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 Other
Updates
New
Information Available on HH PPS Billing & Coding Website
CMS has posted new information regarding HH PPS case-Mix refinements on the
HH PPS Coding & Billing website. The new resources include:
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Questions and Answers
regarding transition episodes. This document describes special steps for
HHAs to take in completing their OASIS assessments at the transition to
the refined HH PPS January 1, 2008. These steps will assure HHAs can
create the proper payment group code for their claims.
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HH PPS HIPPS code weight
tables. These spreadsheets map each of the 1836 new HIPPS code for the
refined HH PPS to its associated case-mix weight and supply payment
amount.
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Presentation on HH PPS
claims processing changes. An outline describing the principle changes
to HHA coding and billing that result from the refined HH PPS.
To access this information, go
to:
http://www.cms.hhs.gov/HomeHealthPPS/03_coding&billing.asp
CMS has released the Toolkit for Healthcare Professionals: Medicare Prescription Drug Coverage. To access the toolkit and other educational resources, visit the drug coverage information webpage (Medlearn) for physicians and other healthcare
professionals at www.cms.hhs.gov/medlearn/drugcoverage.asp.
The Toolkit for Healthcare Professionals: Medicare Prescription Drug Coverage (adobe
PDF 860Kb) includes downloadable educational materials specifically for physicians and other healthcare professionals and their staff to learn the basics about Medicare Prescription Drug Coverage. It also includes materials to distribute to their Medicare patients. The kit contains reproducible artwork, a letter from the CMS Administrator, a fact sheet
(English and Spanish), a brochure, an article, and a list of other resources.
Physicians and other healthcare professionals and their staff, partner organizations, social workers, financial counselors, and discharge planners will find this toolkit a valuable resource to get information to people with Medicare. You may add your logo and business information to these materials and copy freely, if you wish.
Click
here for a policy from CMS relating to initial fills of prescriptions for LTC residents when the medication is nonformulary. This provides additional protection for the beneficiary
Certified Nursing Assistant Renewals:
New CNA renewal certificates will be mailed to CNAs beginning August 8.
Any CNAs who have not sent in their renewal application and fee by December 31, 2005 will become delinquent on January 1, 2006, and will not be able to work. For a complete report, go to
www.myflorida.com
.
Don't forget to include CNAs who are certified but not working in such roles but wish to maintain their certification.
It is expected this will be well-enforced!
Advance copy of new surveyor guidance for determining nursing facilities’ compliance with requirements at F501, Medical Director
On June 9th, the Centers for
Medicare & Medicaid Services (CMS) issued to state survey agency directors
the advance copy of new surveyor guidance for determining nursing facilities’
compliance with requirements at F501, Medical Director. The new guidance, which
is now available on CMS’ web site, includes Interpretive Guidelines, an
Investigative Protocol, and Severity guidance for assigning severity levels for
deficiencies cited at F501. The regulation at F501 has not changed.
CMS will issue the final guidance in
November 2005. According to CMS’ cover memo, the intervening time period is
intended “to allow surveyors to be trained in the new guidance and to permit
facilities and medical directors to study the significantly revised and expanded
guidance.” Changes in the content are not expected when CMS issues the final
document.
ACHA key staff and subcommittee
members are reviewing the guidance. In subsequent communications, we will
provide additional information such as the content and significance of the
guidance, as well as information and materials to help facilities understand and
prepare for implementation.
The guidance also may be accessed on CMS web site at http://www.cms.hhs.gov/medicaid/survey-cert/sc0529.pdf
or as a Word Document by
clicking here.
The Agency for
Health Care Administration has announced that Rule
59G-9.070, Administrative Sanction on Providers, Entities and Persons has been promulgated and became final on April 19, 2005. The
Agency, specifically the Bureau of Medicaid Program Integrity, will begin
imposing sanctions pursuant to this rule on July 1, 2005. You may find
this rule at http://fac.dos.state.fl.us/faconline/chapter59.pdf.
If you have any questions
regarding this rule or the implementation, please contact Kimberly Noble, via email
or via phone at 850-413-9290.
Date: May 11, 2005
Subject: CMS
The date of the new MDS QI/QM
report deployment has tentatively changed to June 19, 2005 (and it may be
extended into July at the latest). CMS is in the process of developing an
S&C Memo to address the SOM Changes for this release.
Section W will still be deployed
this fall. Correction 2 to Version 1.30 of the MDS 2.0 Data Specifications
will be posted in May. Vendors noted the "dash" was not listed
as an acceptable value, and this will be added. Date edits will also be
simplified. More to come when corrections are posted.
Date: May 5, 2005
Subject: CMS
CMS has placed an advanced copy of the new surveyor guidance for incontinence
and catheters on the CMS website: http://www.cms.hhs.gov/medicaid/survey-cert/sc0523.pdf
. (The advance notice to state survey
agencies will allow time for training before implementation.) CMS will issue the
guidance in Appendix PP and it will become effective June 27, 2005. Although the
date on the survey and certification letter says April, it is my understanding
from CMS staff that there is a delay between the date of the release to state
survey agencies and the appearance on the CMS website.
Subject: DELAY in the May 1 Effective Date of the RAI Manual Revision
Importance: High
Due to ongoing efforts, the May 2005 revisions to the December 2002 RAI Manual, Version 2.0 will be delayed.
CMS anticipates a new posting on May 23, 2005 with an effective date of June 15, 2005.
Please stay posted to the MDS website http://www.cms.hhs.gov/quality/mds20. An announcement will be made at the Open Door Forum Call on April 28.
We apologize for any inconvenience this delay has caused. Please spread the word.
The MDS Team.
Mary Pratt
Director
Division of Ambulatory and Post Acute Care
Office of Clinical Standards and Quality
mary.pratt@cms.hhs.gov
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The MDS Fall release will include three new items: a pneumonia question, an influenza question, and a placeholder for the new National Provider Number. The data specifications were posted last week on the MDS 2.0 website at
http://www.cms.hhs.gov/medicaid/mds20
. The specs are now posted as draft but will become final specs on Friday, March 18th. The implementation of the three new items will become
effective for assessments with an assessment reference date of October 1,
2005. The only changes with Version 1.30 of the MDS Data Specifications involve adding a new MDS Section, Section W: Supplemental MDS Items. There are 5 items in Section W:
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W1. National Provider ID -- a voluntary item that is active on the header record and all MDS data records.
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W2a. Influenza vaccine received or not -- required on assessment and discharge data records relevant to the influenza season.
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W2b. Reason influenza vaccine not received -- required on assessment and discharge data records relevant to the influenza season.
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W3a. Pneumococcal vaccine (PPV) status (received or not) -- required on assessment and discharge data records for residents 65 years old and older.
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W3b. Reason PPV not received -- required on assessment and discharge data records for residents 65 years old and older.
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Upcoming MDS Satellite – CMS is anticipating
July 2005 to highlight the additional MDS items (pneumonia, influenza and National Provider Identifier) for the fall release and satellite training.
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Vendor Conference -- CMS planned to host a vendor teleconference on April 21st to discuss the new MDS Data Specifications and required implementation.
http://www.qtso.com/vendor.html
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RAI Manual Changes and Updates – CMS is anticipating clarification to the MDS 2.0 manual on March 28, 2005, with a
May 1st effective implementation date to give people ample time for training, etc. See attached revisions.
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New QI/QM Reports Implementation Date – The national implementation date was postponed until
May 15th (tentatively). CMS piloted the QI/QM reports with Missouri and West Virginia. The REQUEST REPORTS button will be inactivated. Providers will access via the CASPER Reporting System (this is the system that was used to post the providers' quality measures prior to their implementation.) Most providers reviewed their reports at that time, but have not needed to access CASPER since then. User IDs for the CASPER system are the same as providers currently use to submit MDS data. The training materials will be posted on each states’ MDS Welcome Page and
http://www.qtso.com/mdsdownload.html.
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New Minimum System Requirements for Facilities – See CMS Survey & Cert Memo (see attached)
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Upcoming WebCast on RAI-Improving MDS Accuracy - Section P -- scheduled for
June 24, 2005 http://cms.internetstreaming.com
Implementation of the
ASPEN Complaints /Incidents Tracking System (ACTS)
Memo from CMS
Attachment - Guidance to Support Management of Complaints and Incidents
December 2002 Revised Long Term
Care Resident Assessment Instrument User's Manual for the Minimum Data Set
(MDS) Version 2.0
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HIGHLIGHTS
Revisions to the December 2002 RAI Manual, version 2.0 will be
effective May 1, 2005. |
Description: The December 2002
Revised Long Term Care Resident Assessment Instrument (RAI) User's Manual for
the Minimum Data Set (MDS) Version 2.0 replaced CMS's original Long Term Care
RAI User's Manual Version 2.0 published in October 1995.
This version and subsequent updates of the RAI\MDS manual incorporate
clarifications to existing coding and transmission policy, integrate previously
published Questions and Answers (Q&As) into the appropriate sections and
address requested clarifications and scenarios concerning problem areas.
Please note that InterRAI holds the copyright to Version 2.0 of the RAI for long
term care outside of the US. Therefore, this revised Version 2.0 of the RAI/MDS
manual should not be reproduced outside of the United States without permission
of InterRAI. Within the US, Version 2.0 is in the public domain.
UPDATE FILES: The files listed here
include only the pages from the RAI manual with the effected changes and can be
placed directly into your manual. If you wish to download an entire updated
chapter, see the Chapter sections below.
CNA Background Screening Enforcement
The Board of Nursing (under the
Department of Health) is implementing the
following: s. 464.203 (1) F.S. Background Screening of CNA's prior to
Certification.
"The board [of nursing] shall issue a certificate to practice as a certified
nursing assistant to any person who demonstrates a minimum competency to
read and write and successfully passes the required Level I or Level II
screening pursuant to s. 400.215..."
Impact in Nursing Facilities beginning as early as November 1: Individuals
participating in the CNA Test Prep Course, when applying to take the CNA exam,
will be required to submit additional monies and an additional BGS application
to the test vendor. Facilities conducting the CNA Test Prep Course will be
faced with conducting two screenings: one for employment purposes (no change
here in process or fees) and one for certification ($25.00=$15.00 fee for FDLE +
$10.00 processing fee).
According to Florida Health Care Association (FHCA), you may put this expense on
your cost reports, as with your regular background screening costs.
However, at this time, FHCA recommends that facilities not accept a certificate
as evidence of a screening; and continue to conduct employment screenings as
they have. At some point in 2003, there may be a mechanism in place by
which facilities may use a new CNA's certificate as evidence of a clear
screening.
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