National Association for Home Care & Hospice

Session : NAHC1212
900: Opening General Session - Washington Update
Conference : 2012 Home Care & Hospice March on Washington & Law Symposium Conference & Exposition
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Welcome: Val J. Halamandaris, JD NAHC President

National Association for Home Care & Hospice policy staff engaged in negotiations with Congress, federal agencies and other policymaking bodies will provide inside information on issues of vital interest to home care and hospice providers. Your representatives on the front lines will present the latest on legislative, regulatory, legal and research developments relative to the prospective payment system, conditions of participation, quality monitoring and other vital issues.

Objectives: Identify pending regulatory i • ssues and analyze their impact on home care and hospice agencies; • Analyze pending legislative proposals for impact on home care and hospice operations; and • Outline industry advocacy efforts and response to pending legislative and regulatory proposals.

Faculty: Legal, Legislative, and Regulatory Staff, National Association for Home Care & Hospice, Washington, DC

Session : NAHC1213
102: Preparing for Hospice Payment Changes In Medicare
Conference : 2012 Home Care & Hospice March on Washington & Law Symposium Conference & Exposition
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The phase out of the budget neutrality adjustment factor (BNAF) and payment reductions enacted under the Affordable Care Act of 2010 have hospices scrambling to ensure financial stability. The Congress may take additional steps in early 2012 that could further affect hospice financial health. At the same time, changes to the hospice payment system that could be in place as early as October 2013 demand that hospices thoroughly examine their operations and prepare for a major shift in payment incentives. It’s time for all hospices to move beyond theory and into action. This session will gather experienced hospice panelists to discuss what hospice programs can be doing to prepare their programs for the coming transformation of the Medicare hospice program.

Objectives: • Outline scheduled hospice payment cuts and what is known (and not known) about anticipated hospice payment changes; • Examine hospice operational and financial data to determine potential areas of risk in payment reform; and • Outline next steps for adapting hospice practices to anticipate payment reform.

Faculty: Moderator: Robert Simione, Managing Principal, Simione Consultants, Hamden, CT. Panelists: Betty Oldanie, RN BSN MA, VP of Planning/Ethics & Compliance Officer, Suncoast Hospice, Clearwater, FL; Donna M. Gouveia, CPA, President & CEO, Visiting Nurse Service of Greater RI, Lincoln, RI; Angela Hollis- Sells, RN CHPN, VP Clinical Operations, AseraCare Hospice and Home Health, Soddy Daisy, TN; and Jane M. Feinman, MSN RN, Senior VP for Hospice, The Visiting Nurse Association of Greater Philadelphia, Philadelphia, PA.

Session : NAHC1215
201: Home Health Regulatory Roundup
Conference : 2012 Home Care & Hospice March on Washington & Law Symposium Conference & Exposition
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The Centers for Medicare & Medicaid Service (CMS) has instituted a number of new regulations and policies, while others that are pending. This program is being presented in order to inform attendees about the status of the current regulations and policies identified as being of greatest concern to home health agencies. Hot topics include PPS update 2012, face-to-face encounter policies, therapy reassessment requirements, impact of CAHPS participation on 2012 and beyond, Medicaid F2F proposed rule, and more. During this session, attendees will have an opportunity to discuss the challenges that they are facing.

Objectives: • Review current policies and regulations of greatest concern to home health agencies; • Describe their impact on home health providers; and • Identify available resources and courses of action for providers.

Faculty: Mary St. Pierre, RN, BSN, MGA, Vice President for Regulatory Affairs, National Association for Home Care & Hospice, Washington, DC.

Session : NAHC1216
203: Medicaid Advocacy: The National Council on Medicaid Home Care
Conference : 2012 Home Care & Hospice March on Washington & Law Symposium Conference & Exposition
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In 2011, the NAHC Board of Directors initiated the development of the National Council on Medicaid Home Care charged with developing and implementing an action plan to advocate for comprehensive and stable Medicaid home care programs. The Council’s action plan is directed towards Medicaid advocacy on the federal level, advocacy supportive of specific state Medicaid concerns, in-depth research projects on the value of Medicaid home care, and a web-based “toolbox” on Medicaid laws, policies, research, and developing issues. This panel presentation details the plans and activities of the Council while providing an open forum for discussing Medicaid issues.

Objectives: • Identify the planned actions of NAHC’s National Council on Medicaid Home Care; • Describe the Medicaid advocacy priorities affecting home care; and • Describe the Medicaid advocacy tool box developed by the Council.

Faculty: NAHC’s National Council on Medicaid Home Care representatives

Session : NAHC1217
205: Health Information Technology: Where Are We Headed?
Conference : 2012 Home Care & Hospice March on Washington & Law Symposium Conference & Exposition
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Over the past decade, health information technology (HIT) has been promoted as an essential tool to improve quality, reduce preventable errors, and contain rising costs in the US health care system. States and the federal government have demonstrated their support of HIT adoption by delivering strategic plans and sizeable grants to invested stakeholders. Three years after the passage of the 2009 Health Information Technology for Economic and Clinical Health (HITECH) Act, and faced with emerging reforms stemming from the 2010 Patient Protection and Affordable Care Act (PPACA), the home health care community has been prudent in their efforts to participate in existing programs and collaborate with lawmakers to establish policies that encourage the use of of e-enabled technologies. Learn about HIT federal and state efforts that underscore home health’s role as a partner in improving care delivery, outcomes, coordination, and transitions of care.

Objectives: • Describe state and federal efforts to improve transitions in care; • Discuss opportunities for and benefits of collaborating with federal and state grantees/awardees; • Identify state initiatives and policies that expand the use of telehealth and remote monitoring services within the home; and • Describe the role of State HIT Coordinators.

Faculty: Jessica Kahn, MPH, Technical Director for Health Information Technology, Centers for Medicare & Medicaid Services (CMS); Terrance O’Malley, MD, Medical Director, Partners Home Care, Massachusetts; Liza Fox-Wylie, Policy Director, Colorado Regional Health Information Organization (CORHIO)

Session : NAHC1218
301: Home Health Strategic Positioning in the ACO World
Conference : 2012 Home Care & Hospice March on Washington & Law Symposium Conference & Exposition
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The Patient Protection and Affordable Care Act (PPACA) requires the establishment of a variety of innovative delivery models from shared savings programs, such as Accountable Care Organizations (ACOs), Medical Homes, Independence at Home, and Bundling, that require coordination of items and services and promote accountability for care of Medicare beneficiaries. These programs will be comprised of groups of providers of services and suppliers that work together to manage and coordinate care through redesigned care processes for high-quality and efficient service delivery. Home health agencies embody the core values of these concepts, offering a holistic approach to meet the clinical, functional, and social needs of individuals in the community through multidisciplinary services in coordination with other health and social service providers. However, in order to position themselves in the new service delivery world, home health agencies must demonstrate their ability to carry out effective chronic care management, including patient coaching and promotion of patient self-sufficiency. They must ensure that their clinicians demonstrate necessary competencies to be effective care managers and coaches. They must also be prepared to identify and employ proven interventions and effective organizational redesigns in care delivery. This program will provide an overview of training programs, certifications, and organizational redesigns that will help home health agencies to be in a position to assume a vital role in the future of health care.

Objectives: Identify the role of home health a • gencies in the new service delivery models; • Describe knowledge and skills needed to effectively manage chronic care patients; and • Describe successful organizational redesigns and interventions

Faculty: TBA

Session : NAHC1219
302: From QAPI to Report Cards - Smoothing Your Hospice
Conference : 2012 Home Care & Hospice March on Washington & Law Symposium Conference & Exposition
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The 2008 update to the Hospice Conditions of Participation requires all hospices participating in Medicare to have a Quality Assessment and Performance Improvement (QAPI) program in place. In early 2013, hospices will report data from two quality measures used in their programs or be subject to a 2 percent reduction in payment. This session will discuss how QAPI efforts can dovetail with new quality reporting requirements and how hospices can prepare for full compliance, and be ready for expanded reporting in future years.

Objectives: • Describe domains of care from which future measures may be taken; • Describe future focus areas for quality measures being considered by CMS; • Discuss providers’ experiences with voluntary reporting; and • Discuss providers’ experiences with integrating current QAPI efforts and new reporting requirements.

Faculty: Moderator: Katie Wehri, Hospice Operations, NAHC, Washington, D.C. Additional panelists TBA.

Session : NAHC1221
401: Legal Aspects of Marketing For Home Health Agencies and Hospices: Advantages and Consequences, and How PPACA has impacted the Rules
Conference : 2012 Home Care & Hospice March on Washington & Law Symposium Conference & Exposition
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The Affordable Care Act amends the definition of “remuneration” under the Civil Money Penalties laws to exclude certain “charitable and innocuous programs.” This significant change will impact OIG Advisory Opinions on what is a kickback, and will permit certain marketing activities that in the past were questionable. Why is marketing a legal issue? How can marketing help or hurt your organization? Identify legal and illegal marketing practices. Become aware of how employees, customers, and competitors can become whistleblowers of illegal marketing practices. Learn what you can and cannot do from OIG guidance such as Advisory Opinions, Work Plan, Fraud Alerts, Bulletins, Anti-Kickback Safe Harbors, and Compliance Plans.

Objectives: Describe marketing issues for hospices a • nd health agencies • Describe the legal consequences of improper marketing practices and who is policing those activities. • Identify marketing practices that are cost report issues and OIG Compliance Risk issues and describe compliance strategies

Faculty: Connie Raffa, JD, Partner, Arent Fox LLP, New York, NY

Session : NAHC1222
402: HIPAA Incident Response: Are You Prepared?
Conference : 2012 Home Care & Hospice March on Washington & Law Symposium Conference & Exposition
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The federal HITECH Act and implementing regulations impose certain breach evaluation and response requirements on covered entities and business associates in the event of an alleged unauthorized disclosure or use of protected health information. The Office of Civil Rights in the Department of Health and Human Services has instituted enforcement actions against health care providers that have been found liable for breaches, and the fines have been substantial. Participants in this program will be briefed on the legal requirements of HIPAA, and work through some plausible breach scenarios with the presenters. We will discuss the value of a HIPAA and HITECH compliance policy and practice adopted at all levels of the organization. Participants will receive instruction on the elements of an effective security and privacy program, and the procedures for handling an alleged breach. Finally, the participants will be briefed on the applicability of state health information security and privacy laws in the context of a breach incident response. Participants will give recognition that a perfect incident response program is achievable, and will save money and organizational reputation in the long run.

Objectives: • Discuss the applicable law and regulations related to HIPAA security and privacy, and HITECH breach response • Presenters and participants will discuss likely scenarios of potential HIPAA breach incidents in the home health and hospice setting • The final portion of the program will provide the participants with the framework for an effective HIPAA breach incident response plan

Faculty: E. Michael Flanagan, Esq., Principal, The Law Offices of E. Michael Flanagan, Washington, DC; Gregory Koscs, CPA, CHCE, CFO, Allied Health Care Corporation, Fort Lauderdale, FL.

Session : NAHC1223
501: Innovative Care Programs: Separating Yourself from the Pack, Without Making Yourself a Target
Conference : 2012 Home Care & Hospice March on Washington & Law Symposium Conference & Exposition
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This program will look at the diabetic care program implemented by one provider to improve its outcomes/reduce hospitalizations. It will discuss not only the clinical aspects of the program but how this and some other “specialty” programs have helped the agency make it known to local hospitals. The program will evaluate implementing programs to reduce hospitalizations and improve outcomes overall as a key component of differentiating yourself from other agencies and being part of your case for involvement in many of the newer care models proposed under PPACA. The program will also address the compliance and fraud and abuse aspects of this program. After the Miami outlier controversy and the Senate Finance Committee Report on therapy services, the OIG and other regulators are very suspicious of diabetic care and similar “additional services” offered by agencies. These programs are viewed by the regulators as simply a means to increase revenue, not a means to provide medically necessary care to patients. Providers implementing new programs will need to consider the ramifications of recent CMS and OIG pronouncements on therapy, coding creep etc., when implementing programs such as this. We will then evaluate compliance issues related to these types of programs and how providers can not only implement these programs in a compliant fashion, but maintain compliance during operations.

Objectives: Discuss the process of developing a • nd implementing a diabetic disease management program • Marketing the program - differentiating yourself from the herd • Disease management in the current enforcement environment

Faculty: Robert Markette, Esq., CHC, Counsel, Benesh Friedlander Coplan & Arnoff LLP., Indianpolis, IN; Karen Wells, RN, VP of Clinical Services, Innovative Capital Management, Norman, OK; Brian Wilson, RP, Owner, Innovative Capital Management, Norman, OK.