Lead October 14, 2021 - LeadingAge Illinois

HCBS:
CMS HCBS Spending Plan Approval Document
Home Health and Hospice Town Hall

Other:
LeadingAge Letter to FTC on Staffing Agency Practices and Pricing

Top Stories:

LeadingAge Illinois Testifies Before Legislative Committees on Medicaid Rate Reform
LeadingAge Illinois was back before four Illinois House legislative committees yesterday for the third in a series of hearings on Nursing Home Reform. The subject matter for yesterday’s hearing in downtown Chicago was the Medicaid Rate redesign.

Angela Schnepf, president and CEO and Jason Speaks, director of government relations at LeadingAge Illinois attended the hearing and LeadingAge Illinois Consultant, Matt Werner, also attended to provide testimony on the association’s behalf. During her testimony, Angela responded to the Illinois Department of Healthcare and Familyt Services (HFS)’ report: “A Comprehensive Review of Nursing Home Payment with Recommendations for Reform.” She also delivered points on the LeadingAge Illinois/Illinois Health Care Association’s joint Medicaid Rate Reform proposal. She stated that the associations are encouraged that HFS report and recommendations will serve as a catalyst to finally link Medicaid reimbursement to improving resident outcomes in an accountable and transparent manner.

Provider Relief Fund Webinar on Phase 4 Supporting Documentation
HRSA held a webinar focused on what supporting documentation providers will need to upload as part of their application for Phase 4 funds. HRSA will be comparing revenue and expense data so Q1 of 2019 will be compared to Q1 of 2021 but the Q3 and Q4 of 2020 will be compared to these same quarters in 2019. It is when HRSA observes anomalies or revenue and expense data that is outside an expected range for a particular group of providers (e.g. nursing homes). Other highlights include:

Supporting documentation is critical to ensure providers get the payments for which they are eligible. The supporting documentation must include recent tax forms and/or audited or internal financial statements. Some providers will need to provide additional documents like cover letters that explain acquisitions or divestitures, organizational structures or other anomalies. Many providers will also need to complete the Annual Revenue from Patient Care worksheet and upload that to explain complex organizational structures or in situations where a parent organization is applying on behalf of one or more billing TINs. This worksheet will be helpful in identifying what total annual revenue must be reported and the annual revenue from patient care on the application itself. Insufficient documentation can lead to a provider receiving no or a reduced payment.
Providers need to double check that the data reported on the application matches up with the supporting documentation provided. Providers can continue to revise or update their submission until the deadline for submitting applications on October 26 at 10:59 p.m. CST.
Members should check out the HRSA resources on supporting documentation.
- Fact Sheet for Complex Organizational Structures
- FAQs especially related to what is considered patient care revenue.
- Recordings of prior webinars can be accessed on this page under Technical Assistance webinars.

Housing:

HUD Updates
We have a few updates related to the U.S. Department of Housing and Urban Development (HUD), including:

HUD Allows Key Deadline Flexibilities for CSP Requests
HUD Notice: 30 Days’ Notice for Eviction and Required Information Sharing to At-Risk Tenants
Deadline Flexibility in New CSP FAQ from HUD; Draft Request Form

HUD Allows Key Deadline Flexibilities for CSP Requests:
In response to advocacy by LeadingAge, HUD is allowing key relief payment deadline flexibility for capital cost reimbursements due to COVID-19. HUD announced the change in a 20-question COVID-19 Supplemental Payment (CSP) FAQ document that answers questions from LeadingAge and others; HUD also released a draft version of the CSP request form. LeadingAge National’s full analysis of the FAQs is available here.

HUD Notice: 30 Days’ Notice for Eviction and Required Information Sharing to At-Risk Tenants:
On October 7, HUD published Notice H 2021-06, requiring HUD-assisted owners and public housing agencies must provide no less than 30 days’ advance notification of lease termination due to nonpayment of rent. Further, owners and PHAs must provide information to affected tenants as necessary to support tenants in securing such available funding. The Notice does not require specific language be included in notifications of terminations for nonpayment of rent; rather, landlords must ensure that such notification is provided no less than 30 days prior to any actions to terminate the lease of the affected household. As for the information that owners must relay to at-risk tenants about the availability of Emergency Rental Assistance, HUD is requiring owners use language found in the Notice to convey this information. Owners must, at a minimum, use HUD-provided language, updated to reflect the entity issuing the notification with the appropriate link to the local ERA grantee. Read a LeadingAge article here for more information.

Deadline Flexibility in New CSP FAQ from HUD; Draft Request Form:
On October 8, HUD issued the CSP draft request form and an FAQ for the CSP round four. As LeadingAge has strongly advocated, the FAQ provides some flexibility for the CSP round four’s October 31 deadline for all purchases and installation services to be complete.

The FAQ says purchases and installation services should “generally” be complete by October 31 but, given delays caused by the pandemic and natural disasters, prior to the close of the CSP expenditure period on October 31, 2021. HUD is allowing additional flexibility on the timing of delivery and installation of eligible capital items.

Where the owner is unable to find a vendor who can complete delivery by October 31, 2021, HUD will allow inclusion of amounts for Eligible Capital Expenses in CSP requests in the following circumstances:

Payment has been completed AND delivery/installation date has been specified by the vender to occur not later than March 31, 2022. OR
Payment has not been disbursed to the vendor, but legal liability to complete the purchase has been established.

Agreements must include delivery/installation no later than March 31, 2022. Additional information is in the FAQ. LeadingAge will issue a complete analysis of the new CSP FAQ. Also on October 8, HUD issued a draft request form for CSP round four (the final version to be used in owner submissions will be posted on HUDCLIPS later this month).

Home and Community Based Services (HCBS):

CMS HCBS Spending Plan Approval Document
The Illinois Department of Healthcare and Family Services has posted an updated CMS HCBS Spending Plan Approval document.

Home Health and Hospice Town Hall
Please join LeadingAge National for their Home Health and Hospice Town Hall on Tuesday October 19 at 1:00 p.m. CST. The discussion will inform LeadingAge’s 2022 home health and hospice policy priorities. We aim to hear your top concerns, whether it is civil monetary penalties & survey enforcement for hospices or the value-based purchasing and the Review Choice Demonstration for home health. We want to hear from you about your top policy priorities for next year and the kinds of tools that will help you engage in policy work. Please register here. After registering, you will receive a confirmation email containing information about joining the meeting.

Other:

LeadingAge Letter to FTC on Staffing Agency Practices and Pricing
LeadingAge sent a letter to the Federal Trade Commission (FTC) today requesting the FTC to use its resources and expertise to address an issue that has become dire for long-term care providers during the COVID-19 pandemic – the anticompetitive and pricing gouging practices of nurse-staffing agencies.