Greetings !
This week we have following sections covered under this newsletter.
AMITY HEALTHCARE GROUP NEWS
OASIS -E Corner
- OASIS item M1400
- OASIS-E items A1005, A1010, A1250, B1300, D0700
NATIONAL NEWS
- The National Alliance for Care at Home
- Medicare Revalidation
- Compliance Program
- Educational and Development Opportunities
TEXAS NEWS
- Workplace Violence Prevention Policy
- EVV Training
COLORADO NEWS
- Adult Long-Term Home Health (LTHH) PAR Process – ALERT
- Employment Laws Updates
We are pleased to announce that Amity Healthcare Group is now an approved provider of Home and Community Support Services Agencies administrators and alternate administrators training. Learn More or Register HERE.
We are also including a new rubric in our newsletter – Texas News (please see below).
OASIS -E Corner
In this issue we would like to bring your attention to the following OASIS related items/ questions:
I) OASIS item M1400
When is the patient dyspneic or noticeably short of breath?
Quality Measures: The Improvement in Dyspnea Measure is included as an outcome measure for both Quality of Patient Care star ratings and HHVBP OASIS-based quality measures. Beginning in 2025, Improvement in Dyspnea (M1400) outcome measure will have a weight of 6% in the agency’s total performance score which will be compared with similar agencies to determine the adjusted payment percentage for each of the agency’s Medicare claims.
TIPS: The intent of item M1400 is to identify the level of exertion/activity that results in a patient’s dyspnea or shortness of breath, regardless of any underlying condition. This is achieved by evaluating the level of exertion required to produce shortness of breath.
- Assessment should include observation of the patient during the assessment, while walking and doing ADLs.
Consider the level of effort required. - We are looking to determine the amount of effort that causes the patient’s dyspnea. So, this item is not collecting IF our patient is short of breath or dyspneic, but WHEN and with what level of exertion or activity.
- If the patient uses oxygen continuously, code the response based on assessment of the patient’s shortness of breath while using oxygen.
- If the patient uses oxygen intermittently, code the response based on the patient’s shortness of breath without the use of oxygen.
- M1400 reports what is true at the time of the assessment (the 24 hours immediately preceding the visit and what is observed during the assessment).
- The patient has improved in dyspnea when the OASIS score at discharge is numerically less than the score at the beginning of care.
II) OASIS-E items A1005, A1010, A1250, B1300, D0700
If a patient is confused and consistently does not respond appropriately to questions, is the assessing clinician required to ask the questions for the social determinants of health (SDOH) OASIS items, such as A1005 – Ethnicity, A1010 – Race, A1250 – Transportation, B1300 – Health Literacy, and D0700 – Social Isolation?
Answer: Each OASIS item should be considered individually and coded based on guidance specific to that item.
- For A1005 – Ethnicity, use clinical judgment to determine if the patient is able to respond. If it is determined that the patient is unable to respond, then code X – Patient unable to respond. If it is determined that the patient is unable to respond, a proxy response may be used. If neither the patient nor a proxy is able to provide a response to this item, medical record documentation may be used.
- For A1010 – Race, use clinical judgment to determine if the patient is able to respond. If it is determined that the patient is unable to respond, then code X – Patient unable to respond. If it is determined that the patient is unable to respond, a proxy response may be used. If neither the patient nor a proxy is able to provide a response to this item, medical record documentation may be used.
- For A1250 – Transportation, use clinical judgment to determine if the patient is able to respond. If it is determined that the patient is unable to respond, then code X – Patient unable to respond. If it is determined that the patient is unable to respond, a proxy response may be used. If neither the patient nor a proxy is able to provide a response to this item, medical record documentation may be used.
- For B1300 – Health Literacy, use clinical judgment to determine if the patient is able to respond. If it is determined that the patient is unable to respond, then code 8 – Patient unable to respond. This item is intended to be a patient self-report item. No other source should be used to identify the response for this item.
- For D0700 – Social Isolation, use clinical judgment to determine if the patient is able to respond. If it is determined that the patient is unable to respond, then code 8 – Patient unable to respond. This item is intended to be a patient self-report item. No other source should be used to identify the response for this item.
NATIONAL NEWS
The National Alliance for Care at Home
On September 6th, 2024, the National Association for Home Care & Hospice (NAHC) and the National Hospice and Palliative Care Organization (NHPCO) unveiled the new name (the National Alliance for Care at Home) and logo, as well as the initial website, of the new national organization that will carry forward the work of serving home care, home health, hospice, and palliative care providers as they deliver patients the highest quality care in their own homes and communities.
Dr. Steven Landers was named as the new CEO of the National Alliance for Care at Home (Alliance) on August 26, 2024.
The organization also launched its integration website at AllianceForCareAtHome.org. In addition to providing information on the Alliance, this new website serves as a single sign-on hub for members. With single sign-on, the resources of both legacy organizations will be available to all members of either NAHC or NHPCO with one, unified log-in.
The new site offers an updated Find a Provider tool to help consumers find providers of home care, home health, hospice, and palliative care. In the coming weeks, Alliance members will gain access to a combined set of 29 online member communities to enable professional exchange of ideas and best practices. The Alliance is working on a new website to launch in 2025; the new site, which will be housed at the same URL.
Medicare Revalidation
Just a reminder to ensure that you timely revalidate your Medicare provider enrollment to avoid deactivation of your enrollment with CMS.
If you are not sure when your next revalidation is due, use the Medicare Revalidation List to find out if you need to revalidate your enrollment record.
CMS usually posts revalidation due dates 6-7 months in advance, but we’ll establish your date at least 90 days in advance. A due date of “TBD” means that CMS has not set your due date, and you don’t need to do anything now.
CMS will not issue new revalidation due dates for November 2024 – April 2025 and will resume in May 2025.
See Revalidations (Renewing Your Enrollment) for more information.
Compliance Program
Reminder for CHAP accredited home health providers: effective June 1, 2024, for surveys on and after August 1st, a new key performance area (KPA), “Compliance Program”, will be embedded in all CHAP service line standards of excellence.
I) Home Care Technology Advisory Council 2024 Technology Summit
II) 2024 Home Health & Hospice MAC Collaborative Summit
III) New CMS Resources Available for Home Health Providers
I) Home Care Technology Advisory Council 2024 Technology Summit
Don’t miss the inaugural HCTAC Summit in Orlando, Florida, October 1-2, 2024 at Rosen Shingle Creek Hotel! Join NAHC and the Home Care Technology Advisory Council for a unique opportunity to connect with industry leaders. This summit brings together technology leaders, experts, and innovators shaping the future of home care technology. Engage in discussions on critical issues like interoperability, AI, and cybersecurity. Network with your peers and gain valuable insights from the minds shaping the home care technology landscape. Register HERE
II) 2024 Home Health & Hospice MAC Collaborative Summit
Registration for 2024 Home Health & Hospice MAC Collaborative Summit Perfecting Performance By Breaking Down Barriers is now open! This event is being held live, in-person at the Flamingo Las Vegas Hotel & Casino in Las Vegas, Nevada, October 2, 3 & 4, 2024.
National Government Services, Inc. (NGS), Palmetto GBA and CGS Administrators have designed this unique collaborative educational opportunity for HHH providers from every state and Medicare jurisdiction.
For more information and registration, please go to: https://web.cvent.com/event/
III) New CMS Resources Available for Home Health Providers
A) What You Need to Know: PAC QRP Key Program Updates – FY/CY 2025 Web-Based Training
The Centers for Medicare & Medicaid Services (CMS) is offering a cross-setting web-based training course that provides an overview of key updates to the post-acute care (PAC) Quality Reporting Programs (QRPs) for Fiscal Year (FY)/Calendar Year (CY) 2025. This targeted training discusses new, removed, and revised quality measures, timelines for public reporting, and measure specifications. In addition, assessment guidelines and coding instructions are presented for two new data elements: O0350. Patient/Resident’s COVID-19 vaccination is up to date. To access the training, click on the following link: FY/CY 2025 Web-Based Training
B) Patient Mood Interview (Patient Health Questionnaire PHQ-2 to 9©) Video Tutorial
The Centers for Medicare & Medicaid Services (CMS) is offering a video tutorial for completing D0150, Patient Mood Interview (PHQ-2 to 9) and D0160, Total Severity Score. This video depicts two scenarios that demonstrate the coding of the PHQ-2 to 9 for the purposes of completing D0150, Patient Mood Interview (PHQ-2 to 9) and D0160, Total Severity Score. Two patient vignettes are depicted, one in which the PHQ-2 is demonstrated and one in which the entire PHQ-2 to 9 is completed. This video can be viewed through the following link: https://youtu.be/_JU7ABmbBGA.
C) Section GG Web-Based Training Series
The Centers for Medicare & Medicaid Services (CMS) is also offering an updated series of web-based training courses that provide an overview of the assessment and guidance to promote accurate coding of the post-acute care (PAC) cross-setting Section GG data elements. Each course contains interactive exercises to test your understanding. To access the courses, click on the links below:
- Course 1: Section GG Data Accuracy and Quality Measures.
- Course 2: Prior Functioning and Prior Device Use Items.
- Course 3: Accurate Coding for GG0130 and GG0170 Items.
- Course 4: Understanding Admission and Discharge Performance for GG0130: Self-Care Items.
- Course 5: Understanding Admission and Discharge Performance for GG0170: Mobility Items.
If you have questions about accessing any of the above resources or feedback regarding trainings, please email the PAC Training Mailbox. Content-related questions should be submitted to the HH QRP Help Desk.
TEXAS NEWS
Workplace Violence Prevention Policy
In support of the providers’ compliance with the requirements of the Workplace Violence Prevention law in Chapter 331 of the Texas health and Safety Code, Amity Healthcare Group has created the Workplace Violence Prevention Plan Policy that can be adopted by Home Health/Home Care agencies to ensure regulatory compliance as well as safe and secure working environment for all employees, contractors, patients, and visitors.
To obtain a copy of the Workplace Violence Prevention Plan Policy, please reach out to us at phone: 713-564-5011 or email ig@amityhealthcaregroup.com.
EVV Training
Providers, please remember to register for the annually required EVV training.
Registration available for HHSC EVV Policy Training Webinars for Program Providers and CDS Employers. HHSC is hosting Electronic Visit Verification (EVV) policy training webinars for program providers and Consumer Directed Services (CDS) employers.
Training Audience:
- EVV system users – staff who have access to the EVV system, perform EVV system operations and visit maintenance in the EVV system.
- EVV Portal users – staff who have access to the EVV Portal, conduct visit or claim searches, and generate reports.
- Billing staff – staff who submit Medicaid claims for an EVV-required service.
Webinar Registration:
Agendas are included in the registration links. Select from the dates below to register for one webinar.
- Annual EVV Policy Training for Program Providers:
- Annual EVV Policy Training for CDS Employers:
Alternatively, program providers and CDS employers can also complete the annual EVV policy training requirement on the HHS Learning Portal.
The EVV Required Training Checklists (PDF) will help track completed EVV trainings.
Register for EVV GovDelivery to receive EVV notices by email, such as training updates and future webinar registrations.
COLORADO NEWS
Adult Long-Term Home Health (LTHH) PAR Process – ALERT
On September 6, 2024, Colorado Department of Healthcare Policy and Financing issued an Operational Memo (MEMO) for Adult Long Term Home Health providers describing changes to the administrative procedure related to the process of submission of the Prior Authorization Requests (PARs) for Adult Long-Term Home Health (LTHH).
Effective October 7, 2024, Adult Long-Term Home Health (LTHH) PARs will have to be submitted to the Utilization Review Contractor (URC)-Acentra instead of Case Management Agencies. As the result of this change, Home Health Agencies (HHAs) will be required to submit requests for Prior Authorization for all LTHH services directly to the URC, Acentra, via the Atrezzo portal. The HHA will upload required documentation to the portal for review. Required documentation will include the Department (HCPF)-issued PAR Form, physician or allowed practitioner approved Plan of Care/CMS-485, and any other medical information that will document the medical necessity for the home health services. Once approved, the LTHH PAR will be transmitted to Gainwell so billing can occur.
After submitting the PAR and supporting documentation to Acentra, HHAs will then send copy of LTHH Plan of Care/CMS-485 to the assigned Case Management Agency (CMA) for notification of the member’s need for home health services.
Acentra is offering provider training and resources for PAR submission and portal access as follows.
Acentra Provider Training:
Benefit-Specific training will cover Adult Long-Term Home Health (LTHH).
- September 23, 2024, 12:00 p.m. – 1:00 p.m. MT REGISTER
- September 24, 2024, 5:00 p.m. – 6:00 p.m. MT REGISTER
- September 26, 2024, 8:30 a.m. – 9:30 a.m. MT REGISTER
PAR Submission Training is for all new users on how to submit a PAR using Acentra’s provider.
PAR portal, Atrezzo:
- September 18, 2024, 12:00 p.m. – 1:00 p.m. MT REGISTER
- September 19, 2024, 3:00 p.m. – 4:00 p.m. MT REGISTER
Please also reference to the training calendar at https://hcpf.colorado.gov/par.
Action To Be Taken Now:
HHAs must attend one of the training sessions hosted by Acentra to learn the updated process. HHAs must register and obtain access to the Atrezzo portal. prior to Monday, October. 7, 2024.