Thursday, May 26, 2016

Administration Improperly Funded ACA Cost-Sharing Subsidies

Dianne De La Mare

US District Judge, Rosemary Collyer, has held that the federal government has improperly spent billions of dollars over the past two years to reimburse insurance companies for providing health coverage at lower costs to low- and moderate-income consumers (US House of Representatives v Burwell). Judge Collyer has not taken any immediate action to stop this spending, however, and is instead allowing her decision to be challenged on appeal (either to a federal court of appeals or directly to the US Supreme Court).

There is no doubt that the Obama Administration will appeal, especially because this controversy goes to the key question of whether the private insurance industry will remain willing to provide lower-cost health coverage through the ACA exchanges, or marketplaces, that have now enrolled millions of new consumers.

Webinar: An Overview of the Functional Assessment Standarized Item (FASI)

Adrienne Riaz-Khan

This webinar will provide a brief overview of the Functional Assessment Standardized Items (FASI), which is part of the CMS Testing Experiencing and Functional Tools (TEFT) project. CMS will be testing this FASI, a revised version of the CARE tool, for use in home and community-based waiver settings which includes assisted living. CMS will be evaluating the reliability and validity of the FASI and asking states to demonstrate their use of the FASI elements. CMS has requested comments on this project by July 1, 2016. 

An Overview of the Functional Assessment Standardized Item (FASI)
Friday, June 3, 2016
2:00 PM – 3:00 PM Eastern Time

Lindsay Schwartz, Senior Director, Workforce & Quality Improvement, NCAL
Lilly Hummel, Senior Director of Policy, NCAL

Objectives: After attending this webinar, attendees will be able to:

· Provide an overview of the Functional Assessment Standardized Items
· Explain how states may use the FASI in HCBS settings
· Provide a brief overview of the TEFT project

Registration is now open:

Wednesday, May 25, 2016

AHCA/NCAL Webinar to Provide an Overview of the Functional Assessment Standardized Items (FASI)

Lindsay Schwartz

This webinar will provide a brief overview of the Functional Assessment Standardized Items (FASI), which is part of the CMS Testing Experiencing and Functional Tools (TEFT) project. CMS will be testing this FASI, a revised version of the CARE tool, for use in home and community-based waiver settings which includes assisted living. CMS will be evaluating the reliability and validity of the FASI and asking states to demonstrate their use of the FASI elements. CMS has requested comments on this project by July 1, 2016. This webinar will be held on Friday, June 3rd at 2:00pm –3:00pm Eastern. Please pre-register here for the webinar.

AHCA/NCAL 67th Annual Convention & Expo Preliminary Program

Jon-Patrick Ewing

It’s here and it’s hot! This year’s AHCA/NCAL Convention & Expo Preliminary Program is now available online! You can even read it on your mobile devices. Take a look at what Nashville has in store for you October 16-19 in this easy-to-access, easy-to-read flip book.

This year's Convention & Expo offers national keynote speakers, valuable education, professional networking, exciting exhibits staffed with experts ready to help your company excel, and music, of course! In the spirit of the Grand Ole Opry, the Gala Dinner & Show (separate ticketed event) features three artists, each with their own unique style and sound. You’ll enjoy an evening with award-winning county artists Charlie Daniels, Jo Dee Messina, and Phil Vassar.

Once you preview the electronic Preliminary Program, you’ll be inspired to register for the AHCA/NCAL Convention & Expo. Early bird registration and savings continue through July 22.

CMS Rule Tightens Special Enrollment Periods

Dianne De La Mare

The US Department of Health, Centers for Medicare & Medicaid Services (CMS) has released an interim final rule, Patient Protection and Affordable Care Act; Amendments to Special Enrollment Periods and the Consumer Operated and Oriented Plan Program.  This requires individuals who enroll in coverage through a special enrollment period after a permanent move to prove that they were previously covered for at least 1 day in the 60 days before relocating. 

CMS states that making those changes faster through an interim final rule is necessary to avoid adverse selection or gaming, and it also helps to ensure that issuers have confidence in their pricing.

OCR Releases Nondiscrimination Rule

Dianne De La Mare

On May 13, 2016, the US Department of Health and Human Services (HHS), Office for Civil Rights (OCR) published the Nondiscrimination in Health Programs and Activities; Final Rule, implementing §1557 of the Affordable Care Act (ACA), and prohibiting discrimination on the basis of race, color, national origin, sex, age or disability in certain health care programs (including the Medicare and Medicaid programs), effective July 18, 2016.

Section 1557 extends nondiscrimination protections to individuals participating in:
1) any health program receiving HHS funding;
2) any health program administered by HHS; or
3) health insurance marketplaces and all plans offered by issuers that participate in those marketplaces.

Section 1557 builds on long-standing federal civil rights laws including Title VI of the Civil Rights Act (prohibits race, color or national origin discrimination), Title IX of the Education Amendments (prohibits sex discrimination), the Rehabilitation Act, § 504 (prohibits disability discrimination) and the Age Discrimination Act (prohibits age discrimination). The rule specifically focuses on assurance and notice requirements; general prohibitions; discrimination against persons with limited English proficiency; discrimination against persons with disabilities; sex, gender and sexual orientation and enforcement.

Since the passage of the ACA in 2010, §1557 has been in effect and OCR has been enforcing this provision. In light of this final rule, however, AHCA/NCAL encourages its membership to review the recently released HHS press release, summary and fact sheets, to determine any areas for strengthened compliance.

Over 400 AHCA/NCAL Advocates Hit Capitol Hill

Drew Thies

Members meet with Senator John Hoeven (R-ND)
Over 400 American Health Care Association and National Center for Assisted Living advocates came to Washington to hear from political leaders and advocate on behalf of long term and post-acute care providers on Monday and Tuesday.

The 2016 Congressional Briefing event included over 200 visits to Members of Congress and their staff from 47 states to discuss issues such as recent value-based purchasing proposals and the Medicaid provider assessment.

Keynote speaker Chuck Todd, host of NBC’s Meet the Press, spoke to attendees at length about his background covering politics in Washington and answered questions about the upcoming presidential election.

Advocates also heard from party leaders on both sides of the aisle: Representative Greg Walden (R-OR), Chairman of the National Republican Congressional Committee; Representative Xavier Becerra (D-CA), Chairman of the House Democratic Caucus, and Kevin McCarthy (R-CA), Majority Leader of the House of Representatives.

New CMS Data Show Half of AHCA Members Hit 30 Percent Antipsychotics Reduction Goal Ahead of Schedule

The American Health Care Association (AHCA) today announced that half of its skilled nursing center members have reached or surpassed a nationwide goal in reducing antipsychotic usage by at least 30 percent, seven months ahead of the December 2016 deadline. As a result of the Association’s metric-based Quality Initiative and its partnership with CMS’ National Partnership to Improve Dementia Care, the overall decline in antipsychotic use in AHCA member centers is 30.4 percent. The achievement represents a faster rate of reduction than non-members, which currently show a 25 percent decrease.

“Reaching this goal seven months ahead of schedule highlights our profession’s commitment to improve the quality of life for individuals living with dementia,” said Mark Parkinson, President and CEO of AHCA. “This latest milestone means that tens of thousands of residents are no longer experiencing the negative effects of these medications. But we won’t stop with this announcement. We will continue to work with CMS and our Quality Initiative to set new, ambitious goals to reduce usage even more.”

Based on CMS data, 23.2 percent of long-stay residents in non-member centers and 23.6 percent in AHCA member centers were receiving an antipsychotic medication in 2011. Currently, 17.4 percent of residents in non-member centers and 16.4 percent of residents in AHCA member centers are on these medications.

“The sharp drop in usage shows how our members are driving change on a national level,” said Dr. David Gifford, AHCA Senior Vice President of Quality and Regulatory Affairs and a board-certified geriatrician. “Providers, residents and their families are clearly learning more about safer alternatives to treating dementia. Together with CMS and the Partnership, I’m confident we will continue to see progress.”

AHCA launched its metric-based Quality Initiative in 2012 and later joined CMS’ National Partnership to Improve Dementia Care in Nursing Homes to raise awareness about safe alternatives to antipsychotic medications for residents and patients with dementia through a systems-based and person-centered approach to care. In 2014, AHCA and CMS set goals to further decrease the use of antipsychotics in skilled nursing centers by a total of 30 percent by December 2016.

In April, CMS added antipsychotic medications to its long-stay quality measure component of Nursing Home Compare to track and encourage improvements in skilled nursing care centers.

The Association expanded its Quality Initiative in May 2015 to include eight measurable targets that align with the CMS Quality Assurance/Performance Improvement (QAPI) program and federal mandates, such as Five-Star and the Improving Medicare Post-Acute Care Transformation (IMPACT) Act. For more information, visit the AHCA Quality Initiative website.

Saturday, May 21, 2016

AHCA Submits Statement for Congressional Hearing Record on VA Provider Agreements

Dana Halvorson

The office of the Chairman of the House Committee on Veterans’ Affairs, the Honorable Jeff Miller (R-FL-01), requested a statement from AHCA for the May 24 hearing record relating to the topic of making permanent the Veterans Choice Program. AHCA’s Senior Vice President of Government Relations, Clif Porter, noted in the AHCA statement that nursing care centers are currently not included in the Veterans Choice Program as one of the eligible health care providers, and that AHCA has been advocating for policies which would grant the U.S. Department of Veterans Affairs (VA) the legislative authority to enter into Provider Agreements for extended care services. As you know from previous correspondence, Medicare (Parts A and B) or Medicaid providers are not considered to be federal contractors. However, if a provider currently has VA patients and a VA contract, they are considered to be a federal contractor.

VA Provider Agreements would help to ensure that our skilled nursing care centers are able to care for veterans in their communities. Our centers already meet very strict compliance guidelines under the Medicare and Medicaid programs. Adding additional regulations on top of this is simply inefficient, redundant and takes staff time away from these veterans at the bedside. AHCA continues to work with our Congressional champions on getting VA provider agreements across the finish line, and taking those with VA contracts out of the scope of being deemed a federal contractor.

Friday, May 20, 2016

AHCA/NCAL LTC Career Center Launches a 25% Off Sale for New Users

If you have never used the AHCA/NCAL Long Term Care Career Center, now is the time to give it a try because new users receive 25% off their first posting. Simply enter promo code New25off to receive this special discounted price.

Employers who utilize the site also receive superior exposure through rotating job listings on AHCA’s home page – the web site where long term care professionals go for news and information. In addition, employers who post vacancies through the center receive bonus rotating listings on the Long Term Care Career Center home page.

Rates for posting job vacancies are affordable and give prospective employers far greater exposure than local ads and job boards by connecting to a network of more than 330 health care organizations and societies. Employers are also able to post vacancies as they occur and search resumes on the network. And, of course, the LTC Career Center is always free for job seekers.

To reach talented health care professionals, check out the LTC Career Center today and remember to enter promo code New25off to save 25% on your first job posting.