Category: Long-Term Care

Indiana Medicaid to Reimburse Home Health Agencies for Certain Telehealth Services

Senate Enrolled Act 554 from the 2013 legislative session set the stage for an upcoming change in Medicaid policy that will provide reimbursement for certain telehealth services provided by Home Health Agencies (“HHAs”).  The Indiana Health Coverage Programs (“IHCP”) released Bulletin BT201454 earlier this week outlining the policy change that will cover an HHA’s remote monitoring of data related to an IHCP member’s qualifying chronic diagnoses.  The change takes effect December 1, 2014 and targets these three chronic conditions:  congestive heart failure, chronic obstructive pulmonary disease (“COPD”) and diabetes. … Continue Reading →


Caution – Pay No Mind to the Department of Labor’s Temporary Non-Enforcement Policy Relating to the Companion Services Exemption

In the October 9, 2014 Federal Register, the Department of Labor (“DOL”) indicated it will delay enforcement of the Companion Services Rule (“Rule”) until June 30, 2015 (the “Notice”). The DOL suggests this delayed enforcement is meant to assist the provider community with implementing changes in the Rule. In its commentary, the DOL suggests that non-enforcement means it will not bring actions against employers for alleged violations of the obligations resulting from these changes. Additionally, it will not investigate potential violations, supervise settlements for unpaid wages owed under the act or  file suit in federal court to recover such wages. The DOL indicates that when it receives a complaint during this non-enforcement period, it will go to the employer and “work to educate the employer further on the requirements of the new regulation.”  … Continue Reading →


Are Major Changes Coming to Home Health Conditions of Participation?

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On October 8, 2014, CMS announced two initiatives with the objective of improving the quality of post-acute care.  Important to home health providers, CMS released a proposed rule that would revise the conditions of participation (“proposed COPs”) that regulate home health agencies…. Continue Reading →


CMS Reiterates Need for Discharge Assessment to Non-Certified Beds

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On August 25, 2014, CMS issued a survey transmittal regarding the need for nursing homes to complete a discharge assessment when a resident transfers from a SNF and/or NF certified bed to a non-certified bed in the same facility.  CMS issued this transmittal to reinforce to facilities that discharge assessments are critical to ensure the accuracy of CMS mandated quality measures…. Continue Reading →


Senators Recommend Changes to Recovery Audit Contractor Payment System

At a recent roundtable, the Senate Special Committee on Aging criticized the Medicare claims review process, suggesting it unfairly burdened providers and failed to improve program integrity. The senators blamed the current payment system for the auditors and suggested moving from an arrangement that currently incentivizes recovery of overpayments to one that incentivizes reducing improper provider payment rates over time…. Continue Reading →


Extension of Due Date for Nursing Home Automatic Sprinkler Installation

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On May 16, 2014, CMS issued a Survey and Certification Transmittal (“Transmittal”) to the state survey agency directors providing infomation on how Medicare and Medicaid certifed long-term care facilities may obtain an extension of time for the installation of automatic sprinkler sytems.  The Transmittal sets forth the procedures on how a nursing home may seek an extension of time for not meeting the original deadline of August 13, 2013…. Continue Reading →


Indiana Changing the Way Residents Will Obtain Medicaid Coverage Beginning June 1, 2014 – Part 4: Indiana Publishes Final Rule on Changes to Indiana’s Administrative Code

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On June 1, 2014, Indiana will change the way Indiana residents obtain Medicaid coverage in the age, blind or disabled categories. Currently, when Indiana residents apply for Medicaid coverage, they are subject to state-specific restrictive criteria. After June 1, 2014, Indiana residents will automatically be enrolled in Medicaid if the Federal Social Security Administration determines they are eligible for Supplemental Security Income. This transition will eliminate Indiana’s Medicaid Spend Down Program…. Continue Reading →


Indiana Changing the Way Residents Will Obtain Medicaid Coverage Beginning June 1, 2014 – Part 3

On April 21, 2014, Indiana’s Family and Social Services Administration (“FSSA”) offered a webinar for nursing facilities to provide additional information on Indiana’s Medicaid changes and Qualified Income Trusts (also known as Miller Trusts). … Continue Reading →


Indiana Changing the Way Residents Will Obtain Medicaid Coverage Beginning June 1, 2014 – Part 2

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Indiana’s Family and Social Services Administration continues its efforts to communicate, address and refine questions and issues related to the upcoming Medicaid coverage changes. … Continue Reading →


Obama Budget Contains Numerous Post-Acute Care Cuts

President Obama introduced his fiscal year (“FY”) 2015 budget yesterday, and there are many proposed cuts to post-acute care providers.  Some of the highlights include a number of bundled payment initiatives, a $100 co-pay for home health patients not discharged from a hospital and re-admission penalties for skilled nursing facilities (“SNFs”) with high hospital re-admissions.  This information was provided to the Hall Render Post-Acute Practice Group from John Williams, who leads Hall Render’s Federal Advocacy Practice Group from the firm’s office in Washington, D.C. … Continue Reading →