Posts tagged ‘nahc’

October 23, 2012

DH, NAHC alliance will include SHA

I have worked with DecisionHealth for many years across many education venues. This is an exciting opportunity for DecisionHealth and NAHC.

The alliance on education and communication also benefits Selman-Holman Associates! We will be providing ICD-10 education.

Here is some information on the NAHC-DecisionHealth alliance.

WASHINGTON D.C., October 23, 2012— Members of the National Association for Homecare and Hospice (NAHC) will see enhancements to their member benefits in 2013 as a result of a strategic alliance between NAHC and DecisionHealth.

“I am very pleased to announce this alliance with DecisionHealth, a company that has a long and distinguished record in our industry,” said NAHC President Val J. Halamandaris. “This partnership provides an efficient way for us to continue to enhance the depth and breadth of our member benefits while freeing resources to focus further on advocacy.”

Mr. Halamandaris added that the new affiliation covers a broad range of efforts to benefit homecare agencies and hospices, including jointly-produced live events, collaboration on ICD-10 training and education, and preferred discounts for NAHC members on DecisionHealth coding and compliance tools and guidance. The two organizations will also collaborate on offering certification and other professional development programs.

“All of us at DecisionHealth are proud to work with NAHC, the premier advocacy organization for the homecare and hospice community,” said Steve Greenberg, President of DecisionHealth. “We look forward to best-of-breed programs and services that result from our shared expertise and deep understanding of the home care market needs.”

Additional details announced today include:

  • NAHC’s Private Duty Homecare Association of America will collaborate with DecisionHealth to jointly sponsor two conferences next year for leaders of private duty agencies.
  • DecisionHealth will offer discounts for NAHC members on its core coding and compliance products, and its most venerable and longstanding newsletters, Home Health Line and Private Duty Insider.  The latter will expand its coverage to include valuable input from NAHC’s Private Duty Homecare Association of America.
  • The two organizations will launch a series of Home Care ICD-10 Readiness Seminars. These live training events will be designed to assist HHAs with strategic, operational and financial planning to assure seamless transition toward the October 2014 ICD-10-CM mandate.
June 12, 2012

Connolly issues automatic edit for RAP with no CMS Issue Number

The Centers for Medicare & Medicaid Services (CMS) Recovery Audit Contractor (RAC) Connolly recently issued a new RAC issue: RAP claim without corresponding home health claim CMS Issue Number.

The National Association for Home Care & Hospice (NAHC) has requested clarification from CMS about the basis for this since home health Requests for Anticipated Payment (RAP) are supposed to be automatically recovered through the Medicare claims processing system when a home health agency fails to submit a final claim within a certain time period (120 days or 60 days of the RAP payment).

Connolly is the RAC for Alabama, Arkansas, Colorado, Florida, Georgia, Louisiana, Mississippi, New Mexico, North Carolina, Oklahoma, Puerto Rico, South Carolina, Tennessee, Texas, Virgin Islands, Virginia, and West Virginia.

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May 25, 2012

Denials begin for PoC without physician approval

The National Association for Home Care & Hospice (NAHC) recently learned that home health agencies have begun to receive Medicare denials because they provide services and treatments in accord with a plan of care developed after assessing the patient, without obtaining prior approval from the physician for the treatments and services in the plan. In these cases, nurses and therapists conduct patient assessments, initiate care in accord with the referral and create a written plan of care based on assessed needs. They then mail or fax this plan of care to the physician without first receiving approval from the physician for visits and treatments included in the plan of care.

As a result, services that were provided after the initial visit and up to the date of the physician’s signature on the plan of care are denied for lack of physician orders.

The Conditions of Participation (CoP) at 42 CFR 484.18(a) requires that the plan of care be developed in consultation with the agency staff, and that the physician be consulted to approve additions or modifications to the original plan. Further, the CoP require that therapy services include the specific procedures and modalities to be used and the amount, frequency, and duration.

The Medicare coverage rules at 42 CFR § 409.43 specify that the plan of care must contain those items listed in the CoP at 42CFR §484.18(a) and that physician’s orders for services in the plan of care must specify the medical treatments to be furnished as well as the type of home health disciplines that will furnish the ordered services and at what frequency the services will be furnished.

See the Medicare Benefit Policy Manual ( for more specific information, including guidance on oral orders.

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April 6, 2012

OASIS C-1 on the way … and with ICD-10

Thanks to HCLA for letting us know a little about what was said at the recent NAHC conference in Washington DC.
A CMS representative said a new OASIS … C-1 … is in the works.
Pat Sevast of CMS said the revisions are centered about the switch to ICD-10 coding.
While CMS has announced a delay to the implementation of ICD-10, “we are proceeding as if ICD-10 is going to be implemented Oct. 1, 2013,” she said. That’s because CMS’s delay for the new coding set won’t be official until it finishes rulemaking.
August 1, 2011

NAHC pushing for telehealth bill

There are other things going on in Washington besides debt news, and this would should interest us ….

The National Association for Home Care & Hospice (NAHC) is advocating for the Foster Independence Through Technology (FITT) Act of 2011 (S. 501), a bill that would incentivize home care agencies to offer telehealth services.

The measure would, among other things:

  • Create pilot programs to provide incentives for home health agencies to use home monitoring and communications technologies;
  • Provide incentive payments to each participating home care agency equal to a portion of the Medicare savings relative to performance targets.

See the message from NAHC

Here is the background paper, which includes information such as how Veterans’ Affairs saved money with telehealth.