Archive for the ‘Medicaid’ Category

HOME CARE INDUSTRY PLEDGES SUPPORT FOR FLORIDA MEDICAID EXPANSION

April 21, 2015

HCAF Logo
PRESS RELEASE
April 21, 2015
For Immediate Release
Contact: Leanne Norr
(850) 222-8967
LNorr@homecarefla.org

HOME CARE INDUSTRY PLEDGES SUPPORT FOR FLORIDA MEDICAID EXPANSION

HCAF Urges Governor, Legislature to Act Swiftly


TALLAHASSEE, FL- 
On April 2nd, The Florida Senate passed the Florida Health Insurance Affordability Exchange Program that would accept federal funds under the Affordable Care Act to establish a state-run private insurance exchange for low-income residents. The Home Care Association of Florida, representing more than 2,000 licensed home health agencies that serve more than 150,000 Floridians on any given day, strongly supports the proposed plan to expand Medicaid in Florida.

HCAF President, Anthony Clarizio, made the following statement:

 

“Expanding Medicaid to 800,000 state residents who have jobs but cannot afford health coverage is not only a moral imperative, but is the only viable option to address basic health care for those who need it most.

 

“The home care industry, which provides care for 150,000 Floridians per day, plays an integral role in giving expanded quality care to an ever-growing population, all while saving the state money. Caring for patients at home is not only more cost-effective than institutional care, but also decreases hospital readmission rates. Expanding Medicaid would mean that home care providers could service more patients, saving both the government and patients millions of dollars.  

“Florida’s home care agencies are prepared to provide cost-effective, high-quality care to this expanded Medicaid population. The Home Care Association urges lawmakers to put partisan politics aside and provide the support our patients so desperately need.”   

Home Care providers across the Sunshine State also speak out in support of Medicaid expansion:

“Our company performs large percentage of personal care visits in the home for Medicaid patients in the statewide Long Term Care program. The insurance companies involved have reduced prices but assured the quality remains the same. With that reality, Medicaid in Florida has earned the right to grow. Through our company we have seen how expanding Medicaid will save money over all, and we support it.”

-Sean Schwinghammer, Director of Legislative Affairs & Business Development, Caring Home Care

“Medicaid expansion for the State of Florida will increase access to quality care for thousands of under-served Floridians. It is in the best interest of our state to consider Medicaid expansion as a viable option to allow for improving our overall community health and wellness and allow Medicaid patients to receive care support services in the comfort of their own homes.”

               -Bobbie D’Angola, Executive Management, United HomeCare

“Expanding Medicaid in Florida would not only mean that my agency could expand and thrive, but it would also mean that the overall quality of care for patients would increase. In an industry already stifled by government red tape and costly regulations, expanding Medicaid would be a step towards providing the relief our home care agency so desperately needs. There are not enough providers in the state to meet the needs of this under-served population and by expanding Medicaid the patients would receive the care they need. Patients deserve to be at the center of health care in Florida. Expanding Medicaid would significantly increase access to more patients right in the comfort of their own homes.”

-Denise Bellville, RN, SVP of Operations, Comprehensive Home Care

Background on Home Health and Medicaid:

  • AARP reports that on average, the Medicaid program can provide home and community-based long term care services(HCBS) to three people for the cost of serving one person in a nursing home.
  • AARP reports that states that invest in HCBS, over time, slow their rate of Medicaid spending growth, compared to states that remain reliant on nursing homes.

Click here for HCAF’s 2015 Legislative Priorities, including telehealth expansion and expanding prescription practices for ARNPs.

About HCAF

The Home Care Association of Florida is the #1 resource & advocate for Florida’s home care industry & patients, representing more than 2,000 licensed home health agencies that serve more than 150,000 Floridians on any given day right in the comfort of their homes. HCAF was founded in January 1989 & is a non-profit trade association that offers representation, communication & advocacy for providers, and gives them the information they need to deliver the highest quality & most cost-effective services to patients throughout the Sunshine State.

About Home Care

Home care encompasses a wide range of health and social services delivered at home to recovering, disabled, chronically or terminally ill persons in need of medical, nursing, social, or therapeutic treatment and/or assistance with the essential activities of daily living. Generally, home care is appropriate whenever a person prefers to stay at home but needs ongoing care that cannot easily or effectively be provided solely by family and friends.

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Judge Strikes Down New Companionship Services/Overtime Rule in Huge Win for Home Care Patients and Providers

January 14, 2015

Today, the U.S. District Court for the District of Columbia struck down the new Companionship Services/Overtime rule in a triumphant win for patients, staff, and providers of home health care. This ruling completely invalidates the rule, allowing for the current practices of payment for workers to remain in place indefinitely. This lawsuit which was strongly supported by HCAF and lead by the National Association of Home Care and Hospice was crucial to making sure patients would continue to be able to afford high-quality home care, as well as necessary for state budgets to be able to continue providing Medicaid home health. Your membership in associations like HCAF and NAHC is what allows us to advocate on your behalf on critical issues like this one, therefore we thank our members for their continued support and encourage all others to join today.

Please read the press release from NAHC below for details on the case. It is unclear if the Department of Labor will file an appeal on this ruling, but for now, we are celebrating this fantastic success!

NAHC, along with Home Care Patients and Caregivers, Wins Huge Victory: Federal Court Rules to Strike Down Controversial New Overtime Rule

The National Association for Home Care & Hospice (NAHC) and its members today celebrated the decision of the U.S. District Court for the District of Columbia invalidating a proposed new U. S. Department of Labor (DOL) overtime rule slated to take effect on January 1, 2015.

“This decision is a huge victory for patients and their families who will be able to continue receiving home care services without interruption. The decision is a huge victory for caregivers who will continue to be protected instead of being forced to work only part time. The decision is likewise a huge victory for the agencies that serve patients and employ caregivers, and who will see continuity in a rule that has been in effect for 40 plus years and had recently been sustained by the U.S. Supreme Court. Finally, the decision is a huge victory for the states and the federal Medicaid program.” said Denise Schrader, chairman of the NAHC Board.

This is the third victory in this lawsuit for home care interests within the last month. On December 22, the court ruled that patients are entitled to equal rights regardless of whether they or their families paid their home care bills or they were paid by the joint, federal-state health insurance program, known as Medicaid. On December 31, the court ruled for NAHC by agreeing to issue a Temporary Restraining Order (TRO) blocking the DOL from enforcing new rules related to “companionship” and “live-in” care. On January 9, the court, in considering a motion from NAHC attorneys for an injunction to block enforcement of residual parts of these rules through this date or a trial, stated that so much evidence was in the record there would be no need for a trial. The judge therefore agreed to give his decision on the case on or by January 14, when the TRO was set to expire. Today, the judge ruled for NAHC and home care interests, saying the proposed new DOL rules violated the law.

The DOL has not announced whether it will appeal this decision to U.S. Court of Appeals. NAHC President Val J. Halamandaris, stated “The home care community is prepared to defend this case before the higher court. We fought this case once before and took it all the way to the U.S. Supreme Court where we won by a unanimous vote of 8-0. We are prepared to do this again if we need to do so.”

“The victory in the case proves the power of unity,” said Halamandaris. “United, fighting on behalf of the aged, infirm, disabled, and dying, we cannot lose; divided we cannot win.” He also thanked Bill Dombi who helped lead the strategy in this case, the International Franchise Association and the Home Care Association of America which joined in the litigation and the law firm of Littler Mendelson which had been hired to bring the suit.

To read the decision, click here: https://ecf.dcd.uscourts.gov/cgi-bin/show_public_doc?2014cv0967-32

HCAF will continue to keep members up to speed on all the latest developments as they occur. We will be keeping a log of the events, marked with dates at the link below for members.

Click here for more details on the lawsuit and a log of the most recent events.

P.S. With all of these changes happening very quickly, we strongly suggest members attendHCAF’s 2015 Winter Mini-Conference in Ft. Lauderdale, January 21-22. There is so much change occurring at a rapid pace, that HCAF feels it is imperative that we offer an educational event to supplement our Annual Conference and offer increased learning opportunities, on important topics such as this, more often throughout the year. Registration is still open, but space is filling fast!

Click here for more details on HCAF’s 2015 Winter Mini-Conference and make sure to register today!

OIG Exclusions & Sanctions Listing Updated for August

August 9, 2013

HCAF has posted the latest exclusion and reinstatements that were released by CMS’ Office of the Investigator General (OIG) on August 8, 2013. The list includes physicians and other provider types in Florida.

Health care providers must be careful not to make payments to sanctioned entities or employ sanctioned individuals. No payment will be made by any federal health care program for any items or services furnished, ordered, or prescribed by an excluded individual or entity. Federal health care programs include Medicare, Medicaid, and all other plans and programs that provide health benefits funded directly or indirectly by the United States.

The basis for exclusion includes convictions for program-related fraud and patient abuse, licensing board actions and default on Health Education Assistance Loans.

Please compare your referring physicians, employees or vendors against the listing of excluded individuals.

Click here to access the updated OIG list.

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CMS Fraud Prevention Symposium: Sept 25, 2013

August 9, 2013

HealthCareFraudThe Centers for Medicare & Medicaid Services is hosting a Health Care Fraud Prevention Symposium on Wednesday, September 25, 2013 in the Tampa / St. Petersburg area. Participants will hear from leaders of the CMS Center for Program Integrity about goals for detecting and combatting Medicare and Medicaid fraud. In addition, attendees will learn about the roles played by CMS contractors and the State Medicaid agency including Medicare Administrative Contractors (MACs), Zone Program Integrity Contractors (ZPICs) and the Medicaid Program Integrity Unit. Members of the Office of Inspector General (OIG , the Department ) of Justice (DOJ) and the State Medicaid Fraud Control Unit will provide up-to-date information on law enforcement trends in healthcare fraud.

To register for the Tampa / St. Petersburg meeting, go to: http://healthcarefraud-tpa.eventbrite.com

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Medicaid’s Elder Experiment Begins

August 1, 2013

By 

Florida’s statewide Medicaid managed-care gamble gets officially under way on Thursday, beginning with thousands of the state’s most vulnerable clients: low-income seniors too sick to get by without help.

If all goes according to plan, taxpayers will save money and frail elders will get preventive and well-coordinated care. They’ll have the medical and social support they need to remain in their own homes or in the community, rather than in a nursing home. (more…)

Sun-Sentinel: Get Disabled Children Out of Nursing Homes

July 29, 2013

South Florida Sun-Sentinel Editorial

If Pearl Buck was right, and “the test of a civilization is the way that it cares for its helpless members,” Florida got a failing grade this week.

The U.S. Justice Department filed suit Monday against the state, accusing it of violating the federal Americans with Disabilities Act by failing to do enough to keep children with disabilities in Florida from being sent for care to nursing homes for the elderly. The department’s lawsuit called it “deliberate indifference to the suffering” of those children.

The head of the Florida Agency for Health Care Administration, Liz Dudek, called the lawsuit “disruptive” and accused Washington of wanting to take over the state’s Medicaid and disability programs. Seriously?

The Justice Department says it spent six months investigating the plight of disabled kids in Florida nursing homes before calling on the state last September to do more to give their families the option of care at home or in community-based settings. The department filed suit after concluding that it couldn’t count on the state to comply voluntarily. (more…)

Humana to Buy Key Player in Florida’s Medicaid Program

July 26, 2013

TALLAHASSEE — As the state prepares to move forward next month with shifting thousands of elderly Floridians into Medicaid managed-care plans, Humana Inc. is buying a major player in the program.

Humana said Wednesday it has reached an agreement to acquire American Eldercare Inc., which has received contracts to provide long-term care under Medicaid to seniors throughout the state. American Eldercare also has been the largest provider in the state’s longstanding “nursing-home diversion” program. (more…)

Feds Sue Florida for Keeping Kids in Nursing Homes

July 22, 2013

The Associated Press reported today that the U.S. Justice Department is suing Florida, saying the state is unnecessarily keeping hundreds of disabled children in nursing homes.

According to the lawsuit filed Monday, federal officials visited six nursing homes throughout the state and identified about 200 children who didn’t need to be there and could receive care at home. (more…)

CMS: Demand Letters to Medicare Providers & Suppliers Associated with an Item or Service Provided to Incarcerated Beneficiaries

July 17, 2013

The “no legal obligation to pay” exclusion (see section 1862(a)(2) of the Social Security Act and 42 CFR 411.4) generally prohibits Medicare payment under Part A or Part B for individuals who are in custody of penal authorities. Individuals who are in custody include, but are not limited to, individuals who are under arrest, incarcerated, imprisoned, escaped from confinement, under supervised release, on medical furlough, required to reside in mental health facilities, required to reside in halfway houses, required to live under home detention or confined completely or partially in any way under a penal statute or rule.

Before Medicare can make payment for any prisoners’ (or for any patients under a government agency’s custody) medical services, all three of the conditions set out below must be met first: (more…)

OIG Exclusions & Sanctions Listing Updated for July

July 12, 2013

HCAF has posted the latest exclusion and reinstatements that were released by CMS’ Office of the Investigator General (OIG) on July 10, 2013. The list includes physicians and other provider types in Florida.

Health care providers must be careful not to make payments to sanctioned entities or employ sanctioned individuals. No payment will be made by any federal health care program for any items or services furnished, ordered, or prescribed by an excluded individual or entity. Federal health care programs include Medicare, Medicaid, and all other plans and programs that provide health benefits funded directly or indirectly by the United States. (more…)