA performance data. CMS will notify each competing HHA via email when the two reports are available.


The OASIS Data Submission Specifications Version 3.00.1 are now available in the Downloads section of the Data Specifications webpage. This FINAL version applies to the OASIS-E item set, which is scheduled for implementation on January 1, 2023. There have been significant revisions to the edits for items in Sections A, D and N. Also, several items in Section A (as well as one item in Section B and one item in Section D) now have a new response option: patient declines to respond. Please review the OASIS-E Guidance manual for additional information, as well as the Item Change and Edit Change reports within the data specifications.

Reminders About Sequestration

2% payment adjustment beginning July 1, 2022

The 2% payment reduction (sequestration) will be:

  • Applied to all Medicare FFS claims with a date of service /” through” date of service on or after July 1, 2022
  • Calculated after the approved amount is determined and the deductible and coinsurance are applied
    • Note: For claims with DOS that span July 1, 2022 (e.g., 061522 – 071522), the approved amount is determined based on the entire claim (not DOS on or after July 1 only).
  • Reported with claim adjustment reason code (CARC) 253 (Sequestration – reduction in federal payment) on the remittance advice

Updates Regarding Chapter 2 COVID-19 Vaccination Requirements

On June 29, 2022, the Colorado Department of Public Health and Environment (CDPHE) announced that it does not intend to seek another set of emergency rules as related to COVID-19 Vaccination requirements, nor does it intend to seek to make the current Chapter 2 regulations permanent. As such, the Chapter 2 COVID-19 Vaccine Requirements expired on July 14, 2022.
Please note that while the Department let its state licensure vaccination requirement expire on July 14, 2022, the federal requirement for staff to be vaccinated or obtain a valid medical or religious exemption, through the Centers for Medicare and Medicaid Services (CMS), will still apply to any licensed facility that is certified by CMS to receive federal reimbursement.

To summarize:

  • Effective July 14, 2022, current obligations under Part 12 of 6 CCR 1011-1, Chapter 2 related to COVID-19 vaccination expire.
    • This includes the associated obligation to report into Colorado Health Facilities Interactive (COHFI) on a twice-monthly basis.
  • The requirements of Part 11 of Chapter 2 regarding vaccination against influenza are still in effect and not impacted by the expiration of these emergency rules.
  • Despite the expiration of these rules, facilities and agencies may maintain any mandatory vaccination policies they have adopted to date.
  • Facilities certified by CMS are still subject to the federal government’s vaccine mandate.

In addition, the CDPHE does anticipate a possibility for the enactment of the requirements for all licensed facilities and agencies related to infection prevention and control in the light of the House Bill 22-1401 signed by Governor Polis on May 18, 2022 (HB22-1401). While the Department has not yet determined what these requirements will be, the statute requires that they include provisions related to testing, vaccination, and treatment for COVID-19 in accordance with applicable recommendations and guidance. CDPHE’s Health Facilities and EMS divisions will engage in conversations with stakeholders later regarding the implementation of HB22-1401.

Amity’s newsletters will be archived on Amity’s Healthcare Group website at under the Resources/ Our Newsletter section.

Please do not hesitate to reach out for any assistance or questions via email, phone, or website at

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Thank you,
Irina Gorovaya, RN BSN, MBA
Amity Healthcare Group, LLC
Home Health Consulting, Education and Outsourcing Services
720-353-7249 (cell) 303-690-2749 (office) 720-398-6200 (fax)


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