Posts Tagged ‘AHCA quarterly report’

2013 Year in Review: Home Care Regulations and Advocacy

December 27, 2013

2013 was an eventful year within the legal and regulatory realms for home care providers at both the state and federal level. Along the way, HCAF has fought to best represent our members in advocating for the best regulatory environment possible. Below are the most significant developments from the legal and certain regulatory issues from this past year:

1.  HCAF successfully advocates to reduce Florida quarterly report fine from instant $5,000 to $200 per day until $5,000 limit

Until July of this year, all home care providers licensed in Florida were required to complete a quarterly report to be submitted to the Agency for Health Care Administration (AHCA) in order to help curb Medicare and Medicaid fraud. Even agencies who were not Medicare or Medicaid certified were required to complete this report. The penalty for submitting the report even one day late was an instant fine of $5,000 to the agency; a significant amount. Over the years, AHCA had collected over $6.3 million from this fine alone.

HCAF worked with our friends in the legislature, Senator Anitere Flores and Representative Jose Felix Diaz in order to pass a bill that would reduce the fine from $5,000 to $200 per each day the report is late in being submitted with a cap of $5,000. In addition, this bill spared non-Medicare and Medicaid certified providers from needing to answer the report any longer. This was a huge success for the industry in Florida and we could not have done it without our member’s efforts in joining us on our Tallahassee Legislative Days to lobby the legislature for their support.

2. Obama Administration delays the start of the employer mandate provisions of the health care reform law

Responding to the pleas of thousands of small businesses in home care and otherwise, President Obama moved the effective date of the ACA provision mandating that companies either provide health insurance to their full-time employees or pay significant monetary penalties. A NAHC study showed that the vast majority of home care companies, particularly those that provide Medicaid and private pay services, do not currently provide all full-time workers with health insurance.  HCAF has advocated for the delay, explaining to administration officials that care access would be significantly jeopardized by these requirements. Furthermore, we continue to advocate to change the definition of a full-time employee be raised from an employee that works 30 hours per week to 40 hours per week.

3.   US Department of Labor issues final rule on the companionship services overtime exemption

After maintaining a consistent policy for over 37 years, the US Department of Labor completely changed its interpretation of the Fair Labor Standards Act and revised the “companionship services” exemption from minimum wage and overtime compensation. The longstanding rule had been successfully defended by NAHC twice at the United States Supreme Court. The new rule redefines companionship services to virtually eliminate any potential application in home care by removing personal care as a central part of “companionship services.” Additionally, DoL eliminated any application of the remaining exemption to workers employed by third parties such as home care agencies. HCAF and NAHC are evaluating a lawsuit to challenge the changes while working to get payers such as Medicaid to cover any new costs.

4.   CMS Issues Home Health Rate Rebasing Rule

The Centers for Medicare and Medicaid Services (CMS) issued the Final Rule setting out payment rates for home health services in 2014. This rule includes the start of the 4-year rate rebasing required under the Affordable Care Act. CMS reduces the base episode rate by the equivalent of 3.5% of 2010 rates while increasing LUPA per visit rates by 3.5%. The Final Rule was a modest improvement over the proposed rule due to a recalibration of case mix weights and a reduction of the amount of the rate cut. HCAF continues to pursue revisions to the rebasing rule through Congress and potential litigation.

5.   Moratorium on New Home Health Agencies in Certain Areas Instituted

CMS applied the authority it was given under the ACA to establish moratoria on new home health agencies for the first time in Miami-Dade County and an area around metropolitan Chicago. It is expected that the six month moratoria will be extended another six months in both locations in 2014, and that CMS may add other geographic areas as well. HCAF supports the institution of this moratorium in helping the fight against fraud in our industry, but we do believe there are several other places in the country that would benefit from a freeze on new agencies as well.

6.   CMS Initiates Post-Acute Care Bundling Demonstrations

As the first big step towards innovation in Medicare payment policy directly affecting home health services, CMS approved, for Phase 1, a series of bundling proposals for post-acute care. These proposals including bundling with hospitalization payment and post-acute care only.

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Reminder: Home Health Quarterly Reports are Due to AHCA by October 15th

September 18, 2013

Home health agencies must submit a quarterly report by October 15th to the Florida Agency for Health Care Administration, otherwise non-compliant providers will be fined!
Keep in mind that HCAF successfully lobbied for the passage of Senate Bill 1094 which exempted some home health agencies, who meet certain criteria, from submitting the Quarterly Report. See AHCA’s Frequently Asked Questions to see if you are exempt. Fines were also reduced to $200 per each day late up to a maximum of $5,000 effective July 1, 2013.
By law, agencies must report the following information based on the agency’s patient census as of September 30, 2013:

  • Number of insulin-dependent diabetic patients receiving insulin injection services
  • Number of patients receiving home health services from the home health agency AND a licensed hospice provider
  • Total number of patients receiving home health services
  • The names and license numbers of nurses (RN’s or LPN’s) whose primary job responsibility is to provide home health services to patients and received remuneration in excess of $25,000 for the three months of the quarter

Providers can submit reports anytime between Oct. 1 and Oct. 15. For more information and instructions for submitting the report, click here to access the AHCA website or call the HCAF office at (850) 222-8967 or the AHCA Home Care Unit at (850) 412-4403.

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AHCA Announces Changes to the Quarterly Report Effective July 1

June 20, 2013

Following HCAF’s successful efforts to reform the AHCA Home Health Quarterly Report, the Agency has announced changes to the reporting requirement that will go into effect on July 1. The report originated with the 2008 legislative session as a measure to combat health care fraud and abuse. The changes affect the amount of the fine owed for late submissions and which home health agencies are required to report.

Fines Reduced

The fine amounts have been reduced to $200 per day for each day the report is late up to a maximum of $5,000. (more…)

Legislature Passes Budget, Increases Home Health Reimbursement for First Time Since 1987

May 3, 2013

FL capitolThe Florida Legislature adjourned today by passing a $74.2 billion budget for the 2013-14 fiscal year, which runs July 1, 2013 through June 30, 2014. Major components of the state’s largest ever budget includes raises up to $3,500 for public school teachers, money for Florida Forever’s land-conservation program and to protect the state’s springs, increased funding for public universities and state colleges, as well as the first Medicaid home health reimbursement rate increase in 26 years. (more…)

Quarterly Report Reform Bill Passes Florida Legislature

May 3, 2013

After two years, multiple committee stops and countless hours of advocacy in Tallahassee, HCAF is very excited to announce that the quarterly report reform bill passed the Florida House of Representatives this morning by a vote of 115-0. The bill will now be presented to Gov. Rick Scott within seven days to sign it into law, and it will go into effect on July 1, 2013.

What does this bill do for me? (more…)

Quarterly Report Bill Passes Florida Senate 34-0

April 26, 2013

With five days to go in the Florida Legislative Session, HCAF’s bill to reduce the quarterly report fine and exempt private duty providers passed the Senate this morning 34-0. The bill will be voted on in the House of Representatives next week, after which it will go to Gov. Rick Scott for his signature.

Lawmakers are now crafting the budget, so now is the time to contact them to urge their support for increasing reimbursement rates! Click here to take action!

Legislative Session Winding Down: Ask Lawmakers to Support Home Care!

April 18, 2013

The Florida Legislature will adjourn its annual legislative session on May 3, and lawmakers are currently preparing the 2013-14 budget. Medicaid home health reimbursement rates have not increased since 1987, and this is the first year in a handful of years that state revenues are in the black.

HCAF has proposed a 50% increase for Medicaid home health visits and a 15% increase for Medicaid private duty nursing services. The cost to the state is $9,136,110 – no small number, but the savings that home care can provide to the state far exceeds that figure. (more…)

Quarterly Report Reform Bill Clears Legislative Committees

April 18, 2013

This morning, HCAF’s quarterly report reform bill unanimously passed its final committee stop in the Florida Legislature. The bill now proceeds to the floor of the Senate and House of Representatives, its two final stops before going to Gov. Rick Scott for signature. If passed into law, the bill will reduce the quarterly report fine from $5,000 to $200 per day up to $5,000 per quarter and exempt private duty agencies.

Now is the time to get your lawmakers’ support for this critical bill! Click here to send your lawmakers an email encouraging their support.

Week 6 Legislative Session Update: A Good Week for Home Care

April 11, 2013

250px-TallahasseeOldNewCapitals3The sixth week of the Florida Legislative Session is coming to a close with some positive updates for the home care industry.

First, the home health quarterly report bill unanimously passed the House Health Care Appropriations Subcommittee, its third of five committee stops, getting the bill even closer to becoming law. If enacted, the quarterly report fine would be reduced from $5,000 to $200 per day up to $5,000 per quarter, and exempt private duty providers from filing the report all together. Click here to send a message to Florida lawmakers urging them to support the quarterly report reform legislation!

In addition to the quarterly report bill, the Senate unanimously passed a $74.3 billion budget for the 2013-14 fiscal year and includes a 10% increase for Medicaid home health visits and private duty nursing visits provided by a licensed practical nurse. HCAF is seeking a 50% increase for the Medicaid home health visits provided by a registered nurse and LPNs, as well as a 15% increase for PDN visits provided by an LPN. Now that the Senate has passed its budget, the House will follow suit and both chambers will meet to negotiate the final spending plan. HCAF will continue its lobbying efforts to achieve a 50% increase for home health visits and 15% for PDN visits.

Quarterly Report Bill Passes Senate Committee

April 3, 2013

Sen. Flores

This Wednesday HCAF’s home health quarterly report reform bill passed its first of two committee stops in the Florida Senate. The bill seeks to reduce the fine for late reports from $5,000 to $200 per day up to $5,000 per quarter and exempt licensed-only (private duty) providers. (more…)