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Educational
Session Descriptions
MONDAY, April
12, 2010
Concurrent Educational Sessions (100 series)
10:45 am to 12:15 pm
101. CMS Panel on Home Health Regulatory & Policy Issues
Representatives
from the Centers for Medicare & Medicaid
Services (CMS) will discuss regulatory and policy initiatives
for 2010 and beyond. In addition to the latest on vital topics
like payment and survey and certification issues, panelists will
discuss CMS quality initiatives and other efforts.
Objectives:
- Describe major regulatory and policy changes CMS is planning
to make in the home health program;
- Discuss the rationale behind the changes; and
- Identify what impact these changes will have on your agency
and how operations must be modified in order to comply with
changes.
Faculty:
James Coan, Office of Research, Development and Information;
Lori Anderson, Chronic Care Policy Group; Patricia Sevast,
Survey & Certification Group; and Robin Dowell, Office
of Clinical Standards & Quality; Elizabeth Goldstein, Director,
Division of Consumer Assessment and Plan Performance; all of
the Centers for Medicare & Medicaid Services, Baltimore,
MD
No CEs or CPEs.
102. The Future of Private
Plans under the Medicare Program
The Medicare program has had a private plan
option for decades, but enrollment levels have
waxed and waned depending on actions taken
by Congress relative to reimbursement and regulatory
requirements. Dubbed “Medicare Advantage” (MA)
under the Medicare Prescription Drug, Improvement,
and Modernization Act of 2003, private plans
saw dramatic enrollment increases beginning
in 2006. Concerns about payments to MA plans
exceeding costs for beneficiaries under traditional
Medicare became widespread, and Congress and
the Administration have taken steps to rein
in payment to plans, setting in motion a series
of changes that could have significant implications
for beneficiary enrollment and providers who
serve MA enrollees. This session will chart
historic changes in the MA program and provide
insight into recent regulatory and legislative
activities expected to have an impact on the
program’s future popularity and how it
will affect the delivery of home health services.
The session will also provide guidance on specific
areas of concern raised by home health agencies
in dealing with MA programs.
Objectives:
- Outline the structure of the MA program;
- Describe recent regulatory and legislative
changes to the MA program;
- Discuss the potential impact these changes
may have on plan participation, enrollment,
and delivery of home health services to
plan enrollees; and
- Discuss problem areas home health agencies
have encountered in dealing with MA plans,
and potential solutions.
Faculty:
Vicki Gottlich, LLM, Senior Policy Attorney,
Center for Medicare Advocacy, Washington,
D.C.; William A. Dombi, Esq. Vice President
for Law, Director, Center for Healthcare
Law, NAHC, Washington, D.C.
Course Level: Intermediate; 1.5 Nursing CEs;
1.0 Accounting CPE (NASBA/RE)
103. Significant Considerations for Accurate Hospice Cost Reporting
Any modifications to hospice reimbursement in the future should
be based on quality financial information. The Centers for
Medicare & Medicaid Services (CMS) has stated its need for
enhanced financial data regarding hospice activities and operations. The
National Association for Home Care & Hospice (NAHC), working
with CMS, has developed an approach to provide the information
needed to assist CMS and to also provide hospices with meaningful
information regarding their own activities. This program will
address the changing hospice environment and financial reporting,
including cost reporting for the increasing sophistication of
hospices and the services being offered. This session is
part of an overall effort by NAHC to provide more in-depth education
on the importance of proper and accurate cost reporting.
Objectives:
- Describe what is important in both financial and cost reporting
as well as enhanced cost reporting;
- Describe what information can be developed from an accurate
and complete cost report; and
- Explain the mechanics of preparation for filing a hospice
cost report and the importance of filing an accurate annual
report.
Faculty: Ted Cuppett, CPA, Dixon-Hughes, Morgantown, WV; Donna
Gouveia, Chief Financial Officer, VNS of Greater Rhode Island,
Lincoln, RI
Course Level: Intermediate; 1.5 Nursing CEs; 1.0 Accounting
CPE (NASBA/RE)
104. Advocacy from A to Z — How to Lobby Your Member
of Congress
This program will familiarize participants with the methods
and techniques of lobbying to empower them to communicate successfully
with their members of Congress regarding home care and hospice
priorities. Participants will learn how to conduct a lobbying
visit, avoid common errors, and do effective follow-up. Workshop
presenters have extensive experience working on Capitol Hill
and knowledge of current home care and hospice legislative issues.
Objectives:
- Discuss how to conduct a lobbying visit successfully;
- Demonstrate what to do during the three most common types
of legislative interviews and how to avoid the two most common
mistakes;
- Outline follow-up activities; and
- Describe the most effective means for communicating with
members of Congress.
Faculty: Jeffrey
Kincheloe, JD, Vice President for Government Affairs/Senate,
National Association for Home Care & Hospice,
Washington, D.C.
Course Level: Intermediate; 1.5 Nursing CEs; 1.0 Accounting
CPE (NASBA/SKA)
MONDAY, April
12, 2010
Concurrent Educational Sessions (200 series)
2:15 to 3:45 pm
201. HHQI National Campaign Insights
HHQI National Campaign Insights is a four-part interactive session designed to introduce
and enhance campaign participation. Section one includes a campaign overview and
introduction to reducing avoidable hospitalizations and improving oral medication
management. The second part focuses on the use of Internet communication tools to
improve quality. The third phase focuses on cross-setting aspects of the campaign,
including an introduction to care transitions and participant input on physician
education resources. The final section consists of authentic depictions of providers’ home
health experiences and how they relate to quality improvement.
Objectives:
- Implement HHQI National Campaign best practices related
to acute care hospitalization reduction and improvement in
oral medication management;
- Utilize HHQI National Campaign social networking resources
to improve communication and impact quality;
- Act to improve care coordination by gaining an understanding
of care transitions while providing input on physician education
resource development; and
- Learn about best practices from their peers by interacting
and sharing authentic depictions of participants’ home
health experiences.
Faculty:
Shanen Wright, Director, Home Health Quality Improvement
(HHQI) National Campaign, WVMI & Quality Insights, offices
in West Virginia, Delaware, Pennsylvania and New Jersey
Course Level: Intermediate; 1.5 Nursing CEs; 1.0 Accounting
CPE (NASBA/RE)
202. Home Health Cost Reporting: Doing it Right
Home health cost report information has increasingly become
the go-to source used by Congress and the Centers for Medicare & Medicaid
Services (CMS) for making legislative and regulatory decisions
about payment. And with Congress poised to mandate rebasing
of Medicare home health payment rates, stakeholders have become
increasingly concerned that widespread indifference to proper
cost reporting principles could spell financial disaster for
agencies throughout the nation. This session is part of
a nationwide effort sponsored by NAHC’s Home Health Financial
Managers Association (HHFMA) to educate agencies on proper home
health cost reporting principles, common errors, and ways that
cost report information can be used as a valuable tool to improve
an agency’s operations and financial bottom line.
Objectives:
- Discuss proper cost reporting principles;
- Identify common errors in cost reporting; and
- Analyze agency cost report data and identify areas for in-depth
review.
Faculty:
Ted Cuppett, CPA, Dixon Hughes, Morgantown, WV; Katherine
Jones, CPA, CFE, CHC, Manager, HC Healthcare Consulting, LLC,
Boise, ID; Pat Laff, CPA, Managing Principal, Laff Associates,
Hilton Head, SC; Ken McNulty, Senior Vice President/CFO, VNA
of Boston, Charlestown, MA; Mark Sharp, Partner, BKD, LLP,
Springfield, MO.
Course Level: Intermediate; 1.5 Nursing CEs; 1.0 Accounting
CPE (NASBA/RE)
203. Answers from the Experts: CMS Panel on the Medicare Hospice
Benefit
This popular annual program provides attendees the opportunity
to hear from and ask questions of a panel of top Centers for
Medicare & Medicaid Services (CMS) hospice experts. CMS
will address important issues of the day, leaving time for providers
to gain in-depth knowledge and ask questions on other topics
of concern. Among the items discussed will be analysis of
hospice data collected; the latest survey and certification issues;
hospice medical review; the status of potential changes to the
hospice reimbursement system; and other regulatory areas of interest.
Objectives:
- Discuss CMS’s analysis of hospice data collected;
- Discuss the focus of hospice medical review; and
- Identify top survey deficiencies.
Faculty:
Lori Anderson, Chronic Care Policy Group; Kim Roche, Survey & Certification
Group; and Danielle Shearer, Office of Clinical Standards and
Quality; all of the Centers for Medicare & Medicaid Services,
Baltimore, MD
No CEs or CPEs.
MONDAY, April
12, 2010
Concurrent Educational Sessions (300 series)
4 to 5:30 pm
301. What’s Ahead for
Post-Acute and Chronic Care?
Policymakers in Washington have increasingly focused on two inter-related factors
that are driving rising costs in Medicare and other health care programs: post-acute
care and patients with chronic conditions. Home care agencies are well equipped to
play a central role in addressing these formidable challenges. The Centers for Medicare & Medicaid
Services (CMS), the Medicare Payment Advisory Commission (MedPAC), and the Quality
Improvement Organizations (QIOs) are already working on studies and pilot programs
that involve controlling the costs of hospitalizations, re-hospitalizations, and
the management of individuals with chronic conditions. Options under consideration
include Accountable Care Organizations, bundling of post-acute care with inpatient
care, the use of physician-directed medical homes, and the employment of interdisciplinary
teams in chronic care management. Physicians, home health agencies, disease management
entities, and health systems all are actively seeking a controlling position in chronic
care management. This session will examine the latest thinking among policy experts
on how Medicare can most effectively and efficiently deliver post-acute care and
the current state of discussions on post-acute care and chronic care management in
Washington.
Objectives:
- Identify proposals related to chronic and post-acute care;
- Describe the state of policy discussions regarding better
management of chronic conditions under federal health programs;
and
- Discuss projects under way on service delivery in the post-acute
setting;
Invited Faculty:
Jeff Kincheloe, J.D., Vice President for Government Affairs/U.S.
Senate, NAHC, Washington, D.C.; Mara Benner, VP for Government
Affairs, Gentiva Health Services, Atlanta, GA; and Peter Boling,
MD, Virginia Commonwealth University INT, Richmond, VA; Bill
Borne, RN, Chief Executive Officer and Chairman of the Board,
Amedisys, Baton Rouge, LA
Course Level: Intermediate; 1.5 Nursing CEs; 1.0 Accounting
CPE (NASBA/SKA)
302. Responding to Home Health Rate Rebasing: Achieving Efficiency
and Reducing Costs under the New PPS Rates
Cost efficiencies will be the key to meeting the challenges
posed with pending regulatory and legislative cuts to home health
payment rates. NAHC’s Home Care & Hospice Financial
Management Association (HHFMA) is sponsoring this session to
guide agencies to ensure that they are maximizing opportunities
for achieving operating efficiencies and cost controls.
Objectives:
- Identify areas of potential financial inefficiency relative
to agency operations and care delivery;
- Discuss methods for evaluating whether specific cost centers
can be made more cost-effective; and
- Develop a plan for achieving cost savings in specific cost
centers.
Faculty:
Ken McNulty, Senior Vice President/CFO, VNA of Boston,
Charlestown, MA; William Simione, Jr., Managing Principal,
Simione Consultants, LLC, Hamden, CT; William A. Dombi, Esq.
Vice President for Law, Director, Center for Healthcare Law,
NAHC, Washington, D.C
Course Level: Intermediate; 1.5 Nursing
CEs; 1.0 Accounting CPE (NASBA/RE)
303. Financial, Billing, & Service-Level Data: the Impact
on Hospice Programs
The Centers for Medicare & Medicaid Services (CMS) is steadily
increasing its requirements for new and proposed reporting for
the hospice cost reports and billing. This program will discuss
the new regulations, what they mean to hospice providers, how
the provider can use this information in managing their hospice
operations, and best practices for the industry.
Objectives:
- Describe how to use the data collected in the cost reporting
process to assist in meeting the QAPI requirements in the
Medicare conditions of participation;
- Describe how accurate and inaccurate data reporting/collection
on the cost report affects future hospice reimbursement and
payment structures; and
- Describe the impact of financial and service level data
on hospice programs.
Faculty:
Carla Braveman, BSN RN MEd CHCE, CEO/President, Big Bend
Hospice, Tallahassee, FL; Robert J. Simione, Principal, Simione
Consultants, LLC, Hamden, CT
Course Level: Intermediate; 1.5 Nursing
CEs; 1.0 Accounting CPE (NASBA/RE)
304.
OASIS-C Assessment Instrument — Implications and
Implementation Issues
OASIS-C is the first major update to the home health assessment instrument since
it was introduced in 1999. This important tool will be used, beginning in early 2010,
to measure home health quality and establish payment rates. The new instrument contains
significant revisions to existing items and major changes to OASIS, including the
addition of items that measure processes of care. This program will provide a brief
overview of new and changed OASIS items, along with more in-depth discussion of items
that providers have identified as problematic since their implementation on Jan.
1, 2010. Tips on care planning around process measures will be provided. Quality
report timelines will be reviewed.
Objectives:
- Clarify OASIS-C items that have proven to be problematic
- Describe how to use OASIS-C process questions in care planning
- Discuss the schedule for release of OASIS-C reports
Faculty:
Rhonda Will, RN BS HCS-D COS-C, Consultant, Fazzi Associates,
Northampton, MA; Mary St. Pierre, RN BSN MGA, VP for Regulatory
Affairs, and Mary Carr, RN MPH, Associate Director for Regulatory
Affairs, both of NAHC, Washington, D.C
Course Level: Intermediate; 1.5 Nursing
CEs; 1.0 Accounting CPE (NASBA/RE)
Legal Symposium Workshops
WEDNESDAY, April 14, 2010
General Session Panel Discussion (400 series)
8:30 to 10 am
401. Panel Discussion: "It's All About Integrity..."
Raising the Compliance Bar: The Commitment to Organization-Wide Integrity
With the increased public debate over the high cost of health
care, it’s no surprise that government enforcement agencies
have begun increased scrutiny of providers with the goal of eliminating
wasteful spending, fraud and abusive practices from federally-financed
health care programs. Reports of questionable activities by some
home health providers caught the attention of the leadership
at LHC Group, Inc., a national provider of home care, hospice
and other health care services with operations in 18 states.
Having resolved to be part of the solution, in early 2009 LHC
Group partnered with the respected healthcare consulting firm
of Deloitte & Touche to conduct assessments of its compliance
program and its compliance risks. What followed was a significant
redesign of LHC Group’s compliance program, which is now
viewed as a “best of class” compliance program and
a leading example within the healthcare industry. Representatives
of LHC Group and Deloitte & Touche have agreed to share the
steps they have taken within the last year to achieve their goals
of engaging the entire LHC Group “family” in their
commitment to integrity. At LHC Group, when it comes to their
compliance program efforts “It’s All About Integrity…” The
last portion of this session will allow for questions of the
panel from attendees.
Objectives:
- Describe the state of compliance in the health care industry
at large;
- Outline the steps a home health agency can take to identify
compliance risks within its organization;
- Describe actions a health care organization can take to
redesign its overall compliance program; and
- List the steps a health care organization can take to ensure
it meets the seven key elements of an effective compliance
program.
Panel Participants: John
Indest, Special Advisor to the CEO, Director and Former President
and Chief Operating Officer, LHC Group, Inc., Lafayette, LA;
Peter C. November, Executive Vice President and General Counsel,
LHC Group, Inc., Lafayette, LA; Joshua L. Proffitt, Senior
Vice President and Chief Compliance Officer, LHC Group, Inc.,
Lafayette, LA; Vickie M. Monteith, Director, Health Sciences,
Healthcare Providers and Regulatory Risk and Compliance, Deloitte & Touche, Charlotte,
NC; Cheryl J. Golden, Senior Manager, Health Sciences and Regulatory
Risk and Compliance, Deloitte & Touche, Tampa, FL
Course Level: Intermediate; 1.5 Nursing CEs; 1.0 Accounting CPE
(NASBA/RE)
WEDNESDAY, April
14, 2010
Concurrent Educational Sessions (500 series)
10:15 to 11:45 am
501. Managing Risks: The Latest on Federal Fraud and Abuse
Efforts in Home Care
As the result of increased efforts to root out fraud and abuse
in Medicare and Medicaid, there are increased risks associated
with delivering home care services. This session will provide
an overview of Medicare/ Medicaid/ Department of Justice legal
and regulatory authority and initiatives including new program
integrity efforts, claims review, new False Claims Act provisions,
the Medicaid Integrity Program, and the joint HHS/DOJ Health
Care Fraud Prevention and Enforcement Action Team (HEAT). This
program will also furnish guidance on how to address these risks
in your home health agency or hospice.
Objectives:
- Describe legal and regulatory fraud and abuse provisions;
- Discuss Medicare/Medicaid/DOJ fraud and abuse initiatives;
and
- Identify actions to address risks in your agency and hospice.
Faculty: Denise
Bonn, Esq., Deputy Director, Center for Health Care Law, National
Association for Home Care & Hospice, Washington,
D.C.
Course Level: Intermediate; 1.5 Nursing CEs; 1.0 Accounting CPE
(NASBA/RE)
502.
Back to Basics — Medicare’s Coverage of
Home Health Services
In recent months, there has been an upsurge
in claims reviews and denials of coverage under the Medicare
home health benefit. This program provides a revitalized tour
of Medicare coverage standards regarding skilled care, home health
aide services, homebound status, and the intermittent care requirement.
Special attention is given to therapy coverage standards and
issues. Is your agency’s understanding of Medicare coverage
on target or are you at risk in a targeted review?
Objectives:
- Discuss the scope and breadth of Medicare coverage of home
health services;
- Identify detailed coverage criteria for homebound status
and the intermittent care limitation;
- Outline the standards to meet for coverage of skilled nursing
and therapy services; and
- Discuss proper documentation for therapy services to support
medical necessity determinations.
Invited Faculty:
Cindy Krafft, Senior Clinical Consultant, Fazzi Associates,
Inc., Northampton, MA; Mary St. Pierre, Vice President for
Regulatory Affairs, and William A. Dombi, Esq. Vice President
for Law, both of the National Association for Home Care & Hospice,
Washington, D.C.
Course Level: Intermediate; 1.5 Nursing CEs; 1.0 Accounting
CPE (NASBA/RE)
WEDNESDAY, April
11, 2010
Concurrent Educational Sessions (600 series)
1:15 to 2:45 pm
601. Medicare Appeals: Strategies for Success
Home health agencies have seen an increase in Medicare denials
over the past year. The reasons for this primarily relate to
medical necessity for services and homebound status. This program
will offer insight on the Medicare statute and regulations governing
reasonable and necessary skilled nursing and therapy services
and homebound requirements. In addition, provider appeal rights
and appeal timelines will be reviewed. Detailed guidance will
be offered on identification of supporting evidence in the clinical
record needed to demonstrate compliance with legal standards.
Objectives:
- State which provisions of the Medicare statute and regulations
govern medical necessity and homebound status;
- Identify information in the clinical record that supports
coverage of services; and
- List appeal rights and timelines.
Faculty:
Mary St. Pierre, RN BSN MGA, VP for Regulatory Affairs,
and Denise Bonn, Esquire, Deputy Director, Center for Health
Care Law, both of NAHC, Washington, D.C.
Course Level: Intermediate; 1.5 Nursing CEs; 1.0 Accounting
CPE (NASBA/RE)
602. Combating Medicaid Fraud: The Federal Medicaid Integrity
Program
Historically, states have had primary responsibility for policing
fraud in the Medicaid program. With Medicaid expenditures now
topping $300 billion annually, Congress has demanded a more comprehensive
approach to ensuring accountability in the program. The Deficit
Reduction Act of 2005 required the Centers for Medicare & Medicaid
Services (CMS) to establish a Medicaid Integrity Program (MIP)
to keep a closer watch on provider activities and provide support
and assistance to states in their efforts to combat Medicaid
provider fraud and abuse. On an annual basis, CMS is required
to develop five-year Comprehensive Medicaid Integrity Plans (CMIPs).
This session will provide an overview of CMS’s key planned
activities for MIP contractors, background on the interface between
MIP contractors and the states, and how these developments will
affect providers.
Objectives:
- Describe the MIP program, the program’s goals based
on the current CMIP, and the role of its contractors;
- Discuss the interface between MIP contracts and state Medicaid
fraud units; and
- Discuss the implications these changes will have for providers
of home care services.
Invited Faculty: TBA
Course Level: Intermediate; 1.5 Nursing CEs; 1.0 Accounting
CPE (NASBA/RE)
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