Directors' Memo

Advocacy Day 2017

Feb 10, 2017 — Thank you to members who were able to attend our very successful Advocacy day with LeadingAge New York this past Tuesday. If you were unable to join us for Advocacy Day, we still need your help. Please: Write and/or call your Senators and Assembly Members with this message:  The Governor’s budget proposal includes language intended... Read More

Health Care Fraud & Abuse Report Released

Jan 27, 2017 — The Department of Health and Human Services (HHS) and the Department of Justice (DOJ) has released its Health Care Fraud and Abuse Control Program Annual Report for Fiscal Year 2016. Here are the highlights for New York State providers and for hospice programs nationally. Medicare Fraud Strike Force The Strike Force uses advanced data analysis... Read More

Department of Health Declares Influenza Prevalent in New York State

Dec 28, 2016 — As of December 28, 2016, NYS Department of Health Commissioner Howard Zucker has declared influenza prevalent in New York State. This determination is the threshold which triggers the “Regulation for Prevention of Influenza Transmission by Healthcare and Residential Facility and Agency Personnel.”  This regulation (Title 10, Section 2.59) requires facilities and agencies, including hospices and... Read More

CMS Releases HIS, CAHPS Data

Dec 21, 2016 — On Friday, December 16, CMS posted to their Data.Medicare.gov website data compilations derived from both the HIS as well as the CAHPS reports. The HIS data set includes the national averages (mean) for quality measure scores for reports reflecting the time period July 1, 2015 through June 30, 2016. The National CAHPS data set contains... Read More

FLU Vaccine Claims Are Erroneously Being Returned

Dec 15, 2016 — We have just been notified of a problem relating to hospice claims for flu vaccine administration. The common working file (CWF) is incorrectly editing hospice episode claims against hospice vaccine claims and returning the hospice episode claims with Reason Code U5601 (Services on the claim overlap covered services on a previously accepted claim). This issue... Read More

CMS Issues Sample Notice of Election Statements

Dec 2, 2016 — As we previously reported, in September the Office of the Inspector General for Health and Human Services (OIG) issued a report titled, “Hospices Should Improve Their Election Statements and Statements of Terminal Illness.” In this report, the OIG identified concerns with election statements in one-third of a select sample of general inpatient stays. The report... Read More

Injunction Halts Federal Overtime Threshold Changes, But NYS Regs May Supercede

Nov 30, 2016 — On November 22, the US District Court for the Eastern District of Texas granted a preliminary injunction enjoining the US Dept. of Labor (DOL) from implementing a Final Rule that increased the minimum salary required for status as an exempt executive, administrative or professional employee (EAP). The Final Rule would have required employers to pay... Read More

CMS Issues a Request for Information on Medicaid Home and Community Based Services

Nov 23, 2016 — On November 9, 2016, CMS issued a Request for Information (RFI) on additional reforms, and policy options that they might consider to accelerate the provision of home and community based services (HCBS) to Medicaid beneficiaries. Respondents are urged to provide responses to the following questions: What are the additional reforms that CMS can take to... Read More

CMS Released a Memo to All Part D Plan Sponsors and Medicare Hospice Providers Outlining their Concerns with Part D Billing for Hospice Beneficiaries

Nov 21, 2016 — On Tuesday, November 15, 2016, CMS released a memo to all Part D Plan Sponsors and Medicare Hospice Providers outlining their concerns with Part D billing for hospice beneficiaries. While much of their new findings have already been voiced in various other communications – particularly in the FY 2016 and FY 2017 Wage Index Final... Read More