Expect the Unexpected: This week’s Top Newsmakers in Quality and Regulatory Affairs
One in ten people aged 65 and older in the United States has Alzheimer's or a related dementia illness. Being a caregiver of someone with dementia can be tough. Healthcentric Advisors, the New England quality improvement organization serving as the CMA contracted QIO has created a Dementia Overview mobile app which contains information and advice to help family and professional caregivers understand and respond to behaviors seen in those with dementia. Download it from the app store today by searching for Dementia Overview in your app store!
CMPRP Releases Updated Version
MHCA recently shared information about a new program from the Centers for Medicare & Medicaid Services (CMS) regarding the Civil Money Penalty Reinvestment Program (CMPRP). The program is focused on achieving two main goals of improving the delivery of care and resident life in nursing homes. Recently an updated version of the Nursing Home Staff Competency Assessment was released and available to our members for free to download on CMPRP's website. Download the assessment by visiting Civil Money Penalty Reinvestment Program here. In order to use all functions within the document make sure you download the toolkit and have adobe acrobat installed. If you do not have Adobe Acrobat, download it for free on the Adobe website (https://get.adobe.com/reader).
Emphasize ICD-10 Coding Under PDPM, Experts Say
Skilled Nursing News (1/23, Flynn) reports that under the Patient-Driven Payment Model (PDPM), "ICD-10 codes will form the basis of reimbursements, making it crucial for SNFs to have accurate coding," according to experts. While "ICD-10 procedure and diagnosis codes number in the tens of thousands, making them a daunting training task.” According to Mike Cheek, Senior Vice President of Reimbursement Policy at the AHCA, providers need to train their billing teams "on what they need to know" and not the full scope of the details. The piece adds that the AHCA has developed "ICD-10 diagnosis code training for its members" as a resource, providers can utilize. Maine Healthcare Association, in partnership with AHCA is working to support of members with this transition by offering a one-day intensive training session with accompanying tools and ongoing remote support calls to follow. This event is scheduled for April 17th in Augusta, Maine.
*New* electronic system for provider reimbursement review board appeals
In a January 18, 2019 MLN Matters Article, the Centers for Medicare and Medicaid Services (CMS) promotes the use of a new electronic system for provider reimbursement review board appeals. The new system, the Office of Hearings Case and Document Management System (OH CDMS) went live on August 16, 2018. CMS encourages Part A providers such as SNF to learn more about the benefits of using OH CDMS by attending the upcoming MLN event. Register for the New Electronic System for Provider Reimbursement Review Board Appeals Call scheduled for Tuesday, February 5 from 1:30 to 3 pm ET. The PRRB gives Medicare providers an independent forum for resolving Medicare Part A reimbursement disputes. The PRRB publishes its rules, current alerts, final substantive decisions, and many jurisdictional decisions on the PRRB website.
Director of Quality Improvement & Regulatory Affairs