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Archive January 2024

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Have You Completed the C-Diff Survey? A reminder from Carrie Rice at Maine CDC

Maine CDC and U.S. CDC are offering a free C. difficile infection prevention and control practices assessment in the form of a survey. The survey can be complete anonymously and the purpose is to identify best practices and areas of opportunity in aggregate data.
 
Don’t miss your FREE opportunity to enhance your facilities practices and reduce C. difficile infections. Join your peers who have already submitted!
 
Survey Instructions:
  
The infection preventionist should partner with others (e.g., frontline staff representation, champion representation, quality personnel) to fill out the survey.
 
A hard copy of the survey tool can be used to pre-record and work prior to entering on the survey link.
 
Please answer to current practices occurring and not just best practice policies to help identify any opportunities for improvement.
 
Provide additional context to further interpret results and potential gaps in open text fields. When answering open-text fields consider exceptions to the rule, variations by role, frequency, and challenges.
 
The tool may be filled out anonymously by leaving the optional questions blank.
 
 
Enter answers online by clicking on the Link:
https://www.surveymonkey.com/r/CDI-Maine
 
Please fill out only one survey per facility.
Please complete the survey AS SOON AS POSSIBLE!
 
Staff contact: mcarland@mehca.org
 

HHS Office for Civil Rights Releases Visitation Guidance Resources

Last week, the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) released the following materials pertaining to visitation guidance: This initiative aims to avoid religious discrimination, particularly during a public health emergency. These resources remind organizations of their obligation to ensure visitation policies do not discriminate but also effectively communicate visitation restrictions to patients and residents.

Please send questions to regulatory@ahca.org.
 
Staff contact: mcarland@mehca.org
 

AHCA/NCAL members invited to register for two upcoming free webinars!

1.  LTC Workforce Webinar Series:  This series focuses on workforce-related matters impacting long term care (LTC) providers across the country, including career ladders, getting more youth interested in the LTC field, and hiring immigrants/refugees. Here’s the information about the first session:
  • Title:  Building the Path: Creating Careers in Long Term Care
  • Date:  March 1, 2024
  • Time:  3pm (ET).  
  • Registration Link:   Click Here  
  • AHCA/NCAL Contacts:  Dana Ritchie and Urvi Patel.
2.  Employee Retention Credit Update: What You Don’t Know Will Hurt You:  Join an expert panel of attorneys – Stuart Schabes of Baker Donelson and Mark Reagan of Hooper, Lundy & Bookman – as they share the latest information on the ERC. Topics addressed will include the IRS’s current approach to the ERC application processing freeze implemented in September 2023, what to do if you have been notified of an audit and what you need to know about the IRS’s current posture on the ERC.
  • Date:  February 6, 2024
  • Time:  1:30PM (ET)
  • Registration Link:   Click Here

Issue Corrected: Attention Section 67 Providers – Members Coverage Inadvertently End-Dated in MIHMS

On January 8, 2024, we announced to Section 67 Nursing Facilities (NFs) providers that several members had their MaineCare coverage for NF Services inadvertently end-dated on December 31, 2023. This issue is now corrected, and providers can submit their claims for dates of service from January 1, 2024, to present. 

Please contact your Provider Relations Specialist, Bruce Cosgrove, with questions.  

Staff contact: awesthoff@mehca.org

Unwinding of the Service Provider Tax for PNMI-Cs

The Maine Department of Health and Human Services announced recently that it is bringing closure to a long-standing financing issue dating back to 2018 in Maine’s Medicaid program by eliminating a CMS-contested tax on health care providers (MaineCare). This reflects Governor Mills’ commitment to responsible State budgeting and sustainable long-term financing for MaineCare, a program that provides health and long-term service and supports to over 400,000 Maine residents.

Yesterday, the Governor signed a financial order to enable the Department to pay a $28 million disallowance, or penalty, received in December 2023 from the federal Centers for Medicare & Medicaid Services (CMS). This penalty was expected, which was why last year the Governor’s budget requested and the Legislature transferred sufficient funds to make this payment from the MaineCare Stabilization Fund.

This action was supported by the Legislature, which repealed the health components of the Service Provider Tax in the biennial budget. Eliminating this tax effective January 1, 2025 stopped additional accrual of penalties that would have totaled over $100 million to date, and prevented additional annual penalties of about $34 million each subsequent year.

Seven months ago, the Governor’s budget change package proposed the plan to eliminate this CMS-disputed tax that funds MaineCare services. Maine’s Service Provider Tax was created in 2004 and applies to some health providers, among other entities. Some of the revenue supports MaineCare services. Most states (PDF) use at least one provider tax as a financing source for Medicaid.

In a September 2018 letter, CMS raised concerns about the Service Provider Tax’s application to private non-medical institutions (PNMI) and similar home- and community-based providers in Maine. CMS asserted that this health care tax was an impermissible source of the non-federal share of funding that is used to finance Medicaid services.

As Maine sought clarification, in November 2019, the Trump Administration proposed major changes to provider taxes – preventing Maine from developing a path forward, as explained in a spring 2020 report to the Legislature (PDF). Although the federal government withdrew this proposed rule in the fall of 2020, in December 2020, CMS initiated a compliance action on the State of Maine by “deferring” or delaying payment of federal funds associated with the questioned tax effective back to July 1, 2020. Such deferrals, which are the first step toward a penalty or “disallowance,” continued quarterly and totaled $28 million as of April 2022.

The Department engaged with CMS on development of a plan which halted additional deferrals. That plan was enacted in the biennial budget ( PL23, Chapter 412 (PDF) and repeals the Service Provider Tax on health providers and removes all documented add-on amounts associated with the tax that are built into MaineCare reimbursement, effective January 1, 2025.

The budget also appropriates $18.9 million in ongoing general funds to MaineCare to replace the lost revenue starting in state fiscal year 2025. Additionally, last year’s change package transferred $6.5 million to the Medicaid Stabilization Fund to plan for the likely disallowance, bringing the total in that Fund to $29 million. The budget was signed into law on July 11, 2023, was effective October 25, 2023, and the CMS disallowance was received on December 6, 2023.

Resolving the longstanding dispute over the Service Provider Tax is consistent with the Mills Administration’s commitment to addressing financing challenges head on rather than unduly prolonging the process and potentially increasing amounts owed. Similar actions were taken to avoid passing along debts to future administrations, working to facilitate re-certification of the Riverview Psychiatric Center and pay the $80 million federal disallowance incurred under the previous administration.

Staff contact: awesthoff@mehca.org

MaineCare NF Rate Reform Updates

On Tuesday, January 23rd, the Department of Health and Human Services presented to the Health and Human Services Committee on rate reform. We understand that two 90-minute stakeholder meetings are anticipated for mid-February and all nursing home providers are encouraged to attend. MHCA will send out those details when they become available. 

The Department’s presentation acknowledged some of the challenges facing the sector including continued closures/ conversions and low occupancy relative to pre-pandemic levels. They also noted that the cost settlement system is administratively burdensome for providers and DHHS. We also know that the current case mix system (RUGs) is ending and that the conversation to Patient Driven Payment Model (PDPM) is coming.

The Department’s rate reform objectives include the following:
  • Ensure rates are adequate to help enable sustained access to needed care and support facilities in achieving and retaining a permanent, well-trained work force. 
  • Incorporate feasible and appropriate case mix adjustment method.
  • Ensure rates keep pace with changes in costs of delivering the service.
  • Promote development of Alternative Payment Model (APM) that provides incentives for high value care.
Rate reform for nursing facilities is targeted to be implemented in January 2025. Residential Care/ Assisted Living rate reform is estimated to be at least six months later. 

MHCA continues to have representatives participating in various committees related to rate reform and has ongoing discussions with the Department. Stay tuned for additional information on stakeholder meetings in February.

Staff contact: awesthoff@mehca.org

Maine Care Notice: Attention Providers- Please Respond to Enrollment Cases That Need More Information (NMI)

MaineCare continues to experience a high volume of provider enrollment cases, and they need your help to make progress. Gainwell regularly identifies missing information that delays their ability to complete cases and requires your immediate attention.

Providers who submit an enrollment case that requires additional information will have that case returned for NMI. When this occurs, Gainwell will send the enrollment case back to the HealthPAS Online Portal for updates and will e-mail the individual who submitted the case specifying what the provider needs to correct.   

Gainwell may also contact providers who submit an enrollment case without the case being returned for NMI. Providers must respond to Gainwell and provide needed information as soon as possible.   

New: Gainwell will deny cases in whole or in part if providers do not respond within 10 calendar days. Providers must complete everything required. This will shorten case processing time and help us decrease the overall inventory of enrollment cases.
Checklist and Tips 

As a reminder, please review the updated Enrollment Checklist and Provider Revalidation Tips in the Provider Enrollment folder prior to revalidating or enrolling with MaineCare to verify that you have all the required documentation available. The checklist includes information about what is required for enrollment and revalidation for each provider type. We also include common errors found when submitting revalidation applications through the Provider Enrollment Application (PEA).

Training is Available 
You can register for training courses related to revalidation through the Absorb training platform. If this is your first time using the Absorb training platform, go to the Absorb training site and follow the instructions to create your login credentials. If you would like to request a live training session, you can contact Provider Services at 1-866-690-5585. After entering your NPI, choose Option 7.

If you have questions about your enrollment case, please contact Gainwell Provider Services at 1-866-690-5585, Option 2. If you have specific questions about the NMI process, please contact the Enrollment Manager Kenneth Jamison (KJ).

Staff contact: awesthoff@mehca.org

Free AHCA Infection Preventionist Specialized Training (IPCO)

The IPRO QIN QIO is presenting a unique chance to enhance your team's expertise by granting complimentary access to AHCA/NCAL's Infection Preventionist Specialized Training (IPCO).

AHCA/NCAL's Infection Preventionist Specialized Training (IPCO) is highly recommended for individuals responsible for or interested in infection prevention and control (IP&C). This program is specifically designed to educate Infection Preventionists (IPs) in nursing centers, although many Administrators and leaders have found it valuable as well.

CMS requires that each nursing center appoint a designated and specially trained Infection Preventionist responsible for overseeing a comprehensive infection prevention and control program.

Please be aware that this opportunity is currently limited to one individual per nursing center.
 
Registration is a two-step process:

Step 1:
     Go to HCA Portal   and register. Once you register, you will receive an email with a code.
 
Step 2:
     Go to AHCA Infection Preventionist Tab  and use the code that was emailed to you to access the course at no cost.  
For more information, Click HERE to see the program flyer
 
Staff Contact: mcarland@mehca.org

MHCA Wage & Fringe Benefit Survey Reminder

We encourage provider members to take part in our annual wage and fringe benefit survey, which aids in our advocacy efforts at the Maine Legislature. Your input is vital and we ask you to please complete and return the survey to MHCA by March 3, 2024. As always, individual responses will remain confidential. 
 
If you need a copy of the survey sent to you (or other staff member), please contact Dianne at the Association office (207.623.1146, ext. 201).
 
Staff Contact: dchicoine@mehca.org

Remember ME: Deadline to Nominate a Resident Extended to Friday, January 26

Join us again in recognizing some of our wonderful and inspirational long-term care residents by nominating a resident for Remember ME using the online submission form (https://www.mehca.org/rmeapplication). 
 
When considering a candidate, please be sure the resident is willing to be photographed by our professional vendors if he or she is selected. We strongly encourage submissions to be thoughtful, using the 750 word limit to relay the resident's story. In the past, submissions that are very short or in a bullet format are rarely selected by the judges, as they don't relay enough information.
 
The exhibit will once again feature black and white photographs, accompanied by brief biographies, of residents living in your facilities. The presentation of Certificates of Lifetime Achievement will be on May 9, 2024 at the Augusta Civic Center. We are planning to have the event live streamed.
 
If you have questions or comments, please contact Dianne Chicoine at 623-1146 or dchicoine@mehca.org.
 
Staff contact: dchicoine@mehca.org    
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