MICHIGAN HOME CARE AND HOSPICE ASSOCIATION

CLINICAL OPERATIONS COMMITTEE

Sept 15th, 2016

9:30AM – 12:00PM

At the Okemos Office

MINUTES

  1. Call to Order
  2. Introductions – Sara opened meeting withthose on phone and then attendees introducing.
  3. Approved minutes from July 2016meeting were approved as written.
  4. Agenda Additions –

-Face to Face requirements

-Pre-Auth Claim review

-List Serv for MHHA

  1. Executive Director’s Report –Barry welcomed everyone. States there are more and more mergers and acquisitions going on as part of what he is seeing in our industry and in our state. This MHHA group welcomes all newcomers and current members to join together in meeting the needs of our industry members. Mentioned our state is currently involved in a moratorium on new branches and new agencies as well as the looming start of pre-claim reviews (PCR) starting Jan 1st, 2017. NAHC conference is coming up (October 23-25) and there will be meetings between the states (Forum of States from Oct 21-22) at that conference as well. Barry will be there the first day of the NAHC conference and would be happy to meet with any members that are attending.
  1. Announcements/Reports:
  2. Regulatory Update
  3. NGS –Christine had no new report.
  4. MILARA – Amy discussed that on October 12th there will be an educational offering where they have asked to reschedule our standard MILARA meeting that was scheduled on this same date. They have also asked for some frequently asked questions that they can answer for the educational meeting. Barry shared that the state thought that the moratorium did not allow for expansion of territories. CMS clarified in writing and Barry sent this to the state to have them clarify their direction that the expansion of territories is included even though the branches are not being allowed at this point.
  5. BCBSM Regulatory/QI Committee – Sara shared that we currently have a good relationship with our BCBS reps and encouraged each agency to work with BCBS first and then can also discuss here. SCIO requests are continuing and several folks voiced that they have received up to 16 requests. Seem to be a focus of high therapy to joint replacement patients. Some found RN only with chronic catheters. Asked if all were doing F2F on managed Medicare and all said “yes”. Another member shared that they had sent in physician notes to support face to face encounter. This was not requested by one agency that did not provide. Another stated they DID ask for this and told the agency that they would be making this a requirement soon. This group recommends getting F2F documentation on managed Medicare. HHFMA are wondering if anyone is having difficulty with AETNA? Barry mentioned that Pat Johnson at BCBS who was in charge of auditing has retired and wondered if anyone knew if her position had been replaced. No one knew. Also asked if the SCIO contract is continuing past Feb 2017? Barry would like to have a Liaison contact BCBS to find out these answers. Reimbursement meets on the 21st (offers phone attendance usually, but this meeting is on site here due to a phone conference happening directly thereafter that is on HIPAA and all wanted to participate and encourage others as it is only $60) and Amy Gil is co-chair. There is a separate Billing subcommittee and they joined together the last month which was successful and helpful. She is attempting to bring info from and to these two committees so that we can help each other and they are also looking at their agenda to be sure each team can be more effective. Another member stated the meeting was successful for her biller. Would like to see all groups meet quarterly and on the same day so travel could be combined. There is a benchmark report that Amy compiles and she stresses how the data is all scrubbed before Amy gets the data by the MHHA office staff. Please send your data! Currently only 6 agencies participate. Only members who participate may be able to use this data. This is done to encourage participation. Payer mix, visit types and amounts, and accounts receivable info are the info asked for. This format is obtainable from the MHHA committee and is due the first week in November (3rd quarter data). They will also try to get the tool on the MHHA website. A member asked how do you convince your superiors on how this info will help you. It allows each agency to share and learn whether you are different or are similar and why.
  6. Regulatory –Elizabeth is not available as she is in DC discussing the problems in ILL regarding Pre-Claim Audit process– Sara, Amy and Kim will be managing the Regulatory today.
  7. Education Committee – Cindy shared the most recently upcoming educational offerings and there were handouts for each. The annual meeting has a keynote speaker, Ed Kearns who was on the NY Mets baseball team and has had a lot of medical issues which gave him a first-hand experience with our industry. The theme is “Whole New Ball Game”. Other speakers were also shared and she would like more speakers and topics to be shared. They meet on Tuesday, Sept 20th to get planning going. Plan is to be completed by November to market conference May 3-5, 2017. Some topics would like “How PD can work better with Certified and Hospice agencies”, “How to care for yourself”, “Hospice prep for Final Rule”, “Palliative Care” and many others. Nothing real specific for Home Care Certified. Barry shared that John Mulder and Christine Herrick are the co-chairs of the new Palliative Care Committee that is a subcommittee of the Hospice Committee. The next meeting is Sept 22ndat 9am here at MHHA (will offer phone but encourage attendance). Suggestions from this group “Bundled payments for Joint Rep/ AMI/ Chronic Care Management”. “Impact Act”, “QAPI” for both Hospice and Home Care. NGS may also be helpful to attend. “Transformation Change Management” using a panel discussion with experts from various groups such as PACE. More webinar offerings have been added to MHHA’s offerings so keep attentive as these are very helpful. There is a new contract with Home Care and Hospice Webinars that provides a larger pool to pull webinars from. Some of these topics are Hospice but they will be identified if more home care or hospice. Also, don’t forget about the use of our RCTC education that is also free (member benefit). The agencies that use it are using it a lot. November 30th and Dec 1st for OASIS C2 will be testing on the 3rd.
  8. MPRO –Katie is not here to report today.
  9. Sub-Committee/Task Force Reports:
  10. IV Therapy/Infection Prevention – Deb shared that Infusion Ref manual is available on the website and there is also going to be a competency packet to be available after finalized (hoping to be done by October). Will be INS inspired. Deb, Melody and Rebecca are the authors. $50 buys the package and contribution is for the scholarship program.
  11. Psych Home Care – No report.
  12. Rehab Subcommittee –Meeting today with call and Andrea has announced her new job as Director of Crittenton Home Care and will be stepping down from the therapy subcommittee. Dan was asked if he would take the position, but is not able to unfortunately. Please consider helping this group with membership and leadership.
  13. New Business:
  14. Face to face. Steve asked if anyone was still doing the form? Most said yes, but some said that they were just sending the physician visit notes. Many discussed how the most important thing is that the 5 elements are on the visit note and that the documentation is in the physician’s medical record.
  15. MHHA Listserv info? One member said that they are getting double emails. Those that are on it state that it appears to be valuable. Just call the MHHA office and ask to be on the listserv. There are several. You are reminded of what list servs you are on monthly and you can change your status at that time. Would also like to know how to search if possible?
  16. Pre-Claim Review. NGS has not had any updates on their process. Not going well in Illinois. Reimbursement would also like to ask for a webinar on this from NGS?
  17. Questions to the group about use of PTA's, supervision requirements, Re-eval questions/discussion, etc.
  18. Allscripts participation – many are paying the fee for the referrals as this is the only way to get referrals from hospitals that use this system.
  19. Sharing Segment
  20. Survey Report- No report

Meeting adjourned at 11:45. Regulatory meeting this month is to follow at 12:00.