National Partnership to Improve Dementia Care and QAPI Call — Register Now

Tuesday, December 1 from 1:30-3pm ET To Register: Visit MLN Connects Event Registration. Space may be limited, register early. This call will focus on nursing home providers, as well as transitions of care between acute and long-term settings. A physician will share approaches to effectively manage high-risk medications, and a pharmacist will discuss the importance of drug regimen reviews and medication reconciliation. Additionally, CMS subject matter experts will update you on the progress of the National Partnership and Quality Assurance and Performance Improvement (QAPI). A question and answer session will follow the presentations. Discussion topics will include: Discussion from Washington Post (Popular blood thinner causing deaths, injuries in nursing homes) Medication Management Drug Regimen Review & Medication Reconciliation QAPI National Partnership

December 1st, 2015|News, Newsfront, Quality & Regulatory|

CMS Finalizes Mandatory Hip and Knee Bundling Program

On November 16th, CMS finalized a new rule establishing the Comprehensive Care for Joint Replacement (CJR) program, a mandatory bundled payment program for hip and knee replacement procedures affecting providers in 67 defined Metropolitan Statistical Areas (MSAs) throughout the country.  Gainesville and Athens-Clarke County, GA MSAs are included. CJR Program Summary Under this model, the hospital in which the hip or knee replacement procedure takes place will be accountable for the costs and quality of related care from the time of the surgery through 90 days after hospital discharge -- what is called an "episode" of care. Depending on the hospital's quality and cost performance during the episode, the hospital will either earn a financial reward or, beginning with the second performance year, be required to repay Medicare for a portion of the spending above an established target. This payment structure gives hospitals an incentive to work with physicians, home health agencies, skilled nursing facilities, and other providers to manage costs across providers and settings as well as make sure beneficiaries receive the coordinated care they need. Notable Changes from the Proposed Rule The final rule includes a few notable changes from what CMS originally proposed. First, the Agency is delaying implementation of the program from January 1 to April 1, 2016, allowing providers an extra four [...]

December 1st, 2015|News, Newsfront, Quality & Regulatory|

National Quality Forum Releases Measures Under Consideration (MUC) List for Public Comment

On Friday, November 27, the National Quality Forum released a list of 133 Measures Under Consideration (MUC) for future rule-making in 2016, 12 of which are specific to the Skilled Nursing Facility (SNF) setting.  This is a critical step in the CMS annual process which requires review and voting by the NQF Measure Applications Partnership (MAP) to arrive at a set of measures recommended for use in federal pay for performance and public reporting programs. The IMPACT Act of 2014 requires NQF's recommendation as the next step in the process CMS must follow before including measures in rulemaking. CMS has the ability to disregard NQF decisions and proceed to include measures in rulemaking, however in that case they are required to provide an explanation of their rationale for doing so in the course of the rulemaking process.  We expect the inclusion of the following measures on the MUC list is a strong indication that they are likely to appear in the SNF PPS proposed rule for use in public reporting and/or in future payment programs (e.g. Value Based Purchasing).  This step in the process involves only the specification of the measures themselves. At this point, the intended use of most of the measures has not been detailed.  The exception to this is the SNF Potentially [...]

November 30th, 2015|Newsfront, Quality & Regulatory, Regulatory|

CMS seeks comments on Discharge to Community Quality Measure

The Center for Medicare and Medicaid Services is seeking public comment on CMS' Development of a Discharge to Community Quality Measure, a mandate of the IMPACT Act. Comments are due by November 23rd and the call for public comment can be found on CMS' public comment web page. Additional information on specifications of the measure can be located on the page and will help to inform your comments.

November 30th, 2015|News, Newsfront, Quality & Regulatory|

CMS proposes revisions to Requirements for Discharge Planning for Hospitals

CMS' proposed Revisions to Requirements for Discharge Planning for Hospitals, if adopted, will require hospitals to share Nursing Home Compare and Home Health Compare data with patients as part of discharge planning. This would continue until the impending resource use measures and revised patient assessment measures are finalized. Because the proposed rule would require medication reconciliation as part of the discharge process, it includes several resources on the subject of medication reconciliation. Centers may find it beneficial to review the MATCH Toolkit for Medication Reconciliation and consider potential process changes to enhance this area of care.

November 30th, 2015|News, Newsfront, Quality & Regulatory|

U.S. Government Accountability Office (GAO) Hospital Value-Based Purchasing study

Recently, the GAO released results from a study of Hospital Value-Based Purchasing program (HVBP). The GAO report indicated results show modest effects on Medicare payments and no apparent change in quality-of-Care trends. The GAO's analysis found no apparent shift in existing trends in hospitals' performance on the quality measures included in the HVBP program during the program's initial years. However, the GAO clarifies this could shift as the HBVP continues to evolve.

November 30th, 2015|News, Newsfront, Quality & Regulatory|

Nursing License Renewal—Tis the Season

It’s that time of year again and year end is quickly approaching.  The renewal process is now open for Registered Nurses. Please ensure nurses have verified their license expiration date and, if set to expire at year end, licensure renewal is initiated in a timely manner.  Effective January 31, 2016, all registered nurses will be required to verify continuing education/competency requirements as a condition of licensure renewal.  Additional information related to these requirements can be found HERE.

November 30th, 2015|Education Updates, News, Newsfront, Quality & Regulatory|

2015 Part B Fee Schedules

Thanks to GHCA’s very own President / CEO, Tony Marshall, for calculating the Part B Fee Schedules needed for 2016. Tony has furnished these schedules to AHCA for many years. Click HERE for the 2016 GA Fee Schedules effective January 1, 2016 and HERE  for the 2016 GA MPPR Fee Schedules effective January 1, 2016. Please remember that you will need both of them, as the final rule continues the multiple procedure payment reduction (MPPR) policy for “always therapy” services. The MPPR policy required a 50 percent reduction to be applied to the practice expense component of payment for the second and subsequent “always therapy” service(s) that are furnished to a single patient by a single provider on one date of service (including services furnished in different sessions or in different therapy disciplines).

November 25th, 2015|News, Newsfront, Reimbursement Corner|

Be Sure to Read New VA Contracts Before Signing Them

As you may know, on February 12, 2014, President Obama signed Executive Order 13658, Establishing a Minimum Wage for Contractors. The Executive Order raises the hourly minimum wage paid by contractors to workers performing on covered Federal contracts to: (i) $10.10 per hour, beginning January 1, 2015; and (ii) beginning January 1, 2016, and annually thereafter, an amount determined by the Secretary of the Department of Labor (DOL) in accordance with the Order. On October 1, 2014, DOL published the final rule implementing the provisions of Executive Order 13658. DOL announced earlier this year that the minimum wage for certain federal contracts will increase to $10.15 per hour beginning January 1, 2016. The DOL notice on this increase can be found here. Should your current VA contract be up in the near future, be sure to carefully review and read your new VA contract before signing it for any new additions that could be in the contract that were not in your previous contract. Medicare (Parts A and B) or Medicaid providers are not considered to be federal contractors. However, if a provider currently has VA patients and a VA contract, they are considered to be a federal contractor. Since VA contracts are covered by the Service Contract Act, this Executive Order applies to such [...]

November 25th, 2015|News, Newsfront, Reimbursement Corner|

Recent AON/AHCA Study Suggests That Liability Costs Expected to Rise for Long Term Care Facilities

The cost of liability continues to increase for the long term care profession, according to the findings of an analysis recently released by the American Health Care Association (AHCA) and Aon Global Risk Consulting. The overall national long term care loss rate is expected to grow by 5 percent annually, with claim frequency driving the increase at an expected 3 percent growth rate. In August of this year, at the direction of GHCA Board leadership, GHCA staff convened a group of legal and provider stakeholder in an attempt to craft legislation aimed at liability relief for Georgia providers. An early draft has been prepared and GHCA staff is currently working with legal and legislative stakeholders to build consensus as we move towards the 2016 legislative session. Please click here for a recent article summarizing the full report.

November 25th, 2015|Legislative, News, Newsfront|