Today’s Blog Content:



  • Appeals of Claims Decisions – Revisions
  • MAC Satisfaction Indicator (MSI) Survey
  • myCGS RAP CBR Testing
  • Providers v. UPICs and ZPICs: Another Chapter
  • July 2019 Changes to Common Working File (CWF) Eligibility Systems ELGA, ELGH, HIQA and HIQH
  • Home Health and Hospice (HH&H) Claims Processing Issues Log
  • New MLN Connects Issue 4-18-2019
  • CAPC New Policy Initiatives
  • CGS Home Health Advisory Group Meeting Minutes March 19, 2019

Interest Items

  • Industry News Articles


PAC webinar: Preferred Provider Networks Offering Value-Based Care Thurs. 1-2:30

Southern Utah Home Care and Hospice Coalition Meeting

The next Coalition Meeting is scheduled for the last Tuesday of this month.  Here are the details for this quarter’s meeting:

When: April 30th @ 12:30 p.m.

Where: Intermountain Homecare – 555 S. Bluff St., Ste. 100, St. George, Utah 84770

Lunch Sponsor: Intermountain Homecare and Hospice

Presenters: Southern Utah Veterans Home and Guardian Transportation

Please come hungry and come prepared with any challenges you presently face that the group could potentially troubleshoot together – we’re all going to be stronger and more successful if we work together to push and support one another.  Additionally, it would be great to have a conversation about what we are all doing to prepare for the PDGM transition in 2020.

UAHC Convention and Annual Meeting May 7-8

Dinner with NAHC President Bill Dombi May 6

HIPAA Compliance for Email & Text Messaging: Communicating with Patients, Providers & Peers 5.9.19

CHAP Hospice Accreditation Intensive Webinar Series

Via CHAP: “CHAP has released the 2019 revised hospice standards! Make sure to register NOW for this interactive blended learning series! This blended learning experience beginning May 6 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.” Click here to learn more...

NUHC Upcoming Events

Via NUHC: “We’ve got an exciting Spring Line Up coming your way. Check out the activities outlined below and plan to participate as you can.”  These events include Communication Drills, Regional Media Surge Test, and training for resource requesting and sharing. View the event information here…

Afterlife Conference in Salt Lake City

In its 9th year the Afterlife Awareness Conference will be held in Salt Lake City on June 6-9 2019.

From The Afterlife Awareness Conference: “Since 2010, The Afterlife Conference has served as an educational, social and spiritual gathering place for those seeking evidence of life after death. While other conferences have followed our lead over the years, we maintain the distinction of being the original Afterlife Conference.

Each year we unite the disciplines in exploring the survival of consciousness after death, working with hospice professionals, physicians, mediums, clergy, counselors and alternative healers to offer a deeper understanding of death and beyond.” Click here to find out more about this event…

Barbara Karnes on pain and dying

From WellSky: “Pain management at end of life is not the same as care for someone who is going to get better. As the body shuts down, medication absorption is not that of a normal body. The key to good pain and agitation management is observation, presence, and time spent with family on education. Is your team prepared with the information and understanding they need to provide effective pain management and connect as caring people?

Join us Thursday, April 25th from 11:00am-12:00pm MST for an informative and inspirational webinar – Pain, morphine, and dying in peace: considering pain management at end of life – presented by renowned end of life educator and hospice pioneer Barbara Karnes, RN. Barbara is the author of Gone From My Sight, widely known as the “Little Blue Book,” which has sold more than 20 million copies and is the most widely used resource about the signs of approaching death.” Register here…


Appeals of Claims Decisions – Revisions

Via CMS: “CR11042 revises the Medicare Claims Processing Manual (Publication 100-04, Chapter 29 (Appeals of Claims Decisions)) and adds various policy clarifications regarding appeals of claims decisions. The CR includes the revised manual section.” Read the full MLN Matters article MM11042…

MAC Satisfaction Indicator (MSI) Survey

Via CGS: “Your feedback is extremely important to CGS! The MSI survey provides an opportunity for Part A, Part B, Home Health and Hospice providers to rate their satisfaction with CGS Jurisdiction 15 and the services we provide.

The survey will be used to assist CGS in continuing to expand and improve the services we offer. Be sure to respond to every question and click the SUBMIT button so that your survey counts.

Please provide us with your feedback by completing the MSI Survey today!”

myCGS RAP CBR Testing

From Nykesha Scales: “There appears to be some confusion surrounding my request for you all to test out the newest CBR for RAPs within our portal, myCGS.

Medical Review CBRs (Comparative Billing Reports) have been available within the portal for a while now.  The newest CBR is related to RAPs and compares RAP information to your agency and other providers within the state and J15 as a whole.

Here’s the job aid that was developed for this enhancement (HHA RAP CBR),”

Save the Date: Hospice PEPPER Review

Via The PEPPER Team:

When: May 16, 2019, 1 p.m. MST
What: A WebEx presented by Kimberly Hrehor with the RELI Group
Topic: A review of the new release of the Hospice PEPPER (version Q4FY18, scheduled for release by April 5, 2019)
Registration is required. Click here to register.
This program is being brought to you at no charge.
Because registration is limited to 1,000 sites, hospices are encouraged to coordinate internally to prevent duplicate registrations and to allow as many hospices as possible to participate. Registrants will receive an email with information about how to join the session.
For those unable to participate, the session will be recorded and posted on in the hospice “Training and Resources” section within two weeks following the event.
Handout: Will be posted on the website in the hospice “Training and Resources” section the day prior to the event. It will also be available via WebEx upon joining the session.”

Providers v. UPICs and ZPICs: Another Chapter

From Elizabeth E. Hogue, Esq: “The following article is about another lawsuit filed by a home health agency against a UPIC based on recoupments of alleged overpayments.” Read her full article here…

July 2019 Changes to Common Working File (CWF) Eligibility Systems ELGA, ELGH, HIQA and HIQH

Via CGS: “Effective July 1, 2019, ELGA, ELGH, HIQA and HIQH will display a message before beneficiary eligibility information is made available. Read more…

Home Health and Hospice (HH&H) Claims Processing Issues Log

Via CGS: “Current system-related claims processing issues may be viewed on the HH&H Claims Processing Issues Log (CPIL). Refer to the HH&H Claims Processing Issues Log (CPIL) for details and required provider action. Refer back periodically for updates.”

New MLN Connects Issue 4-18-2019

Read the full MLN Connects from CGS and CMS for 4-18-2019 here…MLN Connects from CGS and CMS for 4-18-2019 here…

CAPC New Policy Initiatives

From CAPC:

A New Foundation for State Palliative Care Policy Activity Stacie Sinclair, MPP Senior Policy Manager, CAPC

“Recent policy successes have demonstrated that palliative care is a broadly supported, bipartisan solution to improving care for people living with a serious illness. To help continue this momentum, Stacie Sinclair, introduces new resources to support state champions in their efforts to further increase palliative care access, and ensure quality.” Read the article here…

Driving Consistent Access to High-Quality Care for People Living with a Serious Illness  Allison Silvers, MBA  Vice President, Payment and Policy, CAPC & Sara Hufstader-Collins, MA  Former Senior Manager, Serious Illness Quality Alignment Hub, CAPC

“The Serious Illness Quality Alignment Hub (“The Hub”) is a three-year project gathering leaders in the field of palliative care together with payers, policy makers, and quality management leaders, working to ensure that all people living with a serious illness receive high-quality care that optimizes quality of life. At the midpoint of the project, Allison Silvers and Sara Hufstader-Collins offer reflections on the work thus far, and suggest where efforts may intensify going forward.” Read the article here…

CGS Home Health Advisory Group Meeting Minutes March 19, 2019

Read the minutes here…

Interest Items

Industry News Articles

Shared via Ellen Almond’s Home Health Media Clips 4-15-2019:

CMS Lays Out ACO Application Timeline For 2020 Start  Inside Health Policy

Health-care law more popular despite Trump’s repeated attempts to destroy it  Washington Post

Democratic proposals to overhaul health care: A 2020 primer  The Hill

Shared via Ellen Almond’s Home Health Media Clips 4-16-2019:

Medicare coverage for telehealth has expanded but still has limits  Lexology

CMMI Invites Stakeholders To Discuss Primary Care And Chronic Illness  Inside Health Policy

Shared via Ellen Almond’s Home Health Media Clips 4-17-2019:

Healthcare jobs grow at rapid clip, but wages lag amid consolidation boom  Healthcare Dive

Transportation Challenges, Internet Access Limit Home Health Care in Rural Areas  Home Health Care News

UnitedHealth CEO says ‘Medicare for All’ would ‘destabilize the nation’s health system’  CNBC

Nation’s biggest health insurer wades into the ‘Medicare for all’ fight  LA Times

5 Care Coordination Strategies for Medicare ACO Success  RevCycleIntelligence

Shared via Ellen Almond’s Home Health Media Clips 4-18-2019:

Chronic Conditions Cost US Economy More Than $4.5 Trillion  Home Health Care News