Home Health & Hospice Week

In just a few short weeks, home health agencies will be grappling with major changes in how they deliver and document therapy services. But CMS was nearly silent on the topic in the latest Open Door Forum for home care providers.

A host of therapy changes will hit April 1, ranging from functional reassessment visits on the 13th and 19th visits and every 30 days to including objective goals in documentation (see Eli's HCW, Vol. XX, No. 6).

The Centers for Medicare & Medicaid Services didn't have the therapy changes on the agenda for the forum held March 2. CMS officials addressed the topic only briefly, in the caller question-and-answer portion of the call.

Responding to a Kaiser Permanente representative, CMS's Lori Anderson clarified that the new therapy assessments and other requirements apply only to fee-for-service beneficiaries, not those enrolled in Medicare Advantage plans.

The next Open Door Forum, scheduled for April 13, occurs after the therapy changes hit. Other issues addressed in the forum include:

• HHCAHPS. Next month, HHAs will start reporting Home Health Consumer Assessment of Healthcare Providers and Systems (HHCAHPS) data that will affect 2013 payment rates, CMS's Lori Teichman noted in the forum. CMS is seeing a "large participation" from agencies in HHCAHPS, Teichman said.

Don't forget: Your job isn't done once you've selected your HHCAHPS vendor. You also have to go to www.hhcahps.org and authorize that vendor, Teichman said. "They cannot submit their HHCAHPS data without that authorization."

• PPS revisions. The Affordable Care Act requires CMS to conduct a study determining whether the home health prospective payment system appropriately reimburses for low income beneficiaries and benes in underserved areas with varying levels of severity of illness, Anderson noted. CMS must issue a report to Congress based on its findings in March 2014.

So far the CMS contractor for the study, L&M Policy Research, has conducted a literature review and convened a technical expert panel, reported L&M's Judy Dey. Now L&M wants feedback from the home care industry on beneficiaries with lower incomes, with a high severity of illness, and/or living in medically underserved areas. L&M would like to hear first-hand accounts of such benes not being to access home care, or having difficulty doing so. Agencies can send their feedback to research@lmpolicyresearch.com by March 16.

Watch for: CMS hopes to have a future special Open Door Forum on this study and its focus areas, Anderson said.

• Claims processing. Adjustments to claims correcting wage index problems in the PPS Pricer should soon wrap up, reported CMS's Wil Gehne. If you submitted claims with a "statement through" date of April 1, 2010, through Dec. 31 of that year, and you submitted the claim between Jan. 3 and early February, the wage index for your CBSA may have been wrong. Contractors have until midto- late March to correct such claims, Gehne said.

• OASIS submission. CMS is switching its OASIS submission vendor from AT&T to Verizon, CMS's Kim Jasmin said in the call. Information about the change will be posted on the QTSO website at www.qtso.com and the OASIS state welcome page, Jasmin added.

Agencies that use AT&T for OASIS transmission will have to begin using Verizon by June 2011, reports the National Association for Home Care & Hospice.

Also, HHAs don't have to worry about new HIPAA 5010 form requirements when submitting OASIS, Gehne told a caller. The HIPAA 5010 requirements affect only standard transactions that are named in HIPAA regulations, such as claims and certain inquiries, he explained. "It wouldn't affect OASIS transmission at all."