New OASIS-E Resources Available: GG0170C, GG0170L, and GG0170P Video Tutorials

The Centers for Medicare & Medicaid Services is releasing short video tutorials to providers in the LTCH setting. These 5-minute videos are designed to provide targeted guidance using simulated patient scenarios to assist providers in coding GG0170C. Lying to Sitting on Side of Bed, GG0170L. Walking 10 Feet on Uneven Surfaces, and GG0170P. Picking Up Object. To access the videos, click on the links below:

• Lying to Sitting on Side of Bed.
• Walking 10 Feet on Uneven Surfaces.
• Picking Up Object.

If you have questions about accessing the resources or feedback regarding the trainings, please email PAC Training. Content-related questions should be submitted to the LTCH QRP Help Desk.

Don’t Waste HCBS 2.0

McKnight’s Home Care | Liza Berger
 
The best things come to those who wait. That old Heinz ketchup slogan may be an apt description for the recent re-introductions of legislation and funding for home- and community-based services (HCBS).
 
Two major developments occurred Thursday in Washington, DC, for proponents of HCBS. Sen. Bob Casey (D-PA) in the morning disclosed he was introducing legislation to help fund the Better Care Better Jobs Act, which would support the expansion of Medicaid HCBS. Called the HCBS Access Act, it would establish “a permanent funding stream to keep the infrastructure strong and to make sure we’re able to continue to pay direct care professionals at a rate that ensures qualified, reliable services in a qualified reliable workforce into the future.”
 
Then an even bigger piece of related news broke: President Biden designated $150 billion for home- and community-based services in his newly released fiscal year budget proposal. For those who don’t follow the play-by-play in the nation’s capital, $150 billion was precisely the amount of the previous Better Care Better Jobs Act, which failed to make it into any legislative package.
 
To those who doubted such legislation would ever make a comeback, I ask, who would’ve thunk it?
 
Even more surprising than the reintroduction of key bills is the president’s new outspokenness on this issue. Through his actions on the budget and his words in recent speeches, there is no question where the president stands at this point. He believes that aging in place is the model for growing older.
 
While passage of any  new legislation is up to Congress (and a divided one at that). aging services providers have a golden opportunity to steer its fate. I am not one to tell people what to do, but it seems to me that if you want a bill containing Better Care Better Jobs or Biden’s funding to pass, the time is now to talk to your senators and representatives. Tell them why HCBS is so important, what the workforce requires to deliver HCBS and how the healthcare system as a whole can benefit.
 
You, providers, have what most people do not — a second chance. Carpe diem, folks.

You Need to Register for this CMS Webinar on PDGM

Wednesday, March 29, 2023 (11:30 PM – 1:00 PM MDT)

Free to all!

Medicare Home Health Prospective Payment System (HH PPS) Calendar Year (CY) 2023 Behavior Change Recap, 60-Day Episode Construction Overview, and Payment Rate Development Webinar.

NAHC has indicated that it is critical that you, and, if possible, multiple people in your organization, register for the CMS PDGM webinar for stakeholders on March 29. You need to sign on to send an overwhelming message to CMS that we aren’t backing down. If only 20-30 people show up, it will be devastating for us as an industry because it would send a message to CMS that our concerns are not important. Can we count on you to register for this FREE webinar and sit in to make sure your voice is heard? Please join all of us in attending and making sure CMS knows we are here to stay, we are here to fight for our industry, and we aren’t backing down.

During this webinar, CMS will provide an overview of several provisions from the CY 2023 HH PPS final rule on behavior changes, the construction of 60-day episodes, and payment rate development.

REGISTER

Guidance for the Use of Telehealth in Hospice and Palliative

SUMMARY:

The following is a synopsis of direction given by NHPCO after consulting with CMS and the HHS Office of Civil Rights, to provide clarity about telehealth in hospice and palliative care. Information includes what stays and what goes at the end of the COVID-19 PHE.

Hospice Face-to-Face Encounters through Telehealth

1.     How long can the hospice face-to-face telehealth flexibility be used?

• The statutory provision extends the hospice face-to-face telehealth flexibility through 12/31/24, regardless of the status of the PHE.

2.     What methods can be used for the hospice face-to-face encounter?

• The statutory requirement for the hospice face-to-face encounter specifies that when an encounter is conducted via telehealth it MUST be performed via audio-visual communications technology.

Use of Telehealth for Hospice Routine Home Care

When can telehealth be used for hospice routine home care?

• Hospice providers can provide services to a Medicare patient receiving routine home care through telecommunications technology (e.g., remote patient monitoring; telephone calls [audio only and TTY]; and two-way audio-video technology), if it is feasible and appropriate to do so.

• Only in-person visits are to be recorded on the hospice claim.

• This waiver will expire at the end of the PHE on May 11, 2023.

Telehealth Services Payable under the Physician Fee Schedule when Furnished via Telehealth

It is likely that some services offered by palliative care providers will be covered as telehealth services. Providers should check the list of codes in the 2023 Physician Fee Schedule to determine how and how long services will be paid. We are grateful to Acevedo Consulting for preparing this list of services to determine their post public health emergency status as the PHE concludes on May 11, 2023.

• In the CY 2023 Final Rule, CMS finalized alignment of availability of services on the telehealth list with the extension timeframe enacted by the CAA, 2022. The CAA, 2023 further extended those flexibilities through CY 2024. Check the Medicare Telehealth Post-Pandemic Resource List (PDF) for deadlines for use.

• Audio-only telehealth services are specially designated in the List of Telehealth Services for Calendar Year 2023 (ZIP) - Updated 02/13/2023

• There are two codes allowed through audio-only interaction that are often used by hospice and palliative care providers – the two advance care planning codes:
  • 99497 – Advance care planning, first 30 minutes
  • 99498 – Advance care planning, additional 30 minutes
  • The hospice face-to-face encounter may NOT be conducted through audio-only telehealth.

Use of Non-Compliant Devices for Telehealth

On April 21, 2020, the Department of Health and Human Services (HHS) issued a Notification of Enforcement Discretion for Telehealth Remote Communications During the COVID–19 Nationwide Public Health Emergency

Under this Notification, covered health care providers may use popular applications that allow for video chats, including Apple FaceTime, Facebook Messenger video chat, Google Hangouts video, Zoom, or Skype, to provide telehealth without risk that the Office of Civil Rights (OCR) might seek to impose a penalty for noncompliance with the HIPAA Rules related to the good faith provision of telehealth during the COVID–19 nationwide public health emergency.

Under this notification, however, Facebook Live, Twitch, TikTok, and similar video communication applications are public facing, and should not be used in the provision of telehealth by covered health care providers.

The allowance to use non-HIPAA compliant devices is set to end at the end of the PHE on May 11, 2023. OCR’s FAQs on the topic indicate it will end with the PHE. See question #6.

The specific provisions that apply to hospice and palliative care providers are still evolving. NHPCO expects that there will be additional clarification issued for some components of hospice flexibilities, so watch for additional updates.