Agency Compliance

We’re well into 2019, and it seems PDGM (Patient-Driven Groupings Model) is among the most discussed healthcare topics at the moment. From industry trade publications to speakers at national conferences, everyone is talking about how PDGM will affect home health agencies in 2020. The information can be insightful, but it can also be overwhelming. Here is a key-point summary that will help your home health agency prepare for 2020, both financially and operationally.

CMS DELAYS RCD UNTIL MARCH 2020

 

Advocates for home health care have achieved a significant triumph regarding the ongoing struggle against implementation of RCD (Review Choice Demonstration).

After a series of sessions reviewing the matter, the Centers for Medicare & Medicaid Services (CMS) released an official statement this past Monday that the RCD will be delayed until March 2, 2020. Originally, implementation of the demonstration was slated to start in Texas on December second of 2019. This would have resulted in home health care providers in the Lone Star state being forced to simultaneously navigate RCD while also dealing with the equally intimidating PDGM (Patient-Driven Groupings Model).

The moment PDGM (The Patient-Driven Groupings Model) takes effect in the year 2020, the Centers for Medicare & Medicaid Services (CMS) looks to see their new edict change the landscape of home health care operations, specifically with regard to double billing. With PDGM representing the largest wholesale revamp in many years, agencies and providers will need to dedicate significant attention to using this year to ensure proper preparation. With the number of changes in store, inevitably some agencies will contest specific aspects of PDGM’s new requirements.

January 2020 OASIS-D Changes

 

OASIS-D to OASIS-D1 Information

OASIS-D is the current version of the OASIS data set. It was implemented on January 1, 2019. OASIS-D introduces new standardized items to support measurement domains mandated by the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014. New items were also added for standardization to align with assessment sets for other post-acute care settings. Several items were also removed to reduce provider and patient burden. OASIS-D was approved by the Office of Management and Budget (OMB) on December 6, 2018, with an intended expiration date of 12/31/2021.

Illinois Review Choice Demonstration to Begin on June 1

The Center for Medicare Services (CMS) recently released information about the next steps for its Review Choice Demonstration (RCD). Illinois will be the first state to participate with the newest version of this demonstration, beginning  June 1, 2019. The Five (5) state claims review demonstration also includes Ohio, North Carolina, Florida, and Texas.

New EVV Survey Raises Concerns Among Homecare Providers & Industry Officials

As the movement towards mandatory EVV on the federal level continues to march forward, officials at CMS have been steadily preparing for the possible rollout of a national electronic visit verification (EVV) survey. This survey would be a non-optional requirement for agencies providing many types of care, and is intended to strengthen agency accountability, patient care, and reduce the rampant fraud that recent reports have suggested is still on the rise in numerous states.

Alora & Sandata Announce Partnership to Offer Homecare Agencies Electronic Visit Verification (EVV)

 

EVV Mandates on the Rise Nationwide

 

EVV systemsSandata Technologies, one of the nation's leading providers of home care solutions designed to simplify the process of managing services for government agencies, Managed Care Organizations, and other home care providers, issued a national press release showcasing the recent team up with Alora to address the need for effective electronic visit verification solutions. While Alora Home Health Software has specialized in simple to use solutions for the home care industry since 2005, their development over the last few years of powerful tools for homecare agencies to verifiy visits including integrated EVV,

Telephony, & AideConnect, places the company at the forefront of providers who focus on compliance paired with homecare technology.

As stated in the press release, their integration with Alora allows agencies using the Alora Home Health Software to maximize the benefits of Sandata's state sponsored EVV solution, while ensuring compliance with the 21st Century Cures Act EVV mandate. 

Read the full press release below.

What to Watch In 2019

As 2019 begins to get into the books, many home health industry insiders and experts are preparing for what’s ahead while learning some lessons from the previous year. By most if not all measures, 2018 was a monumental year of change, growth, and adaptation, particularly within the Medicare-certified home health spectrum.