This page will help you to learn 5 ways to lower your costs during the coverage gap.

On November 15, 2011 Centers for Medicare and Medicare (CMS) announced a new demonstration project that aims to strengthen Medicare by eliminating fraud, waste and abuse. Reductions in improper payments will help ensure the sustainability of the Medicare Trust Funds and protect beneficiaries who depend upon the Medicare program.

The Recovery Audit Prepayment Review will allow Medicare Recovery Auditors (RACs) to review claims before they are paid to ensure that the provider complied with all Medicare payment rules. The RACs will conduct prepayment reviews on certain types of claims that historically result in high rates of improper payments. These reviews will focus on seven states with high populations of fraud- and error-prone providers (FL, CA, MI, TX, NY, LA, IL) and four states with high claims volumes of short inpatient hospital stays (PA, OH, NC, MO) for a total of 11 states. This demonstration will also help lower the error rate by preventing improper payments rather than the traditional “pay and chase” methods of looking for improper payments after they occur.

Click here for additional information on this demonstrations.

The Centers for Medicare & Medicaid Services (CMS) has posted an updated listing of providers that were sent a request to revalidate their Medicare enrollment information as of December 2011. CMS previously released a list of providers who were sent letters in November.

The PPS Pricer for CY2012 has been released and is now available for download.

The Balanced Budget Act of 1997 required the creation of a prospective payment system for home health services. The HH PPS Pricer makes all reimbursement calculations applicable under HH PPS, including percentage payments on requests for anticipated payments (RAPs), claim payments for full episodes of care, and all payment adjustments, including low utilization payment adjustments (LUPAs), partial episode payment (PEP) adjustments, significant change in condition(SCIC) adjustments and outlier payments.

Click here to access the HHA PC Pricer under the Downloads section.

On Jan. 26, a horrific act of violence occurred to a New Orleans home care nurse that raises the importance of safety and self-defense training for home care workers. A visiting nurse was leaving a patient’s home and was abducted at gunpoint, the New Orleans Times-Picayune reported. The nurse was on her cell phone when the perpetrator approached her and forced her into an abandoned home in a blighted area where she was “raped by multiple subjects” before she was able to flee more than three hours after being abducted.

According to reports, one of the men turned himself in to the New Orleans Police Department last Wednesday and is being charged with armed robbery, aggravated rape and aggravated kidnapping. The man also identified three other men, ages 17 to 21, who took part in the crime. Police are now searching for those individuals.

This tragic event raises the issue of safety for home care workers, who are vulnerable to these types of horrendous crimes while providing care in the field. It is critical that agencies offer safety guidance to field nurses, and perhaps even self defense training. In light of these circumstances, HCAF is looking into more educational offerings like this to offer throughout the state, but we would like to hear your thoughts and ideas too. Click here to send HCAF a note.

Check out the latest news from HCAF member agencies, including personnel announcements, mergers and acquisitions, awards and recognition, milestones and more!

Does your agency have news to share? Click here to share your agency’s personnel and company news with HCAF!

New Agency, New Member!

A new private duty agency, Home Health Care of Florida is open and serving Brevard County. HHCF is locally owned and operated by nurses. Its mission is “to support and care for our communities by providing compassionate, innovative and personalized care.” “Caring for the sick, elderly, adults recovering from surgery and new mommies and daddies truly is a privilege for us,” said Lottie Odom, RN and executive director. HHCF provides in-home companions, certified nursing assistants and registered nurses who can provide transportation to and from medical appointments, personal care needs, light housekeeping, meal preparation and medication education. A lactation consultant also is available. Caregivers are screened through checks of their credentials, criminal background, references and physical condition.

People on the Move

Take Care Private Duty Home Health Care has hired Kimberly Schilling as an RN clinical supervisor in the Sarasota corporate office. She previously worked as an orthopedic oncology nurse at Sarasota Memorial Hospital and Doctor’s Hospital on the rehab and surgical acute care units.

Nancy Nusbaum has joined Florida Hospital Home Health as a home-care speech language pathologist. She has experience in long-term care, hospitals and with special needs children, helping patients with language and swallowing disorders. Nusbaum earned a master’s degree in communication disorders from Auburn University.

Recognition

The Visiting Nurse Association has announced that Debra Peirce, patient finance counselor, has been named VNA’s associate of the quarter. Peirce was selected by her peers for her accountability, integrity, excellent customer service and for providing excellent patient care for the VNA.

 

The 2012 Emergency Preparedness Conference, April 11-12, will supply attendees with a portfolio of emergency management strategies using real life lessons taken from specific events, like the Joplin, Missouri tornado, and effective tools that can be implemented upon return to their organizations. The four phases of emergency management and the theme of this year’s conference, mitigation, preparedness, response and recovery woven together, provide a blanket of resilience.

Updated page with Publications and Other Sites to Visit

Standard LD.03.01.01 - Leaders create and maintain a culture of safety and quality - Prepublication Standard - Effective 7/1/2012

In order for a health care organization to participate in and receive payment from the Medicare or Medicaid programs, it must meet the eligibility requirements for program participation, including a certification of compliance with the Conditions of Participation (CoP) set forth. . .

Information to help health care organizations prepare for survey in 2012.

Part of the Medicare Prescription Drug Plan Finder tool that will help you to identify the plans in your state.

Seasonal flu shots are available right now. H1N1 (Swine) flu vaccine is being shipped and will soon be widely available.

Medicare & You contains important information about what's new, health plans, prescription drug plans, and rights and protections to help people with Medicare review their coverage options and prepare to enroll in a new plan if they choose. It is available in both English and Spanish.

Each fall, the Centers for Medicare & Medicaid Services mails a geographic-specific version to all households of people with Medicare. In 2009, there are 59 geographic-specific versions with drug and health plan comparison charts for particular states or regions.

MyMedicare.gov provides direct Internet access to your Medicare benefits, eligibility, enrollment (including prescription drug plans) and preventive health information - 24 hours a day, 7 days a week. Visit the site, sign up, and Medicare will mail you a password to allow you access to your personal Medicare information. MyMedicare.gov also allows you to view your adjudicated claims information, access online forms and publications, and receive important messages from Medicare.