Lead June 9, 2022

Top Stories:
Unclaimed Phase 4 Provider Relief
Movie Licensing Update

Nursing and Rehabilitation:
Top 10 F-Tags
LeadingAge Nursing Home Network

Home and Community Based Services (HCBS):
Hospice Preview Reports Available on Qies
CMS Revises Home Health Manual Removing Allowed Practitioner Section

Other:
TANs and Pendings Update

Top Stories:

Unclaimed Phase 4 Provider Relief
According to HRSA, a number of providers have a Provider Relief Fund (PRF) Phase 4 payment available but have not set up an Optum Pay account, which allows HRSA to distribute them funds to the provider. HRSA indicates that UnitedHealth Group has contacted providers by email, for which this situation applies, multiple times. Providers who believe they are eligible to receive or have received notice that a Phase 4 payment is pending can set up an Optum Pay Account.    It can take up to two weeks to complete this enrollment process and then an additional two weeks for the funds to be available within the providers’ accounts.

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Movie Licensing Update
You may recall the issue of motion picture licensing that came about a number of years ago now.  Now, the Motion Picture Licensing Corporation has compiled a resource on copyright compliance for aging services providers who play movies, music or TV in their settings. It is posted here with permission for the benefit of LeadingAge members.

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Nursing and Rehabilitation:

Top 10 F-Tags
Here are the top 10 F-Tags as of this week:

  • F884 – Reporting to National Health Safety Network
  • F880 – Infection Prevention & Control
  • F689 – Free of Accident Hazards/Supervision/Devices
  • F812 – Food Procurement, Store/Prepare/Serve Sanitary
  • F684 – Quality of Care
  • F677 – ADL Care Provided for Dependent Residents
  • F656 – Develop/Implement Comprehensive Care Plan
  • F761 – Label/Store Drugs and Biologicals
  • F686 – Treatment/Svcs to Prevent/Heal Pressure Ulcer
  • F609 – Reporting of Alleged Violations

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LeadingAge Nursing Home Network
Tuesday, June 28 at 1 p.m. CST is the next LeadingAge Nursing Home Network meeting. Agenda and resources will be shared in the week prior to the meeting, but also keep an eye on the Member Community for updates. Join Zoom Meeting.

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Home and Community Based Services (HCBS):

Hospice Preview Reports Available on Qies
Hospices can now access the latest Provider Preview Reports for the August 2022 Care Compare refresh via the CASPER application.  Please note that the hospice preview reports contain quality measure scores for the two new Claims-based measures, which will be publicly displayed for the first time in August; Hospice Care Index (HCI) and Hospice Visits in the Last Days of Life (HVLDL).

As a reminder, CMS had originally planned to release these two new claims-based measures in the May 2022 Care Compare refresh but ultimately delayed the public release to August 2022. Although the actual “preview period” is 30 days, the reports will continue to be available for another 30 days, or a total of 60 days or until June 27, 2022. CMS encourages providers to download and save their Hospice Provider Preview Reports for future reference, as they will no longer be available in CASPER after this 60-day period.

LeadingAge confirmed with CMS staff that the decision to delay in the inaugural public display of the two new hospice claims-based measures was based on technical errors in the calculation of the measure scores. CMS has since corrected these issues, and hospices can expect to see these two new measures on their preview reports, as well as on the CMS Care Compare/Provider Data Catalog sites, related to the upcoming August 2022 refresh. The August 2022 public refresh will coincide with the anticipated August 2022 introduction of the Hospice CAHPS Star Rating and there is no plan at this time to delay the 5-Star launch.

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CMS Revises Home Health Manual Removing Allowed Practitioner Section
CMS issued a Change Request 12615 and new MLN article removing previous sections of the NOA requirements regarding allowed practitioners. Since March, advocacy efforts from LeadingAge in collaboration with the home health and advanced practice nurse community, pushed to revise the initial Benefits Policy Manual and an accompanying MLN article when it inaccurately summarized regulations for advanced nurse practitioners to certify eligibility and order services for home health. The passage of the CARES Act in 2021 permanently allowed nurse practitioners, clinical nurse specialists, and physician assistants to order home health. However, each state’s practice laws and regulations need to be amended in order to comply with the new federal scope of practice change. The underlying issue in the original Change Request and MLN article were statements made about “collaboration” between advanced practice nurses, physicians assistants, and physicians in states which did not have laws governing collaboration. Many states have proactively removed requirements for written collaborative agreements. CMS has stated to advocates that their intent was not to add additional “collaboration” requirements despite confusion in the article. LeadingAge will continue to work with advocacy partners to ensure that this critical change to home health policy is appropriately enacted allowing for greater access to home health services.

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Other:

TANs and Pendings Update
LeadingAge Illinois Reimbursement Consultant, Matt Werner, has provided an update on Transaction Audit Numbers (TANs) and Medicaid Pendings.

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