In the News

Home Health Care Among Settings Where Masks No Longer Required, CDC Says

Home Health Care News / By Patrick Filbin

Workers in home health care, nursing homes, hospitals and other health care settings are no longer required to wear masks indoors.

Late Friday, the Centers for Disease Control and Prevention (CDC) issued guidance that ended a blanket indoor mask requirement that had been in effect for the last two and a half years.

The guidance was part of the CDC’s revisions to the agency’s COVID-19 recommendations, one of the final sets of changes that began in August.

The CDC recently reported that just over 73% of counties in the U.S. have “high” COVID transmission levels. About 27% of counties meet the substantial, moderate or low categories.

Since early in the pandemic, the CDC has urged people in the U.S. to wear masks – what the agency calls “source control” – while in health care settings.

The new guidelines apply to nursing homes, home health facilities and hospitals. The guidelines do not apply to restaurants and other non-health care environments.

“Updates were made to reflect the high levels of vaccine- and infection-induced immunity and the availability of effective treatments and prevention tools,” the CDC’s new guidance reads.

Even though masks are no longer required in facilities where transmission is not high, the CDC still recommends they be worn:

– If someone has a suspected or confirmed COVID-19 or other respiratory infection
– If someone has close contact or a higher-risk exposure with someone who had COVID-19 for 10 days after their exposure
– If someone lives or works somewhere that is experiencing a COVID-19 outbreak (in this case, universal mask wearing can stop once no new cases have been identified for 14 days)
– If mask wearing is recommended by local public health authorities

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URGENT: Ask Congress to Support Legislation to Stop Home Health Cuts

The Centers for Medicare & Medicaid Services has proposed an alarming, permanent 7.69% cut to Medicare home health services. This cut equates to a $1.33 billion cut from home healthcare in 2023 alone. Further, Medicare forecasts additional cuts of more than $2 billion in 2024 and the years beyond. In total, these cuts could reach $18 billion over the next ten years.

This summer, Senators Debbie Stabenow and Susan Collins and Representatives Terri Sewell and Vern Buchanan introduced the Preserving Access to Home Health Act of 2022 (S. 4605/H.R. 8581) to prevent the proposed cuts to home health from taking effect prior to 2026. 

Now that Congress is back in Washington D.C., we need them to take action to stop these cuts. 

Lawmakers must hear from their home health community constituents about the need to pass this legislation before the end of the year. Voices like yours are highly influential to lawmakers, which is why we need you to ask your Members of Congress to support this important piece of legislation.

Send an email to your federal lawmakers now asking them to support the Preserving Access to Home Health Act and submit a letter to the editor of your local newspaper to raise awareness.

Even if you have contacted your lawmakers about this legislation in the past, we encourage you to reach out again now that they have returned from summer recess. 

 

Telehealth Better Than In-Person Visits on Some Quality Measures: Study

Modern Healthcare / By Mari Devereaux
 
Telehealth visits for primary care can be comparable in quality to in-person visits, suggesting remote testing and screenings are valuable tools to augment patient care.
 
The finding follows a study of more than 500,000 patients across 200 outpatient care sites in Pennsylvania and Maryland who either had exposure to telemedicine or only had in-person visits between March 1, 2020, and November 30, 2021.
 
The report examines the care quality performance of telemedicine and in-person patient groups for 16 Health Care Effectiveness Data and Information Set measures selected across five domains of primary care: cardiovascular, diabetes, prevention and wellness, behavioral health and pulmonary. 
 
In 13 of 16 medication, testing and counseling-based measures, exposure to telemedicine was associated with similar or significantly better quality performance. The study was published in JAMA Network Open.
 
Higher quality scores for telemedicine prove that remote care is worth the cost of reimbursement just like in-office care, said Dr. Derek Baughman, an author of the study and medical director at Barksdale Air Force Base and Medical Clinic. 
 
“This isn't just one or two measures, it's showing that for most of the measures, we're providing at least comparable quality,” he said. “We're not making these measures worse.”
 
For all counseling and testing-based measures—including vaccinations, cardiovascular disease and diabetes testing and screenings for depression and cancer—telehealth care encounters were more likely to meet HEDIS quality benchmarks than solely in-person patients. 
 
The results are examples of clinical domains where telemedicine could be used as an alternative to in-office care, Baughman said. Prioritizing telehealth visits for chronic disease management and preventive care could lead to better quality outcomes as well as more affordable care.

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Repayment and Recovery of COVID-19 CAAP

The Health Group

In March 2021, CMS began recovering COVID-19 Accelerated and Advance Payment (“CAAP”) balances.  After one year, the recovery of the advanced monies was made at twenty-five percent (25%) over eleven months, followed by fifty percent (50%) over the following six (6) months.  Thereafter, any unrecovered monies will be collected at one hundred percent (100%) of Medicare payments until such time as all monies are recovered including four percent (4%) interest.

Depending on when the provider received the CAAP, 100% withholdings may have already started to recover remaining balances.  At the end of the 29th month following the receipt of CAAP, the Medicare Administrative Contractor (“MAC”) should have issued a demand for repayment of any remaining balance.  The provider has all repayment and recoupment options normally available when dealing with other Medicare overpayments.  These options include requesting an Extended Repayment Schedule.

An Extended Repayment Schedule (“ERS”) is a statutorily authorized debt payment schedule, which allows a provider or supplier experiencing financial hardship to pay debts over time in monthly installments, including interest.  An ERS can be extended to as many as five years if certain extreme hardship criteria are met. Providers and suppliers may request an ERS after the Medicare Administrative Contractor (MAC) issues a demand letter requiring repayment of a debt. Providers and suppliers should contact their MAC for information on how to request an ERS. A provider or supplier must meet certain statutory and regulatory requirements to be eligible for an ERS and also will need to meet specified criteria related to financial “hardship” or “extreme hardship” under 42 C.F.R. 401.607(c)(2) in order to be eligible for an ERS.

CAAP FAQ is available here

 

Audit of Cares Act Provider Relief Funds by CMS

The Health Group 

The 2022 OIG Work Plan includes the audit of CARES Act Provider Relief Funds.  The Work Plan includes the following:

“The Coronavirus Aid, Relief, and Economic Security (CARES) Act and the Paycheck Protection Program and Health Care Enhancement Act appropriated $175 billion for the Provider Relief Fund (PRF) to support health care providers affected by the COVID-19 pandemic.  In April 2020, the Health Resources and Services Administration began distributing the funds through general distributions to Medicare providers based on 2018 net patient revenue and targeted distributions for certain provider types (e.g., providers in areas particularly impacted by COVID-19, skilled nursing providers, and providers in rural areas).  Providers such as hospitals may be eligible for PRF payments from the general and targeted distributions.  We will select for audit a statistical sample of providers that received general and/or targeted distributions.  Our objective is to determine whether providers that received PRF payments complied with certain Federal requirements, and the terms and conditions for reporting and expending PRF funds.”

The process has begun as selected providers are being notified of upcoming audits.  The OIG audit notification letter includes the following:

“To expedite completion of our work, we request that you have the documentation pertinent to your entity’s use and reporting of PRF payments available at the time of our meeting. We appreciate your cooperation in this matter and will make every effort to minimize any disruption to the work of your office.”

 
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