Home Health 201: What's New in HH Regulations for 2018?
Even through CMS and the federal government have pledged to reduce regulations this year, there never seems to be a shortage of new and changed regulations that impact home care and this year is no exception. This one day program provides an overview of some of the most significant regulatory issues that have impacted home health services over the last 6-12 months. While our Home Health Fundamentals program focuses on the clinical staff as the key to documentation to support individual eligibility, coverage and payment for home health services, this program provides information for management, supervisory and more experienced clinical personnel to highlight new initiatives, reports, trends, and focus on activities that are impacting home health services across the country in the recent past, currently and in the future.
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The program will enable attendees to:
1. Identify the current players and hot topics that home care providers can expect to see this year:
- Latest updates to the Office of Inspector General’s workplan for home care
- Highlights of the 2017 Annual Report of the Health Care Fraud and Abuse Control program
- Medicare Payment Advisory Commission’s 2018 Annual Report to Congress
- Roles and target areas for CERT, ZPIC, Recovery Auditors, and other CMS contracted oversight organizations in home care in 2018
2. Recent Trends in Regulatory Citations and Claim Denials Resulting from Home Care Audits and Surveys
Palmetto GBA:
- Most common denial reasons, posted audits, Targeted Probe and Educate
- Division of Health Services Regulations Surveys – most common citations under new CoPs
- HIPAA Complaints and compliance reviews
3. Medicare parts A and B Appeals Process
- Appealable and non-appealable home health claims
- Summary of the five Levels of appeal: filing and decision timeframe, request process, minimum amount in controversy, decision maker, audit tips
- Expedited appeal process
4. Summary of Selective updates and initiatives from last 6-12 months such as:
- Non-skilled Home Care Benefit in Medicare Advantage
- Draft OASIS D item set revisions
- New Medicare Cards
- 2018 Federal Budget provisions for home health and hospice: F2F documentation, New HH case mix model
- Value Based Purchasing Demonstration Update
- IMPACT Act update
Presenter: Judy Adams, RN, BSN, HCS-D, AHIMA Approved ICD-10-CM Trainer, Adams Home Care Consulting, Inc. is a well-known health care consultant and speaker with over 30 years of healthcare experience and extensive experience in home care and home health management. Judy frequently speaks nationally on home health coverage; coding; HH COPs; PPS and medical review.
The Association for Home and Hospice Care of North Carolina is an approved provider of continuing nursing education by the North Carolina Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.