New CMS Guidance on Unannounced Surveys and Blackout DatesJune 28, 2023CMS has issued a memo to Accrediting Organizations and State Agencies reiterating that all surveys must be unannounced, and no contact should occur with the agency prior to entrance on the first survey day.
CMS further stated that they understand that some fact gatherings such as business address and hours require communication between the agency and the Accrediting Organization/State Agency. However, they expect that these practices shall cease at least six months prior to the end of the agency’s survey cycle.
In addition, CMS reminded Accrediting Organizations and State Agencies that “black out dates” which are dates the provider requests or prefers not to be surveyed, are not consistent with CMS’ survey expectations.
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How New Education Requirements Could Affect Home HealthJanuary 02, 2019Education requirements for home health admin increased when the updated Conditions of Participation went into effect. Learn more about how these new regulations will impact current and future home health agency administrators. |
Home Health Care Valuable to Seniors’ Mental HealthApril 25, 2017Study after study has revealed that home health services reduce hospital readmissions, help improve the management of chronic diseases, and improve patient engagement, among other benefits. |
How Home Health Care Agencies Can Improve Family Involvement in CareApril 07, 2017Because the number of family caregivers is growing so quickly, there is a major push among advocacy groups to provide better support to these important individuals. |
Using Social Media to Market Your Home Care BusinessDecember 07, 2016Incorporating social media into your HHA’s marketing is a smart move, and can help you build your client base and customer loyalty. |
CY 2017 HH PPS Final Rule is comingDecember 05, 2016CMS has published the final rule with changes in regulation to the PPS System for Medicare for Calendar Year 2017. These regulations are effective on January 1, 2017. Changes include yearly updates to rates and constants, but also include a new way of determining whether a certification period is an outlier, and an update to the outlier payment formula. In this article, you will find a summary of the changes introduced with this final rule. |
CY 2017 HH PPS Final Rule en caminoDecember 05, 2016CMS ha publicado el Final Rule con los cambios regulatorios al Sistema PPS para Medicar para el año calendario 2017. Estas regulaciones son efectivas a Enero 1, 2017. Los cambios incluyen actualizaciones anuales a montos y constantes, pero también incluyen una nueva manera de determinar si un período de certificación es outlier y una actualización en la fórmula del pago de episodios outlier. En este artículo, encontrará un resumen de los cambios introducidos por esta Final Rule. |
CARE ConferenceNovember 29, 2016Igea users, please join us February 6-10 in Clearwater Beach, FL for our first-ever users conference! Click here for more info http://bit.ly/2gvI0y2
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Conferencia CARENovember 29, 2016Usuarios de IGEA, por favor únanse a nosotros del 6 al 10 de Febrero en Clearwater Beach, FL para nuestra primera conferencia de usuarios! Para más información: http://bit.ly/2gvI0y2
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How Employee Engagement Can Improve HHCAHPS ResultsNovember 25, 2016While the star ratings awarded to agencies only tell part of the story, as Quality of Care star ratings are determined by a separate set of criteria, many patients and referring providers will take patient satisfaction into consideration when selecting a provider. |
Cómo el Compromiso de los Empleados puede mejorar los resultados de HHCAHPSNovember 25, 2016Si bien el rating de estrellas asignado a las agencias sólo cuenta una parte de la historia, al estar estos Ratings determinados por un conjunto independiente de criterios, muchos pacientes y proveedores que derivan están tomando en cuenta la satisfacción del paciente al momento de elegir un proveedor. |
CMS announces new Star Rating system for HHCAHPSAugust 25, 2015The Centers for Medicare and Medicaid Services (CMS) created the Home Health Compare website on Medicare.gov to assist patients in selecting a home health care provider with the help of information on provider quality. However, many consumers feel that the site contains too much data and measures for it to be considered user-friendly. |
How will mHealth lead to better patient engagement?June 15, 2015The continuum of care can be a challenging process for providers, especially when the patients involved are elderly or living with chronic health conditions. Thankfully, existing clinical technologies have emerged to facilitate remote monitoring of these at-risk individuals, leading to the emergence of mHealth services. |
HB 441 – Regulación sobre centros de salud y serviciosApril 30, 2015El Proyecto de ley “HB 441” remueve el requerimiento del reporte trimestral para las agencias de cuidado de salud en el hogar, como también las multas por el retraso en la entrega del reporte. En cambio, el proyecto de ley requiere que las agencias reporten el número de pacientes recibiendo servicios a AHCAH durante el proceso de renovación de licencias. |
HB 441 - Regulation of Health Care Facilities and ServicesApril 29, 2015The bill “HB 441” removes the quarterly reporting requirement for home health agencies, and the associated fines for late submittal of the report. Instead, the bill requires all home health agencies to submit the number of patients that are receiving home health services to AHCAH during the licensure renewal process. |
Scheduled CAHSAH bill hearings April 7 - 8April 02, 2015CAHSAH announced two bill hearings next week. The priority bill hearing AB-637 is scheduled to be heard on Tuesday, April 7. SB-3, the minimum wage increase bill is scheduled for Wednesday, April 8th. Read our announcement for more information. |
Revisiones de facturas/OASIS – por MLN (Medicare Learning Network)March 04, 2015Para las facturas de HHAs recibidas a partir de Abril 1, 2015, Medicare comparará el HIPPS reportado contra el HIPPS del OASIS presente en QIES. |
Revised product from the Medicare Learning NetworkMarch 02, 2015For home health PPS claims received on or after April 1, 2015, Medicare will validate the submitted HIPPS code against the OASIS calculated HIPPS code present in QIES. |
NAHC Announces the March on Washington ConferenceFebruary 23, 2015NAHC is hosting the 2015 March on Washington Conference in Washington, DC from March 22 - 25, 2015. |
NAHC anuncia su conferencia de marzo en WashingtonFebruary 23, 2015NAHC organiza su conferencia “March on Washington” en Washington, DC desde Marzo 22 al 25, 2015. |
Proveedores se movilizar en contra de los bonos de garantía para la salud en el hogarFebruary 18, 2015“Home Health Care News” publicó un artículo explicando la propuesta de bonos de garantía de salud a domicilio. Los líderes en la industria de salud en el hogar, tales como la Asociación Nacional para el Cuidado del Hogar y Hospicio (NAHC), están expresando su oposición a los bonos de garantía propuestos. Están pidiendo a los proveedores a unirse a ellos en expresar su oposición, ya que creen que podría perjudicar a las pequeñas agencias de salud en el hogar. El artículo se puede leer a continuación. |
Providers Mobilize Against Home Health Surety BondsFebruary 17, 2015Home Health Care News released an article explaining the proposed home health surety bonds. Leaders in the home health industry, such as the National Association for Home Care and Hospice, are expressing their opposition to the proposed surety bonds. They are asking providers to join them in voicing their opposition, since they believe it could hurt small home health agencies. The article can be read here. |
CMS Extends Targeted Home Health MoratoriumFebruary 04, 2015CMS announces the extension of temporary moratoria on the enrollment of new ambulance suppliers and home health agencies (HHAs) in specific locations within designated metropolitan areas in Florida, Illinois, Michigan, Texas, Pennsylvania and New Jersey. The extension of the home health moratorium is targeted to prevent and combat fraud, waste and abuse. CMS's full article can be read below, and the Federal Register document can also be found at the bottom of this article. |
CMS extiende la moratoria de agencias de salud en el hogarFebruary 04, 2015CMS anuncia la extensión de la moratoria temporal sobre la inscripción de nuevos proveedores de ambulancia y agencias de salud de en el hogar (HHA) en lugares específicos dentro de las áreas metropolitanas designadas, en Florida, Illinois, Michigan, Texas, Pensilvania y Nueva Jersey. La extensión de la moratoria para las agencias de salud en el hogar está dirigido a prevenir y combatir el fraude, despilfarro y abuso. Puede leer el artículo completo de CMS, y el documento del Registro Federal, debajo de este artículo. |
February is National Senior Independence MonthJanuary 29, 2015February is National Senior Independence Month. Throughout the month of January, Igea has been posting #healthtips on our social media sites. We will continue doing this through the month of February to promote health and awareness for senior independence. Caregivers – share these tips with your patients. Seniors – take note of your favorite tips and work them into your daily routine.
Follow us on Facebook, Twitter, Google+ and LinkedIn to receive these #healthtips for seniors. |
Head of Medicare and Medicaid to ResignJanuary 19, 2015The New York Times released an article this weekend announcing that Marilyn B. Tavenner, head of Medicare and Medicaid, will resign. |
More on OASIS C1 and it's changesDecember 12, 2014OASIS-C1 and the changes the new assessment will bring will take effect on January 1, 2015. It is important to note the changes and modifications that will be made due to OASIS-C1. This announcement includes the changes that will come with the new OASIS C1, and how Igea Software’s new version will meet the needs of the new assessment |
Cambios a OASISDecember 12, 2014A partir de Enero 1ro 2015, entran en vigencia el OASIS-C1 y algunos cambios a la estructura del OASIS. Es importante estar al tanto de estas modificaciones relacionadas con la implementación del OASIS-C1. Además, el sistema para envío de los archivos de OASIS dejará de funcionar a las 06:00 pm de Diciembre 26, 2014 hasta las 11:59 pm de Diciembre 31, 2014, con el fin de realizar la transición de los datos desde la base estatal al nuevo sistema federal ASAP. Aquí presentamos un sumario de los cambios que se implementan y qué cosas se implementarán en la nueva versión de Igea Software que se publicará durante Diciembre: |
OASIS C1December 10, 2014A partir de Enero 1ro, 2015, los archivos de OASIS deberán ser enviados a CMS a través del sistema nacional OASIS Assessment Submission and Processing (ASAP). Las agencias no podrán seguir enviando los OASIS a través del Sistema estatal a CMS. Debido a este, y en base a otros cambios relacionado a la implementación de OASIS C1, Igea implementará una nueva versión del sistema durante Diciembre 2014 con todos los cambios necesarios. Ingrese en el artículo para más información sobre OASIS C1… |
OASIS C1 is Coming Soon!December 09, 2014Effective January 1, 2015, OASIS assessment data will be submitted to CMS via the national OASIS Assessment Submission and Processing (ASAP) system. Home Health Agencies will no longer submit OASIS assessment data to CMS via their state databases. Due to this change, along with other changes to OASIS, Igea will be implementing a new version in December 2014 to prepare for these changes. Open this article to read the overview of OASIS C1... |
HCAF submits comments on the proposed conditions of participationNovember 26, 2014HCAF submitted comments on the proposed conditions of participation today to the Centers of Medicare and Medicaid Services. While HCAF believes many of the guidelines in the proposed rule are a positive step with regards to patient safety and agency operational guidelines, there were many areas that HCAF felt it was imperative that changes are recommended for the good of our members and the Medicare home health industry. |
OASIS (HHA) to QIES Assessment Submission and Processing (ASAP) SystemNovember 24, 2014An important announcement from CMS: Effective January 1, 2015, OASIS assessment data will be submitted to CMS via the national OASIS Assessment Submission and Processing (ASAP) system |
CMS anuncia cambios en los pagos de Medicare para home health agencies en el 2015November 14, 2014Los Centros de Servicios de Medicare y Medicaid (CMS) anunciaron cambios en el sistema de pagos del prospected payment system (HH PPS) para el año calendario 2015. |
CMS announces payment changes for Medicare home health agencies for 2015November 05, 2014The Centers for Medicare & Medicaid Services (CMS) announced changes to the Medicare home health prospective payment system (HH PPS) for calendar year 2015. In a recent article, CMS projects that Medicare payments to home health agencies in 2015 will be reduced by 0.30 percent, or $60 million. |
VA Home Care Program Could Revolutionize HealthcareOctober 29, 2014A new article from Home Health Care News describes a program that will provide home care for veterans:
A program from the U.S. Department of Veterans Affairs (VA) that not only provides in-home care to veterans but support for their caregivers as well could revolutionize healthcare, says a recent blog post from The Hill. |
NAHC Establishes Ebola Task Force for Home Care WorkersOctober 24, 2014The National Association for Home Care & Hospice (NAHC) announced the creation of an Ebola Task Force Wednesday, which aims to help home care agencies protect their workers from the spread of the Ebola virus. |
Calif. Court: Caregivers Injured by Alzheimer’s Patients Cannot SueAugust 12, 2014A new ruling from the California Supreme Court says home health workers hired to care for Alzheimer’s patients may not sue them or their families for injuries caused by those patients. |
Corte de Calif.: Los enfermeros lesionados por pacientes con Alzheimer no pueden demandarAugust 12, 2014Un nuevo fallo de la Corte Suprema de California indica que los trabajadores de salud a domicilio contratados para atender a los pacientes con Alzheimer no pueden iniciar demandas en contra de ellos o a sus familias por los daños que los mismos le ocasionen. |
Medicare’s Home Health CutsAugust 06, 2014Great visual on how Medicare’s Home Health Cuts Could Disproportionately Affect Women |
Investing in home health careJuly 21, 2014Home health market poised for growth! Investing tips plus general industry information: http://igeasoftware.com/news/investing-home-health-care/ |
Pecos System Issue updateJune 24, 2014A CMS system integration error with the PECOS and claim processing has been identified. The information below is from Palmetto. According to CGS, a resolution to this issue is scheduled for implementation with the July 2014 system release. No provider action is required. |
New Alternative Penalties for Home Health start July 1June 03, 2014Centers for Medicare and Medicaid Services has added a new chapter to the State Operations Manual, specifically devoted to sanctions when Medicare certified home health agencies are found out of compliance. |
Adjustments will be made to Correct Home Health Claim PaymentsMay 02, 2014Medicare contractors have identified two incorrect payment calculations affecting home health claims. |
It is now official: ICD-10 code delayedApril 02, 2014President Barack Obama has indeed signed the SGR patch legislation – which includes another delay of ICD-10 implementation, to Oct. 1, 2015. |
Possible delay in the implementation of ICD-10April 01, 2014The U.S. Senate voted to pass the Protecting Access to Medicare Act of 2014, which both pushes back the compliance deadline for ICD-10 perseveres the pay rate for doctors treating Medicare patients. Before those officially take hold, however, the President has to sign the bill into law. |
Palmetto GBA says no more snail mail for Remittance Advice NoticesMarch 26, 2014Sign up today to use the Online Provider Services (OPS), which will save your office time and money. |
Emergency preparedness overviewMarch 18, 2014New York Times article give a holistic view behind the new rules regarding disaster plans |
Se extiende el reemplazo del Common Working File (CWF - HIQH) por HIPAA Eligibility Transaction System (HETS)March 05, 2014El cierre definitivo del CWF estaba originalmente programado para Abril 2014 pero CMS extendió la fecha. CMS proveerá la nueva fecha de terminación con una anticipación de al menos 90 días. |
Delay in the HIPAA Eligibility Transaction System (HETS) Replacement of Common Working File (CWF) March 05, 2014The termination was originally scheduled for April 2014, but CMS is delaying the date. CMS will provide at least 90 days advanced notice of the new termination date. |
The Home Health Care Market is Expected to Expand to $130 Billion by 2017February 11, 2014With the Affordable Care Act and other factors coming into play within the health care industry, the home health care market has been seeing a surge or growth in recent years, with even great expectations for the next several years. |
CMS Enrollment Moratorium on new HHA's extended to many counties in TexasFebruary 04, 2014The Centers for Medicare & Medicaid Services (CMS) has extended a temporary enrollment moratorium for Home Health Agencies (HHAs) that enroll in Medicare, Medicaid or CHIP in Dallas and Houston counties. |
Service Specific prepay Probe Review for Select Home Health HIPPS Codes will be performed by Palmetto GBAJanuary 28, 2014Palmetto GBA will be performing service-specific prepay probe reviews on claims billed for selected Home Health HIPPS codes. |
CMS announced a Temporary Hold of Home Health LUPA ClaimsJanuary 21, 2014Medicare contractors have identified an incorrect payment calculation affecting home health claims that would be paid low utilization payment adjustments (LUPAs). To prevent these claims from paying incorrectly, A correction date is now set for February 10. |
CMS anuncio una retencion temporaria de casos facturados tipo LUPA. January 21, 2014Medicare ha identificado errores en el calculo de pago que afecta las facturas tipo LUPA (ajuste de pago por baja utilizacion). |
Proximamente: CMS puede llegar a solicitar a las agencias de salud un Plan de Preparacion para EmergenciasJanuary 14, 2014Aun no existe aun la regulacion pero CMS puede llegar a solicitar un Plan de Preparacion para Emergencias que debe incluir una Evaluacion de Riesgo y Planificacion, polizas y procedimientos, comunicacion, entrenamiento y testeo. |
Coming soon: CMS could require emergency preparedness plans from home health agency. January 14, 2014While there is currently no rule in place, CMS could require home health agencies emergency plans which would include risk assessment and planning, policies and procedures, communication, and training and testing. |
The number of ACO's is on the rise.January 02, 2014Recently, health care providers formed 123 new Accountable Care Organizations (ACOs) in Medicare, providing approximately 1.5 million more Medicare beneficiaries with access to coordinated care across the United States. |
Crece el numero de ACOsJanuary 02, 2014Recientemente proveedores de salud han formado 123 ACOs en Medicare proveyendo aproximadamente 1.5 millones mas de beneficiarios Medicare con acceso a servicios de cuidado coordinados en los Estados Unidos. |
Medicare Finaliza Pagos de Home Health para el año 2014November 27, 2013El 22 de Noviembre, CMS emitió la norma final CY 2014 de atención médica domiciliaria. Las pólizas de la norma se alinean mejor con los pagos de Medicare y los costos que las agencias incurren al proveer atención a los pacientes, al mismo tiempo reducen los costos para los contribuyentes y los 3.5 millones de beneficiarios de Medicare que reciben servicios de salud en el hogar en todo el país. |
Medicare Finalizes Home Health Payments for 2014November 25, 2013The Centers for Medicare & Medicaid Services (CMS) today issued the final calendar year (CY) 2014 home health care payment rule. The final policies in this rule better align Medicare payments with home health agencies’ costs providing care, while lowering costs to taxpayers and the 3.5 million Medicare beneficiaries who receive home health services nationwide |
Se pospone por un año la implementación de los HIPPS Codes para Medicare AdvantageNovember 19, 2013CMS ha anunciado que el 1 de Julio de 2014 será la nueva fecha a partir de la cual las facturas de Medicare Advantage (MA) que no incluyan "health insurance prospective payment system" (HIPPS) code para servicios de home health serán rechazadas. |
CMS Delays Implementation of HIPPS Codes on Medicare Advantage Claims November 19, 2013The Centers for Medicare & Medicaid Services (CMS) has announced July 1, 2014 as the new start date for edits to reject Medicare Advantage (MA) plan claims that fail to provide a health insurance prospective payment system (HIPPS) code for home health services. |
Providing quality care could get more costly!September 27, 2013Recently announced changes to "domestic service" regulations could have a significant impact to your bottom line. Fortunately, igea software is working hard to make sure you stay in compliance while minimizing costly overtime payments! |
Los cambios recientemente anunciados podrían tener un impacto significativo en su balance finalSeptember 27, 2013Los cambios recientemente anunciados a las regulaciones de "servicio doméstico" (domestic Service) podrían tener un impacto significativo en su balance final. Afortunadamente, Igea está trabajando duro para asegurarse de que pueda cumplir con las regulaciones y reducir al mínimo los costos por pagos de horas extras. |
Los costos de empleados de cuidado de salud podrían elevarseSeptember 24, 2013Los cambios recientemente anunciados a las regulaciones de "servicio doméstico" (domestic Service) podrían tener un impacto significativo en su balance final. Afortunadamente, Igea está trabajando duro para asegurarse de que pueda cumplir con las regulaciones y reducir al mínimo los costos por pagos de horas extras. |
Providing quality care could get more costly!September 24, 2013Recently announced changes to "domestic service" regulations could have a significant impact to your bottom line. Fortunately, igea software is working hard to make sure you stay in compliance while minimizing costly overtime payments! |
CMS - HHAs must report new Q Codes for "Place of Service"June 06, 2013CMS announced its Change Request 8136 (revised), which adds new data reporting requirements for Home Health Prospective Payment System (HH PPS) claims. Effective July 1st, 2013, Home health agencies must report new codes indicating the location of where services were provided. |
CMS - Nuevos códigos Q para lugar del servicio (Place of Service) en las facturasJune 06, 2013CMS anunció una Instrucción de Cambio (Change Request) 8136 (revisada), que requiere datos nuevos a ser reportados en la factura bajo el sistema Home Health System Prospective System (PPS HH. Las agencias deberán reportar los nuevos códigos que indican la ubicación del lugar donde se prestan los servicios. |
CMS Announces Temporary Delay in PECOS ImplementationApril 29, 2013Last week, CMS announced a temporary delay in the implementation of Phase 2 PECOS edits that would have been implemented starting on May 1st, 2013:
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CMS anuncia retraso temporal en la implementación de PECOSApril 29, 2013CMS anunció la semana pasada un retraso temporal en la implemtación de la Fase 2 de PECOS con fecha de implementación original Mayo 1, 2013. |
Palmetto Medicare RAP SuppressionApril 23, 2013On late last Friday, HCAF learned that Palmetto GBA plans to suppress RAP payments to home health agencies with a large number of auto-cancelled RAPs. |
Palmetto Medicare: supresión de pagos de RAPsApril 23, 2013El pasado viernes, HCAF hizo publico el plan de Palmetto GBA de suspender los pagos de RAPs a las agencias de salud en el hogar (HHAs) con un gran numero de RAPs auto-cancelados: |
CMS: April 2013 Home Health Claim Hold LiftedApril 18, 2013The Centers for Medicare and Medicaid Services has directed its Medicare claims administration contractors to release all claims into processing that they have been holding as a result of technical issues associated with the April 2013 quarterly systems release. |
CMS: se levantó la retención de facturas de Abril 2013April 18, 2013CMS ha solicitado a los contractores administrativos de Medicare a liberar para su procesamiento a todas las facturas que estaban siendo retenidas como resultado de una cuestion tecnica asociada a la implementacion del sistema en Abril 2013. |
Medicare: claims will be denied if physician not on PECOS starting May 1, 2013March 25, 2013Effective May 1, 2013, CMS will instruct contractors to turn on Phase 2 denial edits on the claims to check for a valid individual National Provider Identifier (NPI) and to deny the claim when the physician´s NPI reported is not enrolled in PECOS. |
A partir Mayo 1, 2013 Medicare rechazará facturas con NPI de doctores que no estén en PECOSMarch 25, 2013A partir de Mayo 1, 2013, CMS instruira a los contratantes activar la Fase 2 de rechazos de facturas para aquellas que no reporten un NPI (Identificador de Proveeder Nacional) valido o no registrado aun en PECOS. |
Palmetto GBA Medicare: Montos positivos incorrectos en ERNs para RAPs TOB 328 February 19, 2013Medicare ha estado entregando Notas de Remitos Electronicos (ERNs) con montos incorrectos para pagos de RAPs con tipo de factura (TOB) 328 al momento de reportar el pago final del episodio junto al Final Claim. |
Palmetto GBA Medicare: Incorrect positive amounts on Remittance Advice for RAPs TOB 328 February 19, 2013Medicare has been delivering Electronic Remittance Notices (ERNs) with incorrect amounts for RAP payments (TOB 328) at the moment of paying the episode´s Final amount (FC payment). |
Meet the New iPOC 5!! – Faster, Easier, Better…January 23, 2013After listening to you and your needs, we are proud to announce the release of the NEW iPOC 5! |
Conozca al nuevo iPOC 5! - Más Rápido, Más Fácil, Mejor ...January 23, 2013Después de escucharlo a usted y a sus necesidades, estamos orgullosos de anunciar el lanzamiento del NUEVO iPOC 5! |
Medicare fraud detection system saves $115 millionDecember 28, 2012A new technology system designed to stop fraudulent Medicare payments before they happen saved about $115 million and triggered more than 500 investigations since its launch in the summer of 2011. |
Sistema de detección de fraudes de Medicare ahorra $115 millonesDecember 28, 2012Un nuevo sistema tecnologico diseñado para impedir pagos fraudulentos a Medicare antes de que estos ocurran ha ahorrado aproximadamente $115 millones y abrio más de 500 investigaciones desde su lanzamiento, en el verano de 2011, |
Medicare Therapy Assessment - New Q&A document by CMSDecember 20, 2012CMS has just released revised therapy assessment Q&As that reflect the changes for the therapy reassessment requirement effective on 1/1/2013. |
Evaluaciones de Terapia Medicare - Nuevo documento con Preguntas y RespuestasDecember 20, 2012CMS acaba de publicar un documento actualizado con Preguntas y Respuestas sobre la regulacion de evaluaciones de terapias, reflejando algunos cambios para la regla que seran efectivos a partir de Enero 1, 2013. |
Holiday Hosting Center MoveDecember 18, 2012We are going to move our servers to a different hosting facility this Friday, December 21st starting at 9:00 pm, PST, and until Saturday, December 22nd at 6:00 am (estimated). During this time access to the servers will be interrupted. |
Mudanza de Hosting Center durante las FiestasDecember 18, 2012Mudaremos nuestros servidores a otro hosting center, este viernes, 21 de diciembre, a partir de las 9:00 pm PST, hasta el sabado, 22 de diciembre a las 6 am PST (estimado). Durante este tiempo, el acceso a los servidores estara interrumpido. |
How Raising eligibility could change MedicareDecember 17, 2012Rising the age for starting Medicare is among the leading proposals to slow the program's spending — key to a federal budget deal. But how would it work? |
Cómo puede cambiar a Medicare elevar la edad de ingresoDecember 17, 2012El aumento de la edad de ingreso a Medicare esta entre las propuestas principales hechas para evitar el crecimiento del gasto de este programa y es clave para un acuerdo presupuestario federal. Sin embargo, ¿como funcionaria esto? |
New Financial Report on Improper Medicare Payment Rates Signals Need for Program Integrity ReformsDecember 14, 2012With improper payment rates remaining high, home health community leaders offer solutions to prevent Medicare fraud and abuse. |
Nuevo Reporte Financiero sobre pagos incorrectos a Medicare señala la necesidad de reformas en la integridad del programaDecember 14, 2012Mientras la tasa de pagos indebidos permanece alta, lideres de la comunidad de cuidados en el hogar ofrecen soluciones para prevenir el abuso y fraude de Medicare. |
Florida Home Health Agency Quarterly Reports (HHQR) – Reminder of changesDecember 13, 2012This is a reminder that beginning January 1, 2013, the Home Health Agency Quarterly Report (HHQR) System will change. |
Florida - Reporte Trimestral (HHQR) - Recordatorio de cambiosDecember 13, 2012Les recordamos que a partir de Enero 1º, 2013, el Reporte Trimestral de Agencias de Salud en el Hogar (HHQR) cambiara su sistema. |
Class Action Lawsuit Settlement may change Medicare Home Health, Skilled Nursing Service, and Therapy Coverage.December 07, 2012The Department of Health and Human Services agreed in a proposed settlement to remove Medicare’s administrative review process that denies coverage for therapy and skilled nursing services when the beneficiary is not supposed to improve his current medical condition, needs only “maintenance services”, has reached “plateau” or has a chronic condition. |
Demanda Legal cambiaría el alcance de la cobertura de Medicare para cuidados en el hogar, servicios de enfermeros especializados y terapiasDecember 07, 2012El Departamento de Servicios de Salud y Humanitarios acordo eliminar el proceso administrativo de revision de Medicare que niega cobertura para servicios de terapias y enfermeros especializados cuando el beneficiario probablemente no mejore su condicion medica actual, necesite solo “servicios de mantenimiento”, haya alcanzado su máxima mejoría o sufra de una condicion cronica. Esta regla es conocida como el “Estandar de Mejoria”. |
Palmetto GBA Holiday hoursNovember 20, 2012Palmetto GBA offices will be closed on Thursday, November 22, 2012, and Friday, November 23, 2012, in observance of Thanksgiving. |
Días de Acción de Gracias de Palmetto GBANovember 20, 2012Las oficinas de Palmetto GBA permaneceran cerradas el Jueves 22 y Viernes 23 de Noviembre, 2012. |
Medicare PPS Home Health FY2013 Final Rule IssuedNovember 08, 2012HHPPS 2013 Rates Reflect Inflation Update and Case Mix Creep Adjustment; Important Policy Changes on CoP Non-Compliance Sanctions: Clarifications and Improvements on Face-to-Face and Therapy Assessment Rules. |
Regla Final de Medicare HH PPS FY2013 publicadaNovember 08, 2012Los montos de pago para HHPPS 2013 reflejan una actualizacion inflacionaria y ajuste al Case Mix, cambios importantes en la politica de las sanciones por no cumplimiento del CoP; aclaraciones y mejoras en las regulaciones del Face-To-Face y evaluaciones de terapia.
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CMS PPS HH FY2013 Proposed Rule overviewOctober 26, 2012On July, the public PPS Home Health for year 2013 Proposed Rule was published. Here is an overview of the most important changes. |
Meeting with Your ICD-10 Project TeamOctober 12, 2012To make sure your organization successfully makes the switch from ICD-9 to ICD-10 by the October 1, 2014, compliance deadline, it will be important to meet with your ICD-10 Project Team regularly to discuss transition activities, challenges, and needs. |
Reuniéndose con su equipo de proyecto ICD-10 October 11, 2012Para asegurar que su organizacion realice un cambio exitoso de ICD-9 a ICD-10 para Octubre 1, 2014, fecha de implementacion final, sera importante que se reuna con su Equipo de Proyecto ICD-10 regularmente para hablar sobre las actividades de la transicion, desafios y necesidades. |
PPS Calculator: estimate payment before admissionSeptember 26, 2012Did you know that with our Igea tool “PPS Calculator” you can estimate the payment for a Medicare patient before the admission? Our calculator let´s you calculate the estimated profit and loss of the patient´s treatment for your agency. |
PPS Calculator: cálculo del pago estimado antes de la admisiónSeptember 26, 2012Con nuestra herramienta “PPS Calculator” usted puede calcular cual va a ser el pago estimado para un paciente de Medicare incluso antes de admitirlo. Nuestra calculadora le permite estimar cual va a ser su ganancia y costos por el tratamiento del paciente. |
From the MLN: “Medicare Enrollment Guidelines for Ordering/Referring Providers” Fact Sheet — RevisedSeptember 20, 2012The Medicare Enrollment Guidelines for Ordering/Referring Providers Fact Sheet (ICN 906223) was revised and is now available in downloadable format. |
“Guia de Medicare para los proveedores que Ordenan/Refieren” – Nueva publicación September 20, 2012El fact sheet “Medicare Enrollment Guidelines for Ordering/Referring Providers” (ICN 906223) fue revisado y esta ahora disponible en un format descargable. |
ICD-10 Transition Information Providers and Payers Need to ShareSeptember 18, 2012The compliance deadline for ICD-10 is now October 1, 2014. With two years to complete ICD-10 implementation, providers and payers will need to communicate regularly to help ensure a smooth transition. Here is some tips you should know. |
2013 ICD9 Diagnosis and Procedure codes updatedSeptember 06, 2012The ICD9 Diagnosis and Procedure codes that will be effective starting in October 1st, 2012 through September 30, 2013 have been already updated in Igea 5 system. For our Igea 3 agencies, the update of the codes will be performed this weekend. |
Los códigos ICD9 2013 de Diagnósticos y Procedimientos han sido actualizadosSeptember 06, 2012Los codigos ICD9 de los Diagnosticos y Procedimientos que seran efectivos a partir del 1ro de Octubre de 2012, hasta el 30 de Septiembre del 2013, ya han sido actualizados en las agencias que tienen Igea 5. Para las agencias con Igea 3, la actualizacion de los codigos se hara este fin de semana. |
Igea “Outlook Warnings” overviewSeptember 04, 2012For Igea 5 we have improved our Outlook Warnings system. Now, you are able to know whatever happens in your system at any time, by enabling the Outlook Warning notifications. Igea will notify you about status changes, remind you about pending claims not billed yet, episodes that need to be recertified and much more! |
La importancia de los “Outlook Warnings” de IgeaSeptember 04, 2012Para Igea 5 hemos mejorado todo nuestro sistema de Outlook Warnings. Ahora, usted puede estar al tanto de todo lo que sucede en su sistema, en todo momento, habilitando las notificaciones Outlook. Igea le notificara sobre cambios de estados; le recordara sobre facturas aun no facturadas; episodios que estan por finalizar y necesitan recertificacion; ¡y mucho mas! |
HHS Press Release: final deadline for ICD-10 October 2014 August 28, 2012Health and Human Services Secretary Kathleen Sebelius announced the release of a rule that makes final a one-year proposed delay—from October 1, 2013, to October 1, 2014—in the compliance date for the industry's transition to ICD-10 codes. |
Fecha de implementación final de ICD-10 confirmada: Octubre 2014August 28, 2012La Secretaria de Health and Human Services¸ Kathleen Sebelius, anuncio la publicacion de la regulacion que confirma la fecha final para la transicion a los nuevos codigos de la industria ICD-10, confirmando el retraso de 1 año desde Octubre 1, 2013 a Octubre 1, 2014. |
Indura Systems: safe and secure Igea data backupAugust 23, 2012Indura Systems would like to remind you, that your Igea data is safe and secure with our periodical backups. All your system information is being backup every day (including weekends) by our backup service, and safely stored in our secure local data centers in California. |
Indura Systems: respaldo de la información de Igea (backups)August 23, 2012Indura Systems desea recordarle que la información de sus sistema Igea se encuentra respaldada de forma segura y confiable a traves de nuestro servicio de backups (respaldo de base de datos). Toda la informacion de su agencia es respaldada todos los dias, incluyendo los fines de semana, a traves de los backups que se guardan de manera segura en nuestros centros de informacion en California. |
California: Home Care Agency Licensure Bill Approved by AssemblyAugust 21, 2012Last week the State Assembly passed SB 411 (Price), the Home Care Services Act of 2012 that will require home care agencies to become licensed by the California Department of Social Services and mandate that caregivers become certified by the state. |
CMS Reminder: Order and Referral/Certifying Claims DenialAugust 16, 2012Palmetto GBA is notifying many agencies about possible claims denial related to the Ordering/Referral/Certifying Physician NPI issues. Many agencies have been receiving letters from Palmetto GBA as a reminder of the requirements when reporting the Physician NPI in the claims. So far, no claims will be denied until the automatic edits are activated, but CMS is notifying those agencies that have been submitting claims not in compliance with the requirements. |
Recordatorio de CMS: Rechazos a facturas por servicios Ordenados/Referidos/CertificadosAugust 16, 2012Palmetto GBA esta notificando a muchas agencias sobre posibles rechazos a facturas relacionadas a problemas con el NPI (National Provider Identifier) de los doctores que ordenan, refieren o certifican. Varias agencias ya han recibido un carta de Palmetto GBA como un recordatorio sobre los requerimientos a la hora de reportar el NPI del doctor en la factura. |
Electronic Remittance Notice (ERN) version X5010: EFT number format changesAugust 09, 2012Since August 1st, 2012, all Medicare contractors and fiscal intermediaries have been sending the providers their ERNs (Electronic Remittance Notice files) under the new X12 version 5010 format. Because of this, providers may notice the payment EFT number (Electronic Funds Transfer trace number) may have changed. |
ERN X5010: cambio en el formato del número EFT (Transferencia Electrónica de Fondos) August 09, 2012Desde el 1ro de Agosto 2012, los intermediarios fiscales de Medicare empezaron a enviar a los proveedores los archivos ERN (Notificación de Remito Electrónico) bajo el nuevo formato X12 5010. Debido a esto, los proveedores podrán notar que el número de identificación del EFT (Transferencia Electrónica de Fondos) ha cambiado su formato |
Florida: Outliers payment issues fixedJuly 31, 2012CMS announced last week that the latest fix to Home Health Outlier underpayment problem was successful. If monies owed have not already been received by agencies, they will be received in the next few days. |
Florida: problemas con pagos de Outliers ya fueron solucionadosJuly 31, 2012CMS anuncio la semana pasada que el ultimo arreglo a los problemas en los pagos de Outliers para Home Health fue implementado exitosamente. Si el dinero que le adeudan no ha sido aun depositado a las agencias, seran recibidos en los proximos dias. |
Act Now to Avoid Claim Denials for Ordered/Referred ServicesJuly 27, 2012CMS will soon begin denying Part B, DME, and Part A HHA claims that fail the ordering/referring provider edits.CMS will provide 60-day advanced notice prior to turning on the Ordering/Referring edits. CMS does not have a date at this time.
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Actúe ahora para evitar facturas rechazadas por Servicios Ordernados/Referidos July 27, 2012CMS pronto empezara a rechazar facturas de Parte B, DME y Parte A HHA que no cumplan con los requerimientos sobre el proveedor que ordena o refiere los servicios. CMS publicara una nota 60 dias previos a comenzar con estas validaciones, pero aun no tiene una fecha establecida. |
CMS Proposed PPS Rule Includes Therapy ChangesJuly 24, 2012Specifications related to CY2011 HH PPS final rule Therapy regulations. Comments may be submitted to CMS until September 4, 2012. |
La nueva regulación propuesta por CMS para PPS incluye cambios a terapiasJuly 24, 2012Especificaciones sobre la regla final CY2011 para HH PPS relacionadas a las regulaciones de evaluacion de terapia. Hay tiempo hasta Septiembre 5, 2012 para enviar comentarios. |
California Home Health and Hospice License Renewal Fees ReducedJuly 19, 2012The California Department of Public Health has reduced its license renewal fees for home health and hospice agencies for the new fiscal year. |
California: reducción en el precio de renovación de la licencia para agenciasJuly 19, 2012El Departamento de Salud Publica de California ha reducido el costo de la renovacion de la licencia para home health y hospice para el proximo año fiscal. |
Steps to Assess How the ICD-10 Transition will affect your Organization July 17, 2012The switch to the new code set will affect every aspect of how your organization provides care, from registration and referrals, to software/hardware upgrades and clinical documentation.
A critical step in planning for the transition is to conduct an impact assessment of how the new code sets will affect your organization.
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ICD-10: pasos para saber de qué manera la transición afectará a su organizaciónJuly 17, 2012El cambio a la nueva codificacion afectara cada aspecto de su organizacion, desde la registracion y las referencias, hasta el software/hardware que tendran que ser actualizados, como tambien la documentacion.Un paso critico en el plan de transicion es realizar una evaluacion del impacto que tendra la nueva codificacion en su organizacion.
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Medicare HH PPS: Actualización de los montos de pago y cambios propuestos para el año 2013 July 13, 2012CMS publico el "HHPPS Proposed Rule" para el año calendario 2013. Los pagos a las agencias se estiman que se reduzcan en aproximadamente un 0.10%, o –$20 millones. |
Medicare HH PPS: rate updates and proposed changes for year 2013July 13, 2012CMS has published the Home Health Prospective Payment System (HHPPS) Proposed Rule for calendar year 2013. Payments to home health agencies (HHAs) are estimated to decrease by approximately 0.10 percent, or -$20 million. |
Ordering/Referring Physicians for Medicare Home Health patients – Notify your NPIJuly 10, 2012For physicians, if an HHA asks for your NPI, be sure to provide your individual NPI (not the group practice NPI). |
Doctores que refieren/ordenan servicios de pacientes Medicare en agencias – Informen su NPIJuly 10, 2012Si usted es un doctor, cuando una agencia le solicita su NPI, por favor asegurese de proveer su NPI individual y no el NPI de grupo de practica. |
U.S. Supreme Court Rules 2010 Health Care Reform Law is ConstitutionalJune 28, 2012The U.S. Supreme Court this morning ruled that the Patient Protection and Affordable Care Act are constitutional. Now that the Affordable Care Act has been upheld by the highest court in the nation, the federal government and states will proceed with implementation of health care reform. |
La Suprema Corte de Estados Unidos declaró que la Ley de Reforma de Salud 2010 es constitucionalJune 28, 2012La Suprema Corte de Estados Unidos declaro esta mañana que la Patient Protection and Affordable Act es constitucional. Ahora que el Affordable Care Act ha sido analizado por el maximo tribunal de la nacion, el gobierno federal y los estados empezaran a implementar la reforma de salud. |
X5010 Transition: starting on July 1, 2012 only X5010 transactions will be acceptedJune 21, 2012Effective July 1, 2012 only ASC X12 Version 5010 formats will be accepted by Medicare FFS and Medicaid. At Indura Systems, Inc. we are proud to notify you that, if your agency have been billing electronically through Igea HHC, you have been successfully billing and submitting X5010 claims for the past months! |
Transición a X5010: a partir de Julio 1, 2012 solamente las transacciones X5010 serán aceptadas.June 21, 2012A partir de Julio 1, 2012 solamente los formatos bajo el estandar ASC X12 versión 5010 seran aceptados por Medicare FFS y Medicaid. Indura Systems esta orgulloso de notificarle que, si su agencia estuvo facturando electronicamente a traves del sistema Igea HHC, ya ha estado facturando bajo la version X5010 durante los ultimos meses! |
Interested in applying for the Medicare Shared Savings Program? Do it now!June 13, 2012The period to apply for the Medicare Shared Savings program has been extended till June 29. In order to apply, agencies must submit a Notice of Intent (NOI). |
¿Interesado en aplicar para el programa “Medicare Shared Savings”? Hágalo ahora!June 13, 2012El período para aplicar para el programa Medicare Shared Savings ha sido extendido hasta Junio 29. Para participar del programa, las agencias deben enviar una Nota de Intencion (NOI). |
Outstanding Outlier PaymentsJune 11, 2012Due to a CMS long-standing problem with the outlier payment processing system, some agencies have not received their full outlier payments for the years 2010, 2011, and 2012. Agencies can submit a request to their Medicare contractor for an accelerated payment about 70% of the total amount due. |
Outliers: Montos pendientes de cobrarJune 11, 2012CMS ha confirmado un problema que viene hace largo tiempo ya en relacion a los procesamientos de pago de outliers y sus montos. Algunas agencias no han recibido el pago completo por sus casos outliers de los años 2010, 2011 y 2012 debido a este problema. Las agencias pueden solicitarle a su contractor de Medicare para que realice un “pago acelerado”. |
CMS Responds to Inquiry on HHA PECOS StatusMay 30, 2012After analysis of the Federal Register notice, the National Association for Home Care & Hospice (NAHC) posed a series of questions to CMS in its efforts to help home health agencies to be prepared for the eventual initiation of edits of claims for Medicare enrollment status of ordering and certifying physicians. |
CMS responde sobre physicians en PECOSMay 30, 2012Luego del analisis de la nota del Federal Register, la National Association for Home Care & Hospice (NAHC) envio una serie de preguntas a CMS con el fin de ayudar a las agencias a estar preparadas para el eventual analisis de las facturas sobre el estado de enrolamiento en Medicare de los doctores que refieren u ordenan servicios. |
CMS Website updates: Therapy and F2F Q&AsMay 28, 2012CMS revised the questions and answers posted at the Home Health Center on its website. Although the CMS responses do not reflect policy changes, the information offers greater clarity to therapy reassessment policy. |
Preguntas y respuestas de Therapy y F2F – Actualización de CMS en su websiteMay 28, 2012CMS reviso en Marzo las preguntas y respuestas hechas en su sitio web en la parte de Home Health Center. A pesar que las respuestas de CMS no reflejan ningun cambio en la regulacion ya existente, la informacion ofrece una gran aclaracion a la politica de therapy reassessment. |
Certification and Face-To-Face: useful information to share with your physiciansMay 18, 2012Medicare Releases “Physician’s Guide to Home Health Certification”. This article is designed to provide education to physicians on requirements for the home health certification and face-to-face encounter. It includes milestones and requirements that must be met to perform Physician Home Health face-to-face encounters, certifications, and recertifications. |
Certificación y Face-To-Face: información importante para que comparta con sus doctoresMay 18, 2012Medicare publico el “Physicians Guide to Home Health Certification” (Guia para el doctor sobre la certificacion de Home Health). Esta publicacion de CMS para los proveedores de Medicare fee-for-service, se focaliza en la certificacion de home health de pacientes Medicare en una edicion especial con título “Una guia para el doctor sobre la certificacion home health de Medicare, incluyendo el encuentro Face-To-Face”. |
HHS Finalizes New Rules to Cut Regulations for Hospitals and Health Care Providers, Savings More Than $5 Billion May 15, 2012On May 9, HHS Secretary Kathleen Sebelius announced significant steps to reduce unnecessary, obsolete, or burdensome regulations on American hospitals and health care providers. Changes Will Reduce Costs and Allow More Focus on Medical Care. |
HHS finaliza nuevas reglas que terminan con algunas regulaciones para Hospitales y proveedores de salud, logrando ahorros de más de $5 billonesMay 15, 2012En Mayo 9, la secretaria de HHS Kathleen Sebelius anuncio pasos significantes para reducir las regulaciones innecesarias, obsoletas o agraviantes de los hospitales y proveedores de salud. Los cambios reduciran los costos y haran mas foco en el cuidado medico. |
Home Health Claims Selected for Review with Dates of Service October 1, 2011 through December 31, 2011May 11, 2012Home Health agencies may want to review any claims with dates of service submitted from October 1, 2011 through December 31, 2011 to make a business decision as to whether or not to adjust the claim based upon a different HIPPS score determination made by V3312 of the HH PPS Grouper and the introduction of 2 new diagnosis codes: 294.20 and 294.21. |
CMS selecciónará facturas de Home Health con fechas de servicio entre Octubre 1, 2011 y Diciembre 31, 2011May 11, 2012Es recomendable que las agencias revisen sus facturas con fechas entre Octubre 1, 2011 y Diciembre 31, 2011 para poder decidir si es conveniente ajustar o no las mismas en base al puntaje del HIPPS calculado con el nuevo V3312 del HH PPS Grouper. |
There is only 1 week to Submit Comments for the HHS Proposed Rule to Delay ICD-10May 10, 2012The proposed rule to delay the compliance date for ICD-10 from October 1, 2013 to October 1, 2014 is posted to the Federal Register. There is only one week left in the 30-day comment period. This comment period allows you to provide very important feedback to HHS about this proposed compliance date change, which will affect many aspects of your organization. |
ICD-10: sólo resta 1 semana para enviar comentarios sobre la regla propuesta por HHS para demorar la implementaciónMay 10, 2012La regla propuesta para demorar la implementacion de los ICD-10 de Octubre 1, 2013 a Octubre 1, 2014 esta publicada en el registro federal. Queda solo una semana para terminar con el periodo de 30 días para enviar comentarios. Este periodo de comentarios le permite enviar su opinion y sugerencias a HHS sobre este cambio de fechas para la implementacion, la cual afectara varios aspectos de su organizacion. |
Face-to-Face Encounter Requirements: additional information and more Q&A published by CMS.May 08, 2012CMS has published a new MLN article with clarifications and regulations about the home health patient certification. It also includes an update document with new questions and answers by CMS related to the Face-to-Face encounter and documentation. |
Requerimientos para el Face-To-Face: más información y más preguntas/respuestas publicadas por CMS.May 08, 2012CMS publico un articulo MLN con el fin de proveer mas conocimientos acerca de los contenidos de la certificacion de home health, incluyendo criterios de homebound y requerimientos sobre la documentacion y el encuentro de Face-to-Face |
Major Improvements to Medicare Online Enrollment SystemMay 02, 2012CMS has made several improvements to the Medicare Online Enrollment System (“My Enrollments” page) and continues to improve the PECOS system. Here you have important information related to Medicare enrollment, Electronic Found Transfers (EFT) agreement and PECOS online services. |
Mejoras en el sistema de enrolamiento online de MedicareMay 02, 2012Durante los ultimos años, CMS ha escuchado las opiniones de varios proveedores relacionadas al sistema de enrolamiento online de Medicare (PECOS) y se han realizado varias mejoras. Aqui hay informacion importante relacionada al enrolamiento con Medicare, acuerdo de EFT y PECOS. |
CMS: Home Health Agencies Must Ensure Physician EnrollmentApril 26, 2012CMS published a rule requiring enrollment of physicians ordering home health and other services to be enrolled in the Provider Enrollment, Chain, and Ownership System (PECOS). Home health agencies should immediately begin checking every physicians Medicare enrollment status in the Ordering and Referring Physician report. This report will continue to be available through the Ordering and Referring Reports on the CMS website. The reports will be updated weekly. |
Indura Customer Support lines experiencing technical issuesApril 25, 2012Our Customer Support telephone lines are experiencing technical issues due to an external cause. |
Results from HHCAHPS survey are now available!April 23, 2012CMS announced the new tool offering prospective patients, their families and caregivers the chance to compare home health agencies by looking at patient survey results. The HHCAHPS Survey, which will be updated every four months with new survey data, will complement the clinical measures already available on the agency’s “Home Health Compare” website. You can now check your agency HHCAHPS results. |
Guidance on Troubleshooting Claims Submissions for Version 5010April 09, 2012Although the Version 5010 upgrade deadline was January 1, 2012, CMS recently extended their enforcement discretion period for the Version 5010 upgrade for all HIPAA-covered entities for an additional three months, through Saturday, June 30, 2012. |
ICD-10 implementation date delayed till October 1, 2014!April 09, 2012In a new press release from HHS, Secretary Kathleen Sebelius announced a proposed rule that would delay the compliance date for ICD-10 from October 1, 2013 to October 1, 2014. |
HHCAHPS Home Health Compare and Preview ReportsApril 07, 2012This month, CMS will include HHCAHPS results on Home Health Compare for the first time. This is expected to be released on or around April 19, 2012. Prior to that release, agencies will also have the opportunity to access their initial results in a Preview Report made available on April 11, 2012 on the Home Health CAHPS website. |
Top 10 HHA errors with OASIS, surveys and certificationsApril 04, 2012Representatives from the Centers for Medicare and Medicaid Services provided an overview of new survey protocols that went into effect in 2011 and the top ten home health survey deficiencies and OASIS transmission errors. All the information was presented using a Power Point which is available online. |
Home Health Agencies must revalidate their Medicare enrollment! FAQsMarch 26, 2012All new and existing providers enrolled with Medicare prior to March 25, 2011, must revalidate their enrollment information in accordance with the Patient Protection and Affordable Care Act, but only after receiving notification from the MAC. Here we list some frequently asked questions answered by Medicare. |
Home Health Agencies to avoid payment reductions! Participate in HHCAHPS (Consumer Assessment of Healthcare Provider and Systems) now!March 21, 2012CMS reminds all HHAs of the requirement to participate in the Home Health Care CAHPS (HHCAHPS) survey for patients served in April 2012 and after to be eligible for the full market basket payment increase for calendar year (CY) 2014, avoiding a reduction of 2% in their payments. |
All Medicare provider and supplier payments to be made by electronic funds transferMarch 20, 2012At the time of enrollment, enrollment change request or revalidation, providers and suppliers that expect to receive payment from Medicare for services provided must also agree to receive Medicare payments through electronic funds transfer (EFT). |
Clock Ticking for Governor to Sign Controversial Medicaid LegislationMarch 19, 2012A controversial measure that would shift $300 million in disputed Medicaid bills to counties has been received by Governor Rick Scott's office, triggering the 15-day window for him to either sign or veto the legislation. |
CMS Extends Discretion Period for Updated HIPAA Transaction StandardsMarch 16, 2012The Centers for Medicare & Medicaid Services’ (CMS) Office of E-Health Standards and Services (OESS) said it will not enforce action against any non-compliant entities for an additional three (3) months, through June 30, 2012. |
DDE Password Change Now Effective March 12, 2012March 09, 2012For security purposes, new DDE password rule changes will be implemented on February 12, 2012, for J11 Part A, J11 HHH and LA & MS Part A. |
Your Medicare FFS Transactions Must be 5010 Compliant by April 1stMarch 08, 2012CMS reported that the vast majority of provider claims are being sent to Medicare in 5010 format. Given these favorable results, CMS is taking the next step towards full implementation of 5010 in Medicare Fee-For-Service (FFS). |
Important Changes for Version 5010 to Keep in MindMarch 05, 2012There are three important changes for version 5010 including Version/industry group ID (GS08), ST03 element and 999 Implementation Acknowledgment. |
Summary of CMS Open Door ForumMarch 05, 2012This article is an overview of CMS’ Open Door Forum held on Wednesday, February 29, 2012. The forum covered Home Health, Hospice and Durable Medical Equipment. |
NAHC Voices Opposition to Co-Payments for Home Health ServicesFebruary 27, 2012Last week the National Association for Home Care & Hospice (NACH) voiced strong opposition to co-payments on home health services included in President Obama’s proposed budget. |
Solution for 2X Printing ProblemsFebruary 24, 2012If you are experiencing difficulties printing from 2X, follow the four steps outlined in this article. |
What the Transition from AT&T to Verizon Means for AgenciesFebruary 23, 2012All Medicare network systems maintained by the Centers for Medicare and Medicaid Services (CMS) will be transitioned from AT&T to Verizon. This move was prompted by an initiative designed to support cross-agency collaboration, transformation and technology improvement. |
Help Us Say Thanks!February 23, 2012This month Florida Senators Bill Nelson (D) and Marco Rubio (R) joined arms at the request of the home care industry and asked Hilda Solis, Department of Labor Secretary, to extend the comment period for the companionship services exemption proposed rule. |
OASIS Q&AFebruary 23, 2012Below are questions and scenarios related to data collection and OASIS items. The Survey and Certification Group at Centers for Medicare & Medicaid Services (CMS) provided the answers. |
OASIS Connectivity Migration – AT&T Connection will be Disabled on February 29thFebruary 21, 2012CMS is transitioning the CMSNet connectivity from AT&T to Verizon. This transition will affect your h@ login ID and will make it easier to connect. |
HHS Announces Intent to Delay ICD-10February 17, 2012As part of President Obama’s commitment to reducing regulatory burden, Health and Human Services Secretary Kathleen Sebelius announced today that HHS will initiate a process to postpone the date by which certain health care entities have to comply with International Classification of Diseases, 10th Edition diagnosis and procedure codes (ICD-10). |
DDE Password Changes DelayedFebruary 14, 2012Due to a technical issue, the DDE password rule changes for J11 Part A, J11 HHH and LA & MS Part A DDE users were not implemented on February 12, 2012. Updates to password rules will be communicated once the technical issues are resolved. |
OASIS Q&A Updated to Reflect Clarification on the F2F RequirementFebruary 13, 2012The Centers for Medicare & Medicaid Services (CMS) recently released their OASIS Q&As for January 2012. In this round, CMS provided clarification on completion of OASIS data for situations where the face-to-face encounter does not occur within the 90 days prior to the start of care (SOC), or within 30 days after the SOC. |
Preparing for the Version 5010 UpgradeFebruary 10, 2012The compliance deadline to upgrade to Version 5010 from Version 4010/4010A was Sunday January 1, 2012. CMS announced an enforcement discretion period for 90 days until Saturday March 31, during which it would not initiate enforcement action with respect to any HIPAA-covered entity that is non-compliant with the ASC X12 Version 5010 (Version 5010), NCPDP Telecom D.0 (NCPDP D.0) and NCPDP Medicaid Subrogation 3.0 (NCPDP 3.0) standards. However, you should continue to upgrade your systems as promptly as possible in order to meet this deadline. |
DDE Password Change Effective February 12, 2012February 10, 2012For security purposes, new DDE password rule changes will be implemented on February 12, 2012, for J11 Part A, J11 HHH and LA & MS Part A. |
Our New PBX Phone SystemFebruary 08, 2012We are pleased to announce that we installed a new PBX phone system last week. There should be a noticeable improvement in the reliability of phone service when you call our Customer Support hotline. The new system is robust and is working great. |
Study Finds Home-Visit Program Could Keep Diabetes Patients Out of the HospitalFebruary 08, 2012A special Medicare program that stresses home health visits for patients with chronic diseases helped keep diabetes patients out of the hospital and may have lowered costs using time-honored prevention methods, researchers reported on Monday. Their findings reported in the journal Health Affairs, supports changes made in the 2003 Medicare Modernization Act and could point to way to help keep health costs down by preventing expensive complications. |
California Will Implement 2012 Medi-Cal Institutional Provider Payment HoldFebruary 03, 2012Due to a severe cash flow shortage, the State of California will implement short-term payment delays to Medi-Cal institutional providers effective March 1, 2012 (the first warrant release date of March). |
Lobby Day for California AgenciesFebruary 01, 2012The California legislature is working on bills and budget items that will have a direct impact on home health, home care and hospice services. Included among those items will be both AB 889 (Domestic Worker’s Bill of Rights) and SB 411 (Home Care Licensure Bill). |
CMS Updated Home Health Compare WebsiteJanuary 31, 2012The Centers for Medicare & Medicaid Services (CMS) has updated the Home Health Compare website, which shows a 1-percentage point improvement on the ambulation, transferring and medication management outcomes. It also shows a 1-percentage point deterioration on the dyspnea outcome. |
Indura Systems Has Been Approved As an X5010 EntityJanuary 30, 2012Indura Systems has been approved by NGS as an X5010 entity. |
Ask Congress to Oppose More Home Care Cuts!January 30, 2012Physicians' reimbursement will be reduced 27% on March 1, 2012, unless Congress finds alternative ways to offset the cuts. According to a panel of industry experts that met on January 26, 2012, hospitals and home health care agencies are the providers most likely to have their Medicare reimbursement cut to help pay for an extension of program payments for physicians. |
Additional Documentation Requests (ADRs) from Palmetto GBAJanuary 27, 2012Palmetto GBA recently changed the process for mailing medical Additional Documentation Requests (ADRs). Previously, medical ADRs were mailed in yellow envelopes. ADRs are now mailed in white Palmetto GBA envelopes. It is possible that a provider may receive an ADR request prior to receiving their probe notification letter. |
Success of Texas Association for Home Care and HospiceJanuary 26, 2012According to the Texas Association for Home Care & Hospice (TAHC&H), they were successful in the 2011 State Legislative Session, preventing or minimizing reimbursement and service cuts to home care; expanding programs to divert persons from higher cost settings; streamlining Medicaid Program design and administration; and protecting reasonable business standards and efficiencies, and home care licensure requirements. |
Calculation of 2012 Home Health PPS PaymentsJanuary 25, 2012The National Association for Home Care & Hospice (NAHC) received confirmation from Centers for Medicare & Medicaid Services (CMS) regarding the way 2012 home health PPS payments are being calculated. |
Version 5010 & ICD-10 Transition ResourcesJanuary 24, 2012Three years ago this month, the U.S. Department of Health and Human Services published final rules mandating that all organizations covered by HIPAA need to upgrade to Version 5010 by January 1, 2012 and transition to ICD-10 coding sets by October 1, 2013. Given the three month discretion period for Version 5010, organizations must complete their upgrade no later than March 31, 2012. Below are several resources from CMS to help with the transition. |
Financial Hardship and ADRsJanuary 19, 2012The Home Care Association of Florida (HCAF) has been in communication with Palmetto GBA regarding the ongoing issue with burdensome ADRs, which is affecting providers throughout Florida. Palmetto assured HCAF their Medical Review Department is well staffed and prepared to assist providers with these issues. |
15-Minute Increment Method Rate Will Not Be ImplementedJanuary 16, 2012The Health and Human Services Commission’s (HHSC) proposed “15 Minute Increment” method for Home Health Therapy rates will not be implemented as planned. |
Home Care and Hospice Manager Certificate ProgramsJanuary 12, 2012The California Association for Health Services at Home (CAHSAH) is holding Home Care and Hospice Manager Certificate programs on March 13 through March 15 in Anaheim, California and on July 17 through July 19 in Las Vegas, Nevada. |
Version 5010 Benefits and ResourcesJanuary 04, 2012There are several improvements in Version 5010 |
Quarterly Report for the Agency for Health Care AdministrationJanuary 03, 2012Beginning January 1 through January 15 all licensed home health agencies must submit a quarterly report to the Agency for Health Care Administration (AHCA). Agencies that do not submit the report by January 15th will be assessed a $5,000 fine. |
Updated Instructions for ASC X12 Version 5010 TransitionDecember 29, 2011The Centers for Medicare & Medicaid (CMS) has released TDL-12148 dated December 22, 2011, which includes updated instructions for the ASC X12 version 5010 transition. As stated in TDL-12148, Medicare intermediaries will not reject compliant ASC X12 version 4010A1 transactions prior to April 1, 2012. |
Recovery Auditor Prepayment Review DemonstrationDecember 23, 2011Recovery Audit Prepayment Review will allow Medicare Recovery Auditors (RACs) to review claims before they are paid to ensure that the provider complied with all Medicare payment rules. The RACs will conduct prepayment reviews on certain types of claims that historically result in high rates of improper payments. These reviews will focus on seven states with high populations of fraud- and error-prone providers (FL, CA, MI, TX, NY, LA, IL) and four states with high claims volumes of short inpatient hospital stays (PA, OH, NC, MO) for a total of 11 states. This demonstration will also help lower the error rate by preventing improper payments rather than the traditional "pay and chase" methods of looking for improper payments after they occur. |
An Inside Look at Indura Systems’ Transition to Version 5010December 21, 2011Indura Systems is prepared for the transition to Version 5010! We have been approved as a trading partner for X5010 submissions and are ready for the January 1, 2012, deadline. |
What is an Accountable Care Organization?December 19, 2011An Accountable Care Organization (ACO) is a type of payment and delivery reform model that helps tie provider reimbursements to quality metrics and reductions in the total cost of care for an assigned population of patients. A group of coordinated health care providers form an ACO, which then provides care to a group of patients. The ACO is accountable to the patients and the third-party payer for the quality, appropriateness and efficiency of the health care provided. |
Case-Mix Hypertension Ends 12/31/11December 19, 2011On January 1, 2012, benign essential hypertension (401.1) and unspecified essential hypertension (401.9) are removed from the case-mix system. Experts warn that providers should not change the codes for hypertension in attempt to increase the case-mix weight unless they were coded in error. |
Transition to Version 5010 is Only Two Weeks AwayDecember 19, 2011The compliance deadline for Version 5010 is only two weeks away! The Centers for Medicare & Medicaid Services (CMS) has updated their website to include a new page dedicated to Version 5010 information. It includes useful resources to ensure a smooth transition to Version 5010 by January 1, 2012. Visit the link below for details. |
Obama Announces New Labor Rules for Home Care WorkersDecember 15, 2011President Barack Obama announced new Labor Department rules that will require home care workers to be paid minimum wage, plus overtime. Currently 29 states don't require minimum wage and overtime for home health care workers. |
Payments Denied for Physicians Who Fail to Identify the Community PhysicianDecember 09, 2011Some contractors are denying claims for failure of the acute or post-acute physician to identify the community physician who will assume care of the patient. CMS has not mandated the acute or post-acute physician to follow a specific protocol to hand-off a patient to the community physician. However, claims are still being denied. |
Payments Denied Following an Acute or Post-Acute StayDecember 08, 2011Some CMS contractors are denying payment for patients who use home health services following an acute or post-acute stay when: |
Updated Mailing Addresses for Filing Cost Reports – J11December 01, 2011Palmetto GBA has updated the filing location for J11 Part A and J11 Home Health and Hospice (HHH) cost reports. All J11 Part A and HHH providers should now file their cost reports to the Columbia, South Carolina location at: Palmetto GBA, Attn: Cost Report Acceptance (AG-330), P.O. Box 100144, Columbia, SC 29202-3144. |
90-Day Discretion Period for Compliance with 5010 DeadlineDecember 01, 2011The Centers for Medicare and Medicaid Services (CMS) recently announced a 90-day enforcement discretion period for all HIPAA covered entities regarding the Version 5010 (ASC X12 Version 5010) transition. |
CMS is transitioning from AT&T to VerizonNovember 17, 2011CMS is transitioning the CMSNet connectivity from AT&T to Verizon. This change affects long term care providers and home health agencies. It will affect their h@ login ID, making it easier to connect to their server. |
Wage Index Corrections for 2012November 15, 2011All providers and suppliers who enrolled in the Medicare program prior to Friday, March 25, 2011, will be required to revalidate their enrollment under new risk screening criteria required by the Affordable Care Act (section 6401a). |
Do You Need to Revalidate Your Medicare Enrollment?November 10, 2011All providers and suppliers who enrolled in the Medicare program prior to Friday, March 25, 2011, will be required to revalidate their enrollment under new risk screening criteria required by the Affordable Care Act (section 6401a). |
Transitioning to ICD-10November 09, 2011All entities covered under the Health Insurance Portability and Accountability Act (HIPAA) must transition to the ICD-10 code sets by October 1, 2013. CMS has created implementation handbooks to assist you with your transition to ICD-10. The handbooks include timelines so you can meet the deadlines, templates and action steps. Visit http://www.cms.gov/ICD10 for more information. |
Medicaid Billing: 9-Digit Zip CodeNovember 08, 2011If you are a Medicaid billing customer, start using 9-digit zip codes. Medicaid won’t reject claims if you use a 5-digit zip code format; however, we are encouraging agencies to use 9-digit zip codes, especially for your office information (Company Zip Code). |
Major Medicare Home Health Final Rule IssuedNovember 04, 2011The Centers for Medicare and Medicaid Services has issued the final rule to update the Home Health Prospective Payment System (HHPPS) for 2012, which includes an estimated decrease of 2.31%, or $431 million. The net effect for providers is a 1.4% payment update, the wage index update and the case-mix coding adjustment. |
Seniors Save More Than $1.2 billion on PrescriptionsNovember 04, 2011So far this year, more than 2.2 million people with Medicare have saved more than $1.2 billion on their prescriptions, for an average of $550 per person, the Centers for Medicare & Medicaid Services announced today. And more than 22.6 million seniors and people with disabilities have taken advantage of at least one free Medicare preventive benefit, including the new Annual Wellness Visit made possible by the Affordable Care Act. |
Time to celebrate!November 03, 2011This is our month to celebrate! Why? It is National Home Care and Hospice Month, a time to honor the hard work of everyone in our industry. Our efforts make it possible for frail citizens to recuperate in the comfort of their own home. Thank you health care administrators, nurses, clinicians, therapists, companions, volunteers and vendors! |
CMS Finalizes 2012 Medicare Home Health Payment ChangesOctober 31, 2011The Centers for Medicare & Medicaid Services (CMS) today issued a final rule to update the Home Health Prospective Payment System (HH PPS) rates for Calendar Year (CY) 2012. Payments to home health agencies (HHAs) are estimated to decrease by approximately 2.31 percent or $430 million in CY 2012, the net effect of a 1.4 percent payment update, the wage index update, and the case-mix coding adjustment. |
Are You Ready for 5010?October 31, 2011ASC X12 v005010 Errata will be the only version of claims accepted by Medicare in just sixty days. Palmetto GBA urges all submitters to contact their billing service or clearinghouse immediately if you are not 5010 compliant. If you are submitting claims directly, please test and move to 5010 production status immediately. |
Home Health Spared from 10% Medi-Cal Reduction!October 27, 2011The Director of the California Department of Health Care Services (DHCS) held a conference to announce that CMS has approved the state’s proposed 10% reduction to Medi-Cal provider reimbursement rates for all provider types except three: physician/clinic services for children, home health services and distinct part subacute facilities. The department stated that they decided to exclude those three provider types based on the analyses and information they were given which demonstrated that the 10% reduction was unadvisable. |
U.S. Medicare 2012 premium hike smaller than fearedOctober 27, 2011Most elderly Americans covered by the U.S. government's Medicare insurance program will see a smaller-than-expected rise in their monthly premiums next year, health officials said on Thursday. |
Phone Security CodeOctober 01, 2011Today we implemented the use of a phone security code. Callers now need to provide their agency name and security code to receive assistance from our Customer Support department. The security code is also required if you want to receive or update information about a particular client. |
New Email Address for SupportOctober 01, 2011Indura Systems is happy to introduce a new line of communication to our clients! We have a new email address for support: support@indurasystems.com. |
ICD9 Database and Grouper UpdateOctober 01, 2011Diagnoses and procedures ICD9 codes valid from October 2011 through September 2012 have been updated. Grouper for OASIS code validation has also been updated. |
Patient and Caregiver Report ImprovementsOctober 01, 2011igeaHHC version 3.3.0.92 introduces many improvements on several patient and caregiver reports. Some of these remarkable improvements include: reporting Total of Admissions and Patients (unduplicated), customizable Totals by criteria (Office, Payer Sources, etc.), new filters and search options, new Summarized report type added on several reports allowing you to show solely the totals instead of all the detailed patient/caregiver information. |