Nursing Facility Policy Alert

December 4, 2009

RECENT RATE LETTERS CONTAIN AN ERROR

DHMH has informed LifeSpan that recent rate letters that were effective December 1, 2009 contain incorrect information.  New rate letters are being mailed out.  Please disregard any rate letters that you have received or that you may receive unless the rate letter states "Corrected."

SURVEY RESPONSES NEEDED BY DECEMBER 20th - DON'T FORGET!

As legislators begin to debate the FY2011 budget, we need to ensure that the full fiscal picture is being taken into account. Not only are nursing facilities facing unprecedented State and federal cuts in Medicaid and Medicare, but these cuts are exacerbated by delays in Medicaid eligibility and non-payment of services as a result of residents being determined ineligible or residents/families not assisting in the eligibility process. Not only does LifeSpan intend to use this information to quantify the fiscal impact on nursing facilities but also to seek changes in the law to assist nursing facilities in addressing non-payment and discharge issues. Please take a few minutes and complete this survey. Click HERE to download the survey. (Remember, member log-in is "quality").

MEDICAID ELIGIBILITY UPDATES:

• ELIGIBILITY MEETING:  On December 15th from 2 PM - 4 PM, LifeSpan will be hosting a Medicaid Eligibility meeting with HFAM for all providers.  This meeting will focus on the issues related to the new Bureau of Long-Term Care Eligibility.  Adrienne Warren, Director, and Patrice King, Assistant Director, will be in attendance.  You must register for the event.  The event is being held at the HFAM offices at 7135 Minstrel Way, Suite 104, Columbia, Maryland.  Space is limited.  Please email Danna Kauffman at dkauffman@lifespan-network.org if you would like to attend.
• BUREAU CONTACT INFORMATION:  The Bureau has released its address, fax number, phone numbers and email addresses for all caseworkers assigned to the Bureau.  Information is posted on the LifeSpan website by clicking HERE.  The Bureau is also in the process of assigning facilities to individual caseworkers.  When that process is complete, LifeSpan will send out the listing to our members.
• STUCK CASE PROCESS MUST BE FOLLOWED:   This past summer, DHR realized a new process for handling "stuck cases."  A stuck case is a case where an outstanding eligibility decision exists on an application or redetermination for LTC medical assistance.  AT09-33 articulates the procedure for implementing this process.  Transmittal A9-033 can be downloaded HERE.  PLEASE do not send inquiries on case status unless you have invoked the stuck case process.  Providers that have used the stuck case process report success with it. 
• REDETERMINATIONS:  LifeSpan understands that the process for redeterminations has slowed considerably within the last few months and is affecting cash flow at facilities.  In addition to the stuck case process, LifeSpan is having conversations at the Secretary's level at DHR and DHMH to rectify this situation and get these cases approved in an expedited manner. 

OHCQ DELAYING QIS TRAINING FOR REMAINING SURVEY TEAMS 

OHCQ has reported that it plans to delay QIS training for the remaining survey teams on the Eastern Shore and Montgomery County until September of 2010.  OHCQ states that CMS has informed them that an upgrade to the software is to occur next year, which will hopefully solve the software glitches that are being experiened.  Team Four recently completed the training and is now conducting QIS - Western Maryland and Prince George's County.

MEDICAID RELEASES TRANSMITTAL No. 224 and 225; ADDITIONAL INFO. ON iEXCHANGE

Prior to the holiday, Medicaid released several transmittals - all of which can be found on the LifeSpan website. Click HERE.

• Transmittal No. 224 revises instructions for the use of Form 259.
• Transmittal No. 225 mandates the use of iExchange when seeking a Medicaid eligibility determination for long-term care facility or home or community based services when a nursing home or chronic care level is mandated. This new mandate goes into effect March 1, 2010 rather than the earlier February 1^st date. There is a training session on December 17^th at 11:00 AM on the use of iExchange. To register, contact Janis Grady at jgrady@kepro.org.

In addition, please note that as of December 1^st, KePro will no longer be sending fax confirmations on MERs submitted via iExchange. To check the status, you will need to examine the notes section of iExchange.

FYI - STATE AGENCIES SUBMIT PROPOSED REGULATORY CHANGES

• The Department of Health and Mental Hygiene has proposed regulations changing the circumstances for requesting a fair hearing under the Medicaid program;
• The Board of Pharmacy is circulating for informal comment regulations concerning pharmacy services in a comprehensive care facility; and
• The Board of Examiners for Nursing Home Administrators has submitted proposed regulations affecting fees, continuing education and carry over hours, requirements of a preceptor and the AIT program. 

LifeSpan is analyzing the regulations and will provide additional information to the membership.  If the meantime, if you would like a copy of any of the above-referenced regulations, please contact Danna Kauffman at dkauffman@lifespan-network.org. 

DON'T FORGET LIFESPAN'S ANNUAL HOLIDAY OPEN HOUSE

DECEMBER 9TH, 2:00 - 5:00 PM

COME CELEBRATE THE HOLIDAYS WITH US!

RSVP to Lisa Fichman at lfichman@lifespan-network.org

 

AS ALWAYS, THANK YOU FOR YOUR MEMBERSHIP!