01/11/2008
REGULATORY UPDATE
January 11, 2008 Weekly Roundup #2
C+ Will Cover Part B Coinsurance for Services Provided in a Nursing Home
We have been notified from one of our members that C+ from BCBS has been denying manual and/or adjusted claims for coinsurance on covered Part B, OT, PT, ST, etc. services in nursing homes. Facilities are reminded to make sure that they are getting payment for these services.
Special Open Door Forum: Minimum Data Set, Version 3.0 (MDS 3.0), Thursday, January 24, 2008, 1:00 pm to 3:00 pm EST
A Minimum Data Set, Version 3.0 (MDS 3.0) Special Open Door Forum (ODF) is scheduled to report on the findings of a 5-year CMS Nursing Home MDS 3.0 Validation Study. CMS will post the MDS 3.0 timeline for implementation on the MDS 3.0 for Nursing Homes page of its Nursing Home Quality Initiative website at: http://www.cms.hhs.gov/NursingHomeQualityInits/25_NHQIMDS30.asp#TopOfPage on the CMS website.
The updated Draft version of the MDS 3.0 form and written introduction is delayed and will be posted before the ODF. The MDS has not had extensive clinical updating since 1995. The changes in MDS 3.0 have been designed to improve data assessment, care planning, and quality measurement. Changes were based on extensive written and oral provider feedback, a Town Hall meeting, CMS/Veterans Administration Research Collaborative, technical expert review and data collection in 8-States. CMS now plans to evaluate the impact of the MDS 3.0 changes on the resident classification system, Resource Utilization Group (RUG-III), used in the Medicare payment structure. This analysis will be conducted as part of the Staff Time and Resource Intensity Verification (STRIVE) study and the results will be available in late 2008/early 2009. Then, the MDS 3.0 changes can be finalized and implemented nationally on October 1, 2009.
To participate (onsite or by telephone) in this Special ODF, please register on the CMS website at http://registration.intercall.com/go/cms2 on the internet. Upon registering, you will receive a confirmation email containing further participation information. The deadline for registration is 2:00 PM EST, January 22, 2008. Capacity is limited so register early. Registering via the web will ensure we can accommodate as many participants as possible.
An audio recording of this Special Forum will be posted to the Special ODF website at http://www.cms.hhs.gov/OpenDoorForums/05_ODF_SpecialODF.asp on the CMS website and will be accessible for downloading beginning January 30, 2008 and available for 30 days.
01/11/2008
STATE NEWS
January 11, 2008 Weekly Roundup #2
Alabama Medical Directors Association News
The Alabama Medical Directors Association is the professional association of physicians and other professionals practicing in the long term care continuum, dedicated to excellence in patient care by providing education, advocacy, information, and professional development.
Their goal is to continue educational programs and advocacy activities to help all Medical Directors and other health care providers maintain the highest level of quality care for our patients.
Their Mid Winter Conference will be held at the Sheraton-Medical Forum, Birmingham, Alabama, on February 16, 2008. Their educational program will provide an opportunity to advance scientific information to attendees, which will ultimately improve patient care. This years program includes the following topics: Fall Risk Management Care Planning; Post-Stroke Care in LTC, Teaming with your Facilities Consultant Pharmacist for Win/Win Results, Update on Neuro-Psychiatric Management of Residents with Dementia, and Wound Care in the Long Term Care Setting. The program provides Continuing Education hours for Medical Directors, Attending Physicians, Administrators, CRNPs, RNs and LPNs.
If you are interested in attending this conference, please contact Lee Ann Cole, Executive Director, and request a registration form. Ms. Coles contact information is listed below.
Alabama Medical Directors Association
9455 Briarlea Court / Montgomery, AL 36117
334-271-1536 or E-Mail at Lcole1019@AOL.com
Alabama Board of Examiners of Nursing Home Administrators Reminder
Please note that according to Alabama state statute No nursing home in the state may operate unless it is under the supervision of an administrator who holds a currently valid nursing home administrator's license, or provisional license, issued by the Board of Examiners of Nursing Home Administrators. Individuals should not sign forms or act as a nursing home administrator in Alabama without proper licensure. Questions pertaining to licensure should be directed to Katrina Magdon at the Alabama Board of Examiners of Nursing Home Administrators at (334) 271-2342.
Attention NCCAP Members
We have been notified that one of our ANHA members is running for a seat on the National Certification Council of Activity Professionals (NCCAP) Board of Directors. Ms. Mona Gail Gunn currently works at Oak Park Nursing Home in Auburn, Alabama. If you are a member of NCCAP, we encourage you to support her in this election. Ms. Gunn currently serves as our Region VI Board of Director Representative for the ANHA Activity/Social Services Auxiliary. Good Luck, Gail!
Medicaid Reimbursement Issues
The ANHA Payment for Services committee will meet in January to discuss the Medicaid Reimbursement System. We are requesting that ANHA members send any rate setting issues, desk audit adjustments, and recent fair hearing results to the ANHA office at 4156 Carmichael Road, Montgomery, Alabama 36106, so that these issues may be addressed at the meeting. If you have questions regarding this, please contact Katrina Magdon at kmagdon@anha.org or by phone at 334-271-6214.
01/11/2008
EDUCATION NEWS
January 11, 2008 Weekly Roundup #2
Legal Compliance in Nursing Homes, Educational Seminar, January 22nd
Please mark your calendars for January 22, 2008, as ANHA will present a seminar entitled Legal Compliance in Nursing Homes. This seminar will be held at the Wynfrey Hotel in Birmingham, Alabama and will cover the following topics: Using Documentation to Position for Positive Outcomes; Abating Immediate Jeopardy and Developing Plans of Correction; Challenging Survey Findings: Quality Assurance Review, Informal Dispute Resolution, and CMS Appeals; Documenting Medical Necessity; Understanding the Resident Discharge Process; Arbitration in Long Term Care: Update on Alabama Law; and Top Ten Labor & Employment Issues in Long Term Care. The seminar will begin at 8:30 pm and conclude at 4:30 pm. Registration will begin at 7:30 am. This seminar has been approved for 6 hours of continuing education for nursing home administrators and social workers. This seminar has also been approved for 7.2 contact hours for nurses.
Attain and Maintain: Restorative Care and Services Program, Educational Seminar, February 12th
Please mark your calendars for February 12, 2008, as ANHA will present a seminar entitled Attain and Maintain: Restorative Care and Services Program. This seminar will be held at the Wynfrey Hotel in Birmingham, Alabama. The seminar will begin at 8:30 am and conclude at 4:30 pm. Registration will begin at 7:30 am. This seminar has been approved for 6 hours of continuing education for nursing home administrators. This seminar has also been approved for 7.2 contact hours for nurses. More information regarding this seminar will come in the following weeks.
Good Care Makes Money: The Role of the MDS to Facilitate Maximizing Reimbursement, Educational Seminar, March 24th & March 25th
Please mark your calendars for March 24th and March 25th, 2008, as ANHA will present a seminar entitled Good Care Makes Money: The role of the MDS to Facilitate Maximizing Reimbursement. This seminar will be held at the Wynfrey Hotel in Birmingham, Alabama. The seminar will begin at 9:00 am and conclude at 5:30 pm on Day 1 and begin at 8:00 am and conclude at 4:30 pm on Day 2. This seminar has been approved for 14 hours of continuing education for nursing home administrators and social workers. This seminar has also been approved for 16.8 contact hours for nurses. More information regarding this seminar will come in the following weeks.
Medicaid Provider Workshops
EDS has invited all Medicaid providers to attend upcoming provider educational workshops. The workshops will introduce you to interChange, the new Medicaid claims processing system, which will be implemented on February 23, 2008. The interChange claims processing system will bring some changes to the way you are currently submitting claims to Medicaid.
Several workshops will be offered in different locations across the state during the months of January and February 2008. They are asking a limit of three attendees from each office attend, so they may accommodate all providers.
The workshops will provide information about the changes to billing necessary for National Provider Identifier (NPI), new interactive web portal, new claim form requirements and Provider Electronic Solutions upgrade. You may register for a workshop at the following Medicaid website: http://www.medicaid.alabama.gov/billing/ichange_provider_workshops.aspx
