KHCA eNews - 01/12/2012 (Plain Text Version)
KHCA NEWS
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AHCA Names KHCA Members to Committees
Congratulations to the following KHCA members who have been selected by AHCA/NCAL to serve on a variety of very important committees.
Judith Bagby Medicalodges, Inc Quality Improvement Committee
Harry Baum Sharon Lane Health Services Independent Owner Council
Harry Baum Sharon Lane Health Services Public Education & Communication Committee
Fred Benjamin Medicalodges, Inc. Finance Committee
Garen Cox Medicalodges, Inc. Legal Committee
Garen Cox Medicalodges, Inc. Regional Multifacility Council
Interested in serving at the national level? Contact us at mailto:khca@khca.org for more information.
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Martin Luther King Jr. Day
The KHCA/KCAL Office will be closed Monday, January 16, 2012 in honor of the Dr. Martin Luther King holiday. The office will re-open Tuesday, January 17, 2012.
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Winter Conference: Collaborating for Quality
Get ready for some first-rate education and legislator conversation at the annual KHCA/Kcal Winter Conference. This year's conference is on January 24-25, 2012 at the Ramada Inn Downtown in Topeka and will focus on Quality.
Rather than going to the state house as a large group, members will have individual appointments to meet with their legislators (you will receive an email with specifics on this). Transportation will be provided to these appointment.
The Tuesday evening Legislative Reception will have a new twist this year as it will be held at the beautiful Kansas State Historical Society/Kansas Museum of History. Fabulous food, music and a host bar will make this "red carpet" event one not to miss. There will again be shuttle buses available between the hotel and the museum. Directions will be available for those who wish to drive themselves.
Scott Brunner from Kansas Health Institute (KHI) will join us Tuesday morning to discuss Medicaid managed care concepts and the nuts and bolts of what managed care is about. BKD partner John Harris will look at the budgeting aspects that QAPI and other qualtiy improvement programs may bring. Attention will also be given to programs that prevent unnecessary re-hospitalizations the tools that can help track and prevent these occuarances. Former Kansas Governor and now AHCA/NCAL President/CEO Mark Parkinson, and KDOA Secretary Shawn Sullivan will join us Wednesday morning at the Leadership Breakfast. This breakfast is open to all conference attendees.
Our valued vendor partners will join us on Wednesday in the atrium of the hotel with displays and information on the newest products and technologies. Lunch includes an excellent presentation by Ted McDonald, an attorney from Kansas City, on Risk Management and we'll end the conference with the inspiring “Lighting Your Candle and Fanning Its Flame” by an old friend of KHCA/Kcal, Ron Willis.
Click HERE for the conference brochure and registration information.
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KU Med Center Offers Educational Series
The University of Kansas Medical Center is pleased to offer a series of six one hour ITV broadcasts on Pharmacology issues. Click here for additional information including how to register.
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AHCA NEWS
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Quality Award Deadline is Today, January 12, 2012
Is your facility on this list? If so, AHCA/NCAL wants to strongly encourage you to apply for the AHCA/NCAL Quality Award. Thursday, January 12, 2012 is the deadline to submit an intent to apply.
ANDERSON COUNTY HOSPITAL LTCU
BRIGHTON GARDENS OF PRAIRIE VILLAGE
BRIGHTON PLACE WEST
CAMBRIDGE PLACE
COUNCIL GROVE HEALTHCARE CENTER
COUNTRYSIDE HEALTH CENTER
GARDEN TERRACE AT OVERLAND PARK
HALSTEAD HEALTH AND REHABILITATION CENTER
HERITAGE HEALTH CARE CENTER
HOLIDAY RESORT OF SALINA
HOWARD TWILIGHT MANOR
LAKEPOINT NURSING & REHAB CENTER OF EL DORADO
LAKEPOINT NURSING CENTER
MEDICALODGES ARKANSAS CITY
MEDICALODGES ATCHISON
MEDICALODGES COLUMBUS
MEDICALODGES DOUGLASS
MORAN MANOR
OVERLAND PARK NURSING & REHAB CENTER INC
PLAZA WEST REGIONAL HEALTH CENTER
PLEASANT VALLEY MANOR
SABETHA MANOR
SEDGWICK HEALTHCARE CENTER
THE CENTENNIAL HOMESTEAD
THE FORUM AT OVERLAND PARK
TRINITY NURSING & REHABILITATION CENTER INC
VALLEY HEALTH CARE CENTER
WHEATRIDGE PARK CARE CENTER
Applicants then have until February 15, 2012 to complete their application.
Applicants for the 2012 AHCA/NCAL National Quality Award program are required to submit a non-refundable $75 Intent to Apply fee by January 12, 2012 at 8 p.m. EST. Get started today with the Intent to Apply Process or visit the Quality Award website to learn more about the program. Questions on submitting the Intent to Apply? Please email.
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VA/Civilian NF “Agreement” Update
AHCA has been working for many years with the Dept. of Veterans Affairs (VA) Central Office on a new contract vehicle between the VA and civilian NFs that serve veterans. The document will be called an “agreement” and will rectify numerous onerous requirements in current VA/NF “contracts,” including:
1) eliminating the Dept. of Labor requirement for government contractors to have affirmative action plans,
2) eliminating requirements for the facility to follow life safety code standards more stringent than CMS mandates,
3) eliminating IT security requirements beyond those in HIPAA, etc.
Update:
VA has been working on a proposed rule to implement these “agreements” for the last few years, but it looks like significant traction has finally been made, specifically:
• VA General Counsel’s office has approved the proposed rule. It will now go to the Secretary for his review.
• The proposed rule will be released for public comment by March/April of this year.
• Notably, the proposed rule also includes implementing “agreements” between the VA and other civilian healthcare providers, including:
1) home health agencies,
2) hospices,
3) adult day care centers, and
4) (potentially) respite providers.
If your company also provides these services, we will seek your input on those portions of the proposed rule as well.
• Although the final rule will allow VA Medical Centers (VAMCs) that contract with civilian NFs to use the new “agreement,” VA Central Office cannot require VAMCs to use it. However, the VA anticipates that VAMCs will eventually use the agreement as their local civilian NFs will not be willing or able to admit veterans otherwise.
• Once a facility has a “provider agreement” with a VAMC, reimbursement will immediately be under the RUG IV system.
• If a facility currently has a VA “contract,” it will remain in effect until the VAMC switches to using “provider agreements.”
AHCA's next steps:
• We will continue to push hard for speedy release of the proposed rule to implement VA/civilian NF “agreements.”
• When the proposed rule is released, we will seek AHCA members’ comments for inclusion in our comment letter.
• Once the rule is final, we will hold webinars and provide other guidance materials so that our member facilities can seek “provider agreements” with the VAMC(s) in their area.
• In addition, if you currently have a VA “contract,” AHCA will advocate on your behalf to encourage your VAMC to swiftly transition from contracts to “provider agreements.”
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ICD-10 and 5010 Summary
We’ve heard from some of you recently that it would be helpful to summarize the information we’ve been distributing over the last several years regarding ICD-10 code sets and electronic transaction standard Version 5010, as there has been a lot of media discussion on these issues of late, and some of our membership may have questions about applicability and implementation. It is important to note upfront that in 2009, HHS published two separate and final rules which facilitate the adoption of the ICD-10 code sets and 5010. See http://edocket.access.gpo.gov/2009/pdf/E9-743.pdf and http://edocket.access.gpo.gov/2009/pdf/E9-740.pdf respectively.
These final rules affect our membership, as all Health Insurance Portability and Accountability Act (HIPAA)-covered entities (NFs and some ALFs) must comply with the rules. The implementation date for replacing ICD-9 codes with ICD-10 codes is October 1, 2013 (which we believe is based on the service date). Noncompliance with this deadline will result in rejected transactions and disruptions in payment. The implementation date for 5010 was January 1, 2012 (which we believe is based on the claims submission date); but CMS has since stated that it will not initiate enforcement action until March 31, 2012. Please note that even though CMS is allowing for a 90-day grace period on 5010, some states are not. For example, Washington is requiring 5010 compliance effective for claims submitted January 1, 2012, and thereafter.
At this time, we do not know how closely HHS/CMS will scrutinize LTC use of the new ICD-10 codes; but in the final rule, HHS articulated that it would use the ICD-10 data to support Medicare’s value-based purchasing initiatives and its antifraud and abuse activities, as well as to support comprehensive quality data reporting. The Medicare program also will likely use ICD-10 to edit claims, even though we don’t know exactly how yet. Members may have to train staff, make changes to business operations and workflows or reprint manuals and other materials to prepare for ICD-10 implementation. Training resources will be key to facility success with implementation. AHCA/NCAL is currently discussing the development of an LTC ICD-10 manual with the American Health Information Management Association (AHIMA) and Leading Age. We are also planning other education tools such as webinars.
In most instances, our membership have not had many questions regarding 5010 because their vendors have communicated extensively with them about these changes and ensured that their software properly supports the new 5010. However, members may have to train staff, make changes to business operations and workflows or reprint manuals and other materials to prepare for ICD-10.
Below is some additional information; but CMS also has an excellent web page at https://www.cms.gov/ICD10/, which includes fact sheets, Q&A’s, etc., on all of these matters. Please don’t hesitate to contact us if you have additional questions.
Background on ICD-10 CM:
• In 2009, CMS released a final rule requiring all HIPAA-covered entities to replace the ICD-9 code sets used for reporting diagnosis codes with the expanded ICD-10 code sets by Oct. 1, 2013. HIPAA- covered entities include health care providers, insurance plans, and clearinghouses that transmit electronic health information in connection with a transaction for which a standard has been adopted by HHS.
• In addition to increasing the number of codes from 17,000 to more than 155,000, adoption of ICD-10 is expected to support Medicare’s value-based purchasing initiatives and also its antifraud and abuse activities by accurately defining services and providing specific diagnosis and treatment information; provide the precision needed for emerging uses, such as pay-for-performance; support comprehensive reporting of quality data; ensure more accurate payments for new procedures, fewer rejected claims, improved disease management and harmonization of disease monitoring and reporting worldwide; and allow US to compare its data with international data to track the incidence and spread of disease and treatment outcomes. HHS also believes that these changes will improve claims processing and payment, as well as facilitate the implementation of electronic health records.
• Non-compliance with ICD-10 implementation will result in rejected transactions or claims and disruptions in receipt of payment.
Background on electronic transaction version 5010:
• In 2009, CMS released a final rule adopting an updated X12 standard (5010), for electronic transactions that flow in and out of provider facilities (e.g. claims, claims status requests and responses, provider payment, or “cash flow”), which would replace X12 standard Version 4010/4010A by January 1, 2012.
• Version 5010 includes updated standards for claims, remittance advice, eligibility inquiries, referral authorization, and other administrative transactions. Version 5010 also accommodates the use of the ICD-10 code sets.
• In December 2011, CMS announced a 90-day enforcement discretion period regarding 5010. The compliance deadline for the implementation of 5010 is still January 1, 2012; but CMS will not initiate enforcement action until March 31, 2012. CMS made this decision based on industry feedback that many organizations and their partners were not yet ready to finalize system upgrades for this transition. During the 90-day enforcement discretion period, the Office of E-Health Standards and Services (OESS) will continue to accept complaints associated with compliance with 5010. HIPAA-covered entities that are subject to these complaints must produce evidence of either compliance or an established plan to become compliant within the enforcement discretion period.
• Even though CMS is allowing for a 90-day grace period, some states are still requiring implementation on the original implementation (January 1, 2012) date.
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AHCA/NCAL Sponsors American Health Lawyers Association Conference
AHCA/NCAL is pleased once again to announce its sponsorship of the upcoming American Health Lawyers Association (AHLA), annual “Long Term Care (LTC) and the Law Conference,” taking place in Phoenix, Ariz., at the Arizona Biltmore, from Monday, February 27 through Wednesday, Feb. 29, 2012. AHLA is the nation’s largest, nonpartisan, not-for-profit educational organization, dedicated to legal healthcare issues. AHCA/NCAL members interested in attending are eligible for discounted registration rates.
AHLA’s 2012 “LTC and the Law” program includes an individual educational track for assisted living, nursing facility, and home health attorneys and providers. The Program Planning Committee has made a concentrated effort to include sessions with practical information useful to providers, as well as those who represent them in areas of Medicare, Medicaid, Enforcement, Fraud, Diversification, Transactions, Risk Management, etc. Each track also includes “hot topic” issues such as predictive modeling, physician integration, Accountable Care Organizations (ACOs), bundling, social media, increasing patient acuity, patient mental health issues to mention only a few.
As a co-sponsor, AHCA/NCAL members are eligible for discounted rates. Non-attorney members will receive a special discounted rate of $550, and AHCA/NCAL in-house counsel will receive a special discounted rate of $690. To redeem these discounts, AHCA/NCAL members need to write “AHCA/NCAL non-attorney member or in-house counsel” on their registration forms. Register here.
CMS NEWS
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HHS HIPAA Audits
HHS Office for civil Rights (OCR) has announced it is beginning Health Insurance Portability and Accountability Act (HIPAA) audits to assess covered entities’ (NFs and some ALFs) compliance with the privacy, security and breach notification rules. Under a $9 million contract announced this last summer, KPMG has developed protocols and begun auditing. The audits are required by the American Recovery and Reinvestment Act of 2009 (ARRA). There are not a lot of audit details to date, but we understand that the audits will include site visits, interviews with leadership, documentation, an examination of operations and an assessment of the facility’s consistency with its written policy. Each audit will generate a report, which will at least address compliance efforts and what corrective actions if any have been taken by the facility. Providers should note that this contract will increase both the frequency and depth of government audits for HIPAA and HITECH compliance over the upcoming year. To obtain more information go to the HIPPA website.
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NLRB Delays Employee Rights Notification Rule
After a federal court in Washington, D.C. asked the National Labor Relations Board (NLRB) to delay its employee rights notice-posting rule, the NLRB moved the requirement from Jan. 31 to April 30, 2012. NLRB determined that delaying the posting date would facilitate the resolution of the legal challenges that have been filed against the rule by employers. Most private sector employers will be required to post the 11-by-17-inch notice on the new implementation date of April 30. The notice is available at no cost from the NLRB through its website, which has additional information on posting requirements and NLRB jurisdiction.
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Adverse Events Under Reported in Hospitals
Adverse events for Medicare beneficiaries are under-reported in hospitals, where incident reporting systems only capture about 14% of errors, according to a government report released Friday January 6, 2012.
While most hospitals have systems that alert managers and administrators to errors, problems that plague the elderly, such as bedsores, infections and delirium, are often not reported, says Daniel R. Levinson, inspector general of the Department of Health and Human Services. Those types of errors often follow seniors to nursing homes. When errors are found, it's usually by nurses who identified mistakes “through the regular course of care,” according to the report.
To improve error reporting and corrective action, the report recommends that healthcare oversight agencies, including the Centers for Medicare & Medicaid Services and the Agency for Healthcare Research and Quality, collaborate to provide guidance and incentives for hospitals to maximize their use of reporting systems.
To read the full report, click here.
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OTHER NEWS
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FDA Alert on Certain Opiates
FDA has issued an alert about certain opiate products manufactured by Endo Pharmaceuticals by Novartis Consumer Health. A potential safety risk has been found related to a packaging problem that may result in a pill, tablet or caplet getting mixed in with a different prescription. The issue impacts dispensing pharmacies who are preparing the affected medications for patients and patients who pick up their prescriptions in the community. However, providers need to be aware of the issue and to make sure there are no unexpected changes in the patient's medication size, color or markings. The affected medications include Opana® ER (oxymorphone hydrochloride) Extended-Release Tablets CII, Opana® (oxymorphone hydrochloride) CII, Oxymorphone hydrochloride Tablets CII, PERCOCET® (oxycodone hydrochloride and acetaminophen USP) Tablets CII, PERCODAN® (oxycodone hydrochloride and aspirin, USP) Tablets CII, ENDOCET® (oxycodone hydrochloride and acetaminophen USP) Tablets CII, ENDODAN® (oxycodone hydrochloride and aspirin, USP) Tablets CII, MORPHINE SULFATE Extended-Release Tablets CII, and ZYDONE® (hydrocodone bitartrate/acetaminophen tablets, USP) CIII. According to the FDA, the risk of pills ending up in the wrong bottle is a rare event. For more information, visit the FDA website.
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Sponsored Link - American HealthTech
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Hospitals will make data-driven decisions and hold you accountable. Get this paper and be ready to produce outcomes reports to market, continuously improve, and report your results to hospitals.
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