CDC: Some Older Adults Should be Revaccinated Against Measles

Rural Access to Hospice Act Reintroduced in Senate, House (via NAHC)

Rural Access to Hospice Act Reintroduced in Congress (via NHPCO)

Have you Retrieved your Hospice PEPPER?

Recovery Audits: Improvements to Protect Taxpayer Dollars and Put Patients over Paperwork

How To Find your RCTCLearn Message Alerts

How to Earn Important “Points” in False Claims Act Investigations

Utah Medicaid Pharmacy Values Your Input

Patient-Centered Care Is Key to Best Practices in Pain Management

Some States Face Severe Nursing Shortages by 2030

MLN Connects 5-9-2019

NAHC Bulletin

HAN Monthly News Update


Compliance Extravaganza June 4-5 with Annette Lee at Jenkins-Soffe Funeral Home

June and July Brochure Copy

CHAP 2019 Hospice Accreditation Intensive Webinar Series

Butterfly Memorial

RCTCLEARN Webinar Announcement

Key Issues in Proposed Payment Rule Webinar

Interest Items

Industry News Articles


CDC: Some Older Adults Should be Revaccinated Against Measles

Via NAHC Report: “People who were vaccinated against measles prior to 1968, with either inactivated (killed) measles vaccine or measles vaccine of unknown type should be revaccinated with at least one dose of live attenuated measles vaccine. This recommendation is intended to protect those who may have received killed measles vaccine, which was available in 1963-1967 and was not effective, according to the Centers for Disease Control and Prevention.” Read the full article here…

Rural Access to Hospice Act Reintroduced in Senate, House

Via NAHC Report: “U.S. Senators Jeanne Shaheen (D-NH) and Shelley Moore Capito (R-WV), and U.S. Representatives Ron Kind (D-WI) and Jackie Walorski (R-IN)  have introduced the Rural Access to Hospice Act of 2019 (S. 1190/H.R.2594), bipartisan/bicameral legislation to improve seniors’ access to hospice care in rural America.

Under current law, patients select a physician or nurse practitioner to serve as their attending physician when they elect hospice care.  Rural health clinics (RHCs) and federally qualified health centers (FQHCs) cannot bill Medicare Part B for hospice attending physician services, preventing some patients from receiving care from their primary care practitioner – the medical professional they know and trust.

The Rural Access to Hospice Act of 2019 would allow RHCs and FQHCs to bill Medicare Part B for hospice attending physician services in instances where these center-employed practitioners provide care for their patients in hospice care.

The National Association for Home Care & Hospice (NAHC) heartily endorses this proposed change and has created a legislative action campaign for use in encouraging your Senators and Representatives to cosponsor this important legislation.  To encourage support, please go to NAHC’s Legislative Action Campaign here.

Historically hospice utilization in rural areas has trailed behind that of urban areas; recent Medicare Payment Advisory Commission (MedPAC) data indicates that Medicare decedent utilization of hospice care in rural frontier areas is 20 percent lower than utilization by urban decedents.  In many rural areas, FQHCs and RHCs are the only source for primary care services and the existing inequity related to coverage of attending physician services creates an unnecessary barrier to hospice care for rural beneficiaries. The Rural Access to Hospice Act of 2019 will correct this error.

“This bipartisan bill improves access to hospice care for seniors in rural areas of the country, including New Hampshire,” said Senator Shaheen. “Granite Staters shouldn’t have to choose between giving up their primary care providers and receiving hospice care. This proposal will help patients and their families receive hospice care and the peace of mind that comes with continuing to see their trusted provider towards the end of life.”

“In the final stages of life it’s more important than ever to be able to receive care from a trusted physician in your own community,” Senator Capito said. “The Rural Access to Hospice Act will make sure this critical service is available to [those] who call rural America home, providing them care and comfort at a critical time. As someone who knows what it is like to have a family member receive hospice care, I know how important this kind of compassionate care is, and I am committed to ensuring hospice care is available to all Americans – regardless of where they live.””

Rural Access to Hospice Act Reintroduced in Congress

Via Lauren Drew at NHPCO:

Dear Hospice Advocate:

I am happy to announce that the Rural Access to Hospice Act was reintroduced in the US House of Representatives yesterday by Congressman Ron Kind (D-WI) and Congresswoman Jackie Walorski (R-IN). It had been reintroduced in the Senate last month by Senators Jeanne Shaheen (D-NH) and Shelley Moore Capito (R-WV). Now that it is fully reintroduced in both chambers, it is imperative that Members of Congress hear from you!

We have reason to believe that a rural health package is being discussed in Congress, and we need to show that the Rural Access to Hospice Act has wide bipartisan grassroots support to bolster our argument to include this bill in the package. Can you please complete our Action Alert, and then share it with your staff and network?

I’ve also attached a brief one-page summary about the Rural Access to Hospice Act. Please feel free to print out copies and share them with your coworkers. The more people who contact Congress about this bill, the more attention it will get!

Once you have completed the Action Alert, please consider completing a Letter to the Editor as well. Members of Congress read their local papers daily, and it influences their decision making if they see specific pieces of legislation mentioned in their local papers. Complete this pre-written Letter to the Editor to help spread the word!

Thank you for making time to be an advocate today, and please let me know if you have any questions.

Have you Retrieved your Hospice PEPPER?

Via NAHC Report: “As previously reported, the Hospice Program for Evaluating Payment Patterns Electronic Report (PEPPER) became available for hospices to download at the beginning of April. The PEPPER is only available via download from the PEPPER Resources portal.  PEPPER is a data report that contains a single hospice’s claims data statistics (obtained from the UB-04 claims submitted to the Medicare Administrative Contractor (MAC) for areas targeted by CMS as being at risk for improper Medicare payment.

Why you should download the PEPPER:

      • See how your hospice compares with other hospices in your state, Medicare Administrative Contractor (MAC) jurisdiction, and nationally in ten target areas.
      • Identify areas in which your hospice can improve.
      • Identify your hospice’s strengths.
      • Identify areas in which your hospice may be audited.

Please note that the data from hospices participating in the Medicare Care Choices Model (MCCM), approximately 97 hospices, is included in the PEPPER results.  These hospices are only required to include the principal diagnosis on their claims.  Therefore, they may appear in the 80th percentile or above in this year’s PEPPER for the target area, Claims with Single Diagnosis Coded. NAHC understands CMS is working on removing the data for these hospices on at least this particular measure in the future.

It has been approximately one month since the PEPPER was released, and six states – South Dakota, Ohio, West Virginia, North Carolina, Maryland, and Florida – have had 60-79% of their hospices download the PEPPER.  See how your state compares.

NAHC presented a webinar to help members understand the PEPPER and how they can use it to help their agency.  We are pleased to have had Kim Hrehor of RELI Group, the CMS PEPPER contractor, join our presentation.  This webinar is recorded and is available free to NAHC members.  Click here to download the recording.”

Recovery Audits: Improvements to Protect Taxpayer Dollars and Put Patients over Paperwork

Via CMS: “The Medicare Fee-For-Service (FFS) Recovery Audit Contractor (RAC) Program is one of many tools CMS uses to prevent and reduce improper payments. RACs identify and correct overpayments made on claims for health care services provided to beneficiaries, identify underpayments, and provide information that allows us to prevent future improper payments. We reduced RAC-related provider burden to an all-time low, as evidenced by the significant decrease in the number of RAC-reviewed claim determinations that are appealed and the corresponding reduction in the appeals backlog.

Examples of key improvements and enhancements:

      • Better oversight
      • Holding RACs accountable for performance by requiring them to maintain a 95% accuracy score
      • Requiring RACs to maintain an overturn rate of less than 10%
      • RACs will not receive a contingency fee until after the second level of appeal is exhausted
      • Reducing provider burden and appeals
      • Making RAC audits more fair to providers
      • Changing how we identify who to audit
      • Giving providers more time to submit additional documentation before needing to repay a claim
      • Increasing program transparency
      • Regularly seeking public comment on newly proposed RAC areas for review, before the reviews begin
      • Requiring RACs to enhance their provider portals to make it easier to understand the status of claims

For more information visit the Medicare FFS Recovery Audit Program website. See the full text of this excerpted CMS Blog (issued May 2).”

How to Find Your RCTCLearn Message Alerts

Via RCTCLEARN: “RCTCLEARN periodically sends out notifications to users regarding new or updated courses, new RCTCLEARN user features, and more.  Whenever you login to RCTCLEARN and see the little red bubble appear on the Notification Bell (located at the top of the My Homepage), simply click on the Notification Bell to view the message.”

How to Earn Important “Points” in False Claims Act Investigations

From Elizabeth E Hogue, Esq: “The following article is about how to get reductions in adverse consequences from the Department of Justice, with regard to violations of the False Claims Act (FCA). ” Read her full article here…

Utah Medicaid Pharmacy Values Your Input

Via The Utah Medicaid Pharmacy Prior Authorization Team: ” As a valued Utah Medicaid provider, you have been selected to participate in our pharmacy prior authorization survey. Your responses will help us improve our pharmacy prior authorization services.
This survey is very brief and will only take about 2 minutes to complete. Please click the link below to go to the survey website (or copy and paste the link into your internet browser).
Your participation in the survey is completely voluntary and all of your responses will be kept confidential. Thank you very much for your time and cooperation. This survey will close on May 19, 2019.”

Legislation to Stop PDGM Rate Cuts Introduced in House of Reps

Via NAHC Report: “On Wednesday May 8, a bill to prevent the Patient Driven Groupings Model (PDGM) rate cuts was introduced in the House of Representatives, an important priority for the home health community and something NAHC advocates have been working on.

The PDGM model devised by the Centers for Medicare & Medicaid Services (CMS) will subject home health providers to a 6.42 percent cut in the base rate derived from assumptions of how providers might respond to the implementation of the PDGM model.” Read the full article here…

Patient-Centered Care Is Key to Best Practices in Pain Management

Via HHS: “Dr. Vanila Singh explains the work of the Pain Management Best Practices Inter-Agency Task Force.” Read it here…

Some States Face Severe Nursing Shortages by 2030

Via NAHC Report: “It is National Nurses Week and nobody is more aware of how important nurses are to America’s health and well being than us, the National Association for Home Care & Hospice. Nurses are at the very heart of the movement to return health care to the home and we honor them every chance we get. Unfortunately, some parts of the country may soon face a major shortage of nurses.
Some American states are facing a severe shortfall of nurses in the next decade, while other states will produce far more than they need, according to a 2017 report from the National Center for Health Workforce and Analysis, as well as analysis by Registered Nursing.
Demand for registered nurses is expected to expand by 15 percent to 2026, growth more than twice as fast compared to the average of all other occupations in the United States, according to the Bureau of Labor Statistics. Demand for nursing assistants is expected to grow by 11 percent to 2026 and by 12 percent for licensed practical nurses.
That means the number of registered nurses the United States needs by 2030 will grow from 2.8 million to 3.6 million, an astonishing 28.4 percent increase. Some states are more prepared than others to meet this massive increase in demand. The entire country is expected to add almost 796,000 new registered nursing positions by 2030.
The states facing the most severe nursing shortages by 2030 are Alaska, South Carolina, South Dakota, California, New Jersey, and Texas. While California’s shortfall – the state is projected to need 44,500 more nurses than it will have – is the most eye-catching, the biggest problem is faced by Alaska, where a shortage of 5400 nurses amounts to a massive 22.7 percent of nursing jobs that will be unfilled in 2030. In South Carolina, almost 17 percent of nursing jobs will be unfilled, while South Dakota will have 14 percent of its nursing jobs empty by 2030.
The slowest growth rate in adding new nursing jobs will be in Nebraska, with only 4.4 percent growth on top of its existing population of 20,300 registered nurses. New York’s 12.1 percent growth rate for new nursing jobs is among the slowest in the country, though the state should have a strong surplus of nurses. Ohio, with a growth rate of 8.1 percent of new nursing jobs, is also among the slow growers, but it, too, will have a surplus of nurses.
South Carolina, despite its projected shortage of nurses, is expected to add 26,600 new nursing jobs, a growth rate of 69.4 percent from the state’s existing 36,900 nurses. Hawaii is expected to add 5600 nursing jobs, a healthy growth rate of almost 51 percent.
Florida is projected to produce 69,400 new registered nurses, 53,700 more than the state is expected to require. Ohio, Virginia, New York, and Missouri are also near the top of the states that will produce a nursing surplus. However, it is Wyoming that will produce the biggest surplus in percentage terms, with almost 51 percent more nurses than it will need. New Mexico and Ohio are also high on the list in terms of percentage surplus of nurses.
Clearly, the country will need to redistribute nurses from states where the need is less and production great, to those states, like Alaska and California, where production of new nurses will not match the future need.”

MLN Connects 5-9-2019

Read the recent news from CMS here…

NAHC Bulletin

Read Calvin McDaniel’s recent NAHC Bulletin here…

HAN Monthly News Update

Read the Hospice Action Network’s Monthly Update here…


Compliance Extravaganza June 4-5 with Annette Lee, Jenkins-Soffe Funeral Home

Join your hospice and home health colleagues as Provider Insight’s Annette Lee shines a light on all things compliance in our industries. June 4 will be a full-day focus on home health, and the morning of June 5 is a half-day of hospice. Jenkins-Soffe Funeral Home will provide the location at its South Jordan location. Both days include snacks and drinks, And June 4 includes lunch.

This members-only workshop is a benefit of your UHPCO/UAHC membership. Registration fees will cover expenses, but will be a bargain for UHPCO and UAHC members. Check back soon for details and pricing.

“Hospice and home health compliance can sometimes seem like a moving target,” Lee says. “The rules change, they are sometimes difficult to interpret, and it may feel impossible to apply them in the ‘real world.’

Provider Insights, Inc, founder Annette Lee has a background in the “real world,” coupled with over a decade of working with CMS. She knows the rules, and how to make them work for you. Her mission is to empower you and your agency with clear, consistent information that will enable you to provide quality care and reduce your risks, while being as efficient and cost-effective as possible.

June and July Webinars announced!

Via Hospice & Home Care Webinar Network:

We are excited to announce the July Brochure Copies. Here is the Dropbox link for the entire year of brochures (separated out by month) and the most current webinar schedule. Please let me know if you have any questions.

6/6/2019    Effectively Managing Hospice Live Discharges Part 2: Eligibility Assessment, Documentation, Discharge Planning & the Care Continuum   Kathy Ahearn, Ahearn Advisement Partners

6/13/2019   Agency Success & Leadership Excellence Series: Hire Well, Live WellTM – Minimizing Turnover & Maximizing Productivity  Larry Prince, Prince Health, LLC

6/18/2019   How to Develop & Implement a Palliative Care Program   Gloria Turner, Turner Healthcare Consulting

6/20/2019   False Claims Act: Fraud & Abuse Update    Robert W. Markette, Jr., Hall, Render, Killian, Heath & Lyman, P.C.

6/27/2019   Boundaries, Burnout & Compassion Fatigue: Developing Professional & Personal Resilience Gary Gardia, Gary Gardia, Inc.

7/9/2019    Building Strong & Compliant Skilled-Nursing Partnerships  Gloria Turner, Turner Healthcare Consulting

7/11/2019  The IDG Meeting: It Takes a Special Skill Set   Kathy Brandt, the kb group LLC & Co-Presenter Gary Gardia, Gary Gardia, Inc.

7/18/2019   Building Strong & Compliant Hospital Partnerships  Gloria Turner, Turner Healthcare Consulting

7/25/2019   Eligibility Requirements & Notice of Election  Melinda Gaboury, Healthcare Provider Solutions, Inc.

CHAP 2019 Hospice Accreditation Intensive Webinar Series

Via CHAP: “Learn at your own pace! This blended learning experience beginning May 6, 2019 includes self study readings, interactive courses, live or on demand webinars and an online discussion forum designed to help you retain knowledge. Earn 13.0 contact hours as CHAP accreditation experts cover the CHAP accreditation process as well as the updates in the 2019 CHAP Hospice Standards.

Learning Objectives

At the end of this webinar, participants will be able to:

      1. Outline the CHAP Accreditation process.
      2.  Identify the modifications and additions within the New CHAP Hospice Standards of Excellence .
      3.  Identify trends in deficient practice under the CMS Hospice Conditions of Participation.
      4.  Apply performance improvement strategies specific to identified deficient practices.”

Interested? Register here…

Butterfly Memorial

From Zion’s Way Home Health & Hospice: “We want to invite you, and your teams and your families to the first annual Butterfly Memorial! We’re excited to fill the skies with butterflies on May 18th at 10:00 a.m. Come enjoy a day at the park and help us release 1,000 beautiful “Painted Lady” butterflies. You enjoy this FREE healing event which includes a short memorial program, music, activities for children and food and drink from great local vendors, including: THE SUGAR COOKIE, DIXIE CHURRO and HOKULIA SHAVE ICE. It’s all FREE!
Each of us will experience loss in our lives. Some of us, due to the professions we work in, deal with loss on a regular basis. This event is designed to be fun, entertaining but also healing for anyone who is, who has or who will yet experience loss in their lives. Please come join us at the Butterfly Memorial on May 18th! The program will be brief but you can enjoy free food and a beautiful day at the park for as long as you’d like.”
May 18, 10 A.M. at  Vernon Worthen Park, 300 S 400 E St George, UT 84770.

RCTCLearn Webinar Announcement

Via RCTCLEARN: “RCTCLEARN.NET will again be hosting webinars for agencies or training coordinators new to RCTCLEARN.NET and/or new to the My Certificate tool for tracking course completions.  The webinars provide an excellent opportunity to learn about the new features on the system as well as discuss ideas on how to introduce or re-introduce the programs.   While designed for new users, they may also be beneficial for existing agencies and training coordinators as well.  Webinars typically last around 15 minutes or a little longer depending on user questions.

Participants can sign-up at  Please note, the time listed is in Central Time with the corresponding time zones listed behind that.  Before the event, participants will receive connection information via email.”

Upcoming Date/Time

Wednesday, May 15th, 2019 at 11:00 a.m. CST (12:00 p.m. EST, 10:00 a.m. MST, 9:00 a.m. PST)

Additional Webinar Date/Time:

Wednesday, June 5th, 2019 at 11:00 a.m. CST (12:00 p.m. EST, 10:00 a.m. MST, 9:00 a.m. PST)

Interest Items

Industry News Articles

From Ellen Almond’s Home Health Media Clips 5-6-2019:

5 Things to Know From World Health Care Congress 2019  AJMC

From Ellen Almond’s Home Health Media Clips 5-7-2019:

Hospitals’ Control of Bundled Payments ‘One of the Biggest Threats’ to Post-Acute Success  Skilled Nursing News

CBO: Exchange Market Will Shrink, But Remain Stable Through 2029  Inside Health Policy

CMS Bans Diverting of Medicaid Payments to Home Health Unions  RevCycleIntelligence

Opinion: It Is Time to Fix the Electronic Health Records Boondoggle  Morning Consult

From the Carolinas Center’s News of Note 5-7-2019:

Strategies to Prevent Drug Diversion in Hospice Care Hospice News  04.29.19

‘What should we do, doctor?’ Emergency medicine intern recalls hard discussion about end of life  The Philadelphia Inquirer  05.02.19

Palliative Care Rates in Heart Disease Not Improving  Medpage Today  05.03.19

Do You Talk to Your Patients About Advance Care Planning?  Medscape  04.24.19

From Ellen Almond’s Home Health Media Clips 5-8-2019:

Why Do Accountable Care Organizations Leave the Medicare Shared Savings Program?  Duke Today

Senators Urge Slower Move to Electronic Health Data Sharing  Bloomberg BNA

Study: Sticker shock ahead for middle-income seniors  Union Leader (Reuters)

From Ellen Almond’s Home Health Media Clips 5-9-2019:

Plans, ACOs Ask CMS To Make Next Generation ACOs Permanent  Inside Health Policy

Medicare Advantage Enrollees May Have Less Need for In-Home Care  Home Health Care News

Gloves Are Off in Democrats’ Battle With Trump: Balance of Power  Bloomberg Government

From Ellen Almond’s Home Health Media Clips 5-10-2019:

A plan to ease healthcare workforce shortage  NH Business Review

AT&T: In-Home Remote Patient Monitoring Ready to Take Off  Home Health Care News