Home Health & Hospice

Weekly Roundup

Homecare Insider, October 5, 2015

This past Thursday (October 1, 2015), began the live implementation of ICD-10 across the healthcare continuum. Threat of claim denials for agencies unprepared to code ICD-10 correctly is now very real, as 69,000 new codes enter the playing field. Major disturbances or issues have not yet been reported. It should be noted that some physicians, however, were given a one-year leeway for the conversation, making it possible for agencies to inadvertently rely on physician's old, ICD-9 coding for their own documentation. In July 2015, CMS released a regulatory guidance stating that for one year after Oct. 1, Medicare will not deny Part B claims from physicians or other practitioners “based solely on the specificity of the ICD-10 diagnosis code,” as long as providers use valid codes “from the right family.” According to CMS' FAQ “family of codes” is the same as the ICD-10 three-character category. Codes within a category are clinically related and provide differences in capturing specific information on the type of condition.

Home health agency Nurses's Registry and Home Health Corp. is in hot water after a civil judgment that found the agency and its owner guilty of Medicare fraud and using kickbacks to get referrals from doctors—including Taylor Swift tickets and alcohol. The ruling found that the agency systematically falsified claims to make it seem that patients were homebound or needed skilled nursing services when they weren't. It also found that physicians even knew that they could request tickets to popular events, such as Taylor Swift concerts, if they referred patients to the agency. Read more here.

The Samueli Institute has partnered with the National Hospice and Palliative Care Organization (NHPCO) for a nine-month collaborative called "Optimal Healing Environments in Hospice and Palliative Care." The collaborative "intends to transform the experience of care for patients and caregivers by evolving current palliative care practices," according to the press release. The collaborative provides an incredible opportunity for hospice organization to focus on how to implement practices to mindfully create healing environments for the patients and their families they serve,” states NHPCO Senior Director of Access and Chair of the Samueli Institute collaborative Gwynn Sullivan.  “In essence, from attending the collaborative, hospices can return their attention back to the roots of healing from which they began.”   Read more here.