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New in Hospice: HCBS and Provider Relief Increases and Addendum Clarifications

Published: 10/11/2021
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To keep you informed on news, innovation, education and advocacy issues around home-based care, we’ve pulled together these important headlines.

Mandatory Vaccinations

Massachusetts Governor Charlie Baker announced the expansion of the vaccination mandate to include assisted living facilities, hospice programs and home care workers. While increasing rates of vaccinations is important, providers are worried that they will lose significant numbers of staff to other industries at a vital time. There are also concerns about the need for clarity around exception rules. Read the full article here.

President Biden announced a six-pronged COVID-19 strategy. The administration requires most home health workers to get vaccinated as well as an increase in testing and masking. The Department of Labor’s Occupational Safety and Health Administration (OSHA) is developing a rule to require employers with 100 or more employees to ensure full workforce vaccination. Read the rest of the article here.

CMS

The Partnership for Quality Home Healthcare (PQHH) released a statement explaining why they believe that one of CMS’ conclusions is fundamentally flawed. CMS stated that the 2020 base payments were set 6% higher than they should have been to meet budget neutrality. PQHH believes that the COVID-19 has distorted data and that episodes should be compared to pre-covid data from 2018 instead. Read the rest of the article here.

Provider Relief Funds

The Biden Administration announced the addition of $17.7 billion to the Provider Relief Fund (PRF). The additional funds will help offset rising labor costs, COVID-19 testing requirements, PPE, vaccine requirements and other pandemic-related costs. Read the full article here.

HHS has also released $8.5 billion from the American Rescue Plan resources for providers that service rural Medicare, Medicaid or Children’s Health Insurance Program (CHIP) patients. While PRF funds have been a helpful lifeline, many agencies have opted to return relief funds due to confusion over how the rules for the funds will be enforced and concerns over public perception. Read the rest of the article here.

HCBS Payments

During the pandemic, CMS has allowed flexibility to states to modify their home and community-based services (HCBS) programs. According to a review by the Government Accountability Office (GAO), 38 states have increased payments for some HCBS organizations. These payments were designed to cover new costs like PPE and hazard pay. 42 states allowed HCBS providers to exceed amount of care limits. Read the full article here.

Long Term Care Recommendations

The Bipartisan Policy Center (BPC) released a report recommending that Congress expand access to home and community-based services (HCBS). Over 800,000 Americans are on HCBS waiting lists. The BPC stresses that it is important to build up home-based care to create transitional care for those waiting for access to HCBS programs. Read the rest of the article here.

A study from ATI Advisory looks estimates that the potential cost of adding long term care to Medicare or Medicaid programs is between 1.1 and 12.8 billion per year. However, including support for long term care could reduce expenditures in other aspects of healthcare. Read the full article here.

THIS MONTH IN HOSPICE

Illinois POLST

Illinois Governor J.B. Pritzker signed a law removing the requirement for a witness when signing the Physician Orders for Life-Sustaining Treatment (POLST) form. The witness requirement often becomes a barrier to advanced care planning in remote and in-home situations. The law is expected to make advanced care planning easier for hospice patients in Illinois. Read the full article here.

Addendum Clarifications

The final hospice payment rule for 2022 included several clarifications regarding the hospice addendum requirement. Hospice News summarized the updates including clarifications regarding timeframes, signatures and documentation requirements. Read the rest of the article here.

CAPC Database

The Center to Advance Palliative Care has created a public database that tracks state policies on services related to palliative care. The database is designed to encourage policy changes that reduce health care disparities and encourage research and development. An additional benefit of the public database will be education for potential patients who often don’t understand palliative care. Read the rest of the article here.

Medicare Advantage

The Medicare Advantage hospice carve-in has been in effect since January 1, 2021. While participation is voluntary, hospice agencies are urged to work on consultative relationships with MA providers now. Setting up a relationship so that you are in-network with payors will help you secure a seat at the table for future negotiations and deal structuring. Read the full article here.

NHPCO

CEO of the National Hospice & Palliative Care Organization, Edo Banach, sat down with Hospice News to explain the thought process behind some of NHPCO’s latest suggestions to CMS and his reactions to the national vaccine mandate for healthcare workers. Read the rest of the article here.

PCHETA

Support for the Palliative Care and Hospice Education and Training Act (PCHETA) is growing with endorsements from more than 50 national and 35 state organizations. The act is intended to support physician and nurse training in hospice and palliative care as well as interdisciplinary professions. The goal would be to help recruitment efforts and alleviate workforce shortages. Read the full article here.

Palliative Care Benefit

Ten members of Congress have written to CMS to call for an official palliative care demonstration. A Medicare palliative care benefit is expected to improve quality of life for patients, alleviate the burden on hospitals and reduce expenditure. In addition, the Expanding Access to Palliative Care for Seniors Act, if passed, would push for a Medicare demonstration. Read the rest of the article here.

HOSPICE CUSTOMERS IN THE NEWS

Transitions Health

Transitions Health announced the acquisition of Lumicare Hospice operating in Kansas and Missouri. Traditions Health has completed almost a dozen M&A deals from 2019-2020 and they are continuing to grow at a rapid rate. The company is expanding into new states in 2021, expanding their reach. Read the full article here.

Hospice and Palliative Care Buffalo

New York State has announced vaccine mandates and Hospice Palliative Care Buffalo is following up with a two-phase approach to ensure staff vaccinations. Exceptions will be offered for religious and medical reasons. More than 80% of the organization’s staff has already been vaccinated. Read the rest of the article here.

St. Croix Hospice

An article in Wisconsin News examined hospice music therapist Nicholas Scholtz’s work with one of HCHB’s premier customers St. Croix Hospice. Scholtz uses his classical guitar skills and his music therapy degree to work to provide pain relief and to help patients recall memories.

Abbie Watson, VP, Central Operations for St. Croix Hospice has been named a 2021 Future Leader by Home Health Care News. Abbie addressed important changes that need to come to the hospice industry, including reducing fear and misconceptions around end of life care and the increase of specialized care. Read the full article here.

St. Croix Hospice announced the opening of a de novo location in the Oak Creek Community of Wisconsin. This is the 5th de novo location the provider has opened in 2021 and the company expects to add new de novo and acquired locations before the end of the year. Read the rest of the article here.

Compassus

Chief Medical Officer, Kurt Merkelz, M.D. spoke with Hospice News about the new campaign Compassus launched to help suicide prevention in hospice patients. He discussed some of the challenges that lead to suicide towards the end of life and addressed the importance of full interdisciplinary assistance. Read the full article here.