21st Century Health Care Consultants

Delay in CoPs changes to 2018

The Centers for Medicare & Medicaid Services (CMS) has proposed delaying the implementation date for the new home health Conditions of Participation (CoPs) until January 2018. The proposal comes after home health industry associations and providers pushed back against the original implementation timeline for the CoPs, which were finalized in early January 2017. Instead of going […]

CMS VALUE-BASED PURCHASING-Will your state be affected?

CMS VALUE-BASED PURCHASING-Will your state be affected? CMS, after several false starts, has unveiled its proposed pilot program on value-based purchasing (VBP) in the proposed rule. The VBP model follows a path previously traveled with hospitals, but with some significant variation. Generally, a VBP program establishes a financial bonus pool funded by payment reductions to […]

Initials & Not a Full Signature, Allowed?

Initials & Not a Full Signature, Allowed? One of the things home health and hospices frequently have issues with is physician signatures. Often the issues surround the physician not dating their signature or making changes on hard copy documents where it is not identifiable who made the changes. On October 2, 2015, CMS released Change […]

Medical Review Additional Development Request (ADR) Process

WHAT IS AN MR ADR? – When a claim is selected for medical review, an additional development request (MR ADR) is generated requesting medical documentation be submitted to ensure payment is appropriate. Documentation must be received by the intermediary within 45 calendar days for review and payment determination. WHY AN MR ADR? – Any claim […]

2015 OASIS UPDATES

JANUARY 1, 2015 21ST CENTURY HEALTH CARE CONSULTANTS OASIS-C1/ ICD-9 Version OASIS-C1/ ICD-9 Version is an interim version of OASIS that was created for use during the legislatively mandated ICD-10 delay; To create the OASIS-C1/ ICD-9 Version, the following five items which use ICD-10 codes have been removed from the OASIS-C1 data item set: (M1011, […]

Changes to the CoPs January 1, 2015

Below is a quick overview of what is contained within the rule: 2015 Home Health Prospective Payment System rates that reduce rates under the 4-year rebasing Face-to-Face Physician Encounter rule modifications including the elimination of the physician narrative requirement Significant change to the requirement for professional therapy reassessments, dropping the 13th and 19th visit requirements […]

Companionship Services Lawsuit Advances

The National Association of Home Care (NAHC) lawsuit challenging the US Department of Labor rule that virtually eliminates the Fair Labor Standards Act (FLSA) exemptions for “companionship services” and “live-in domestic services” was presented to federal US District Judge Richard J. Leon on Wednesday, November 19, 2014. Judge Leon heard oral arguments on the pending […]

CMS Releases Proposed Updates to Home Health Agency Conditions of Participation

Oct 13, 2014 On October 6, the Centers for Medicare and Medicaid Services (CMS) released its proposal to modernize Medicare’s Conditions of Participation (CoPs) for home health agencies. The proposed changes represent the first update to the Home Health Agency (HHA) CoPs since 1989 and respond to numerous changes in the home health industry. According […]

Top 10 CHAP Deficiencies

The following is a list of the top 10 CHAP deficiencies cited during 2014 surveys.  Listed with the standard description is the number of your policy(s) that supports compliance with the CHAP standard. Our goal with providing you with this information is to give you an additional edge for your survey.       CHAP Standard: Description […]

Changes to QIO Providers beginning August 1st, 2014

Ohio KEPRO  (KEPRO) was recently awarded three CMS Beneficiary and Family-Centered Care (BFCC) contracts that encompasses 34 states across the nation. States affected are: District of Columbia, Delaware, Florida, Georgia, Maryland, North Carolina, South Carolina, Virginia, West Virginia, Alabama, Arkansas, Colorado, Kentucky, Louisiana, Mississippi, Montana, North Dakota, New Mexico, Oklahoma, South Dakota, Tennessee, Texas, Utah, […]