Federal News and Information

 

Office of Inspector General (OIG)

During 2022, the OIG Office of Audit Services will perform a nationwide review of hospice eligibility, focusing on those hospice beneficiaries that haven’t had an inpatient hospital stay or an emergency room visit in certain periods prior to their start of hospice care.  No further information is available at this time.

 

Health and Human Services

 

Office of Assistant Secretary for Preparedness and Response

Renewal of Determination That A Public Health Emergency Exists

The Secretary of Health and Humans Services Xavier Becerra renewed the public health emergency, effective January 16, 2022.  To review, go to:  https://aspr.hhs.gov/legal/PHE/Pages/COVID19-14Jan2022.aspx or https://www.phe.gov/emergency/news/healthactions/phe/Pages/default.aspx#:~:text=Public%20Health%20Emergency%20Declarations%20Title,%E2%80%8BAugust%2030%2C%202021%2018%20more%20rows%20.

 

Centers for Medicare and Medicaid Services (CMS)

 

TNMHO would like to remind membership of the following:

QSO–20-09-ALL Guidance for the Interim Final Rule – Medicare and Medicaid Programs; Omnibus COVID-19 Health Care Staff Vaccination applies to you!  Within this QSO there is a link to the CMS website where you will find the new 42 Code of 418.60 Conditions of Participation:  Infection Control.  Please take this seriously as Conditions of Participation deficiencies carry serious penalties when you are found out of compliance!  Any questions regarding religious exemptions should be referred to an attorney.  To access the QSO, rules, guidance and survey expectations, go to:  https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/guidance-interim-final-rule-medicare-and-medicaid-programs-omnibus-covid-19-health-care-staff-1 .

Vaccine due dates are:

  • New Mexico: First vaccine due January 27, 2022 and second vaccine due February 28, 2022
  • Texas: First Vaccine due February 22, 2022 and second vaccine due March 21, 2022

 

Reminders

 

Free N95 Masks

The Biden administration announced last week that N95 masks will be distributed to pharmacies and community health centers. Find specific manufacturer’s instructions for your N95 model on the CDC website. https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/free-n95-manufacturers.html

 

 

 

Free At-Home, Rapid COVID-⁠19 Tests

As reported in last week’s COVID-19 update, American households can request free rapid COVID-19 tests online at: https://www.covidtests.gov/.

Palmetto

 

Amendments have been made to the Medicare Program Integrity Manual Chapter 3 Verifying Potential Errors and Taking Corrective Actions.  Areas covered are:  Amendments, Corrections and Delayed Entries in Medical Documentation and Recordkeeping Principles.

Entries in Medical Records: Amendments, Corrections and Addenda

Entering information into patients’ medical records in a timely manner is important for many reasons. The Centers for Medicare & Medicaid Services (CMS) provides some guidance regarding what is considered timely for Medicare purposes.

 

We strongly encourage all health care providers to enter information into the patient’s medical record at the time the service is provided to the patient — that is, contemporaneously (meaning existing, occurring, or originating during the same time).

 

CMS recently published established recordkeeping principles to provide further guidance regarding the timeliness of entries in medical records. These principles apply to all Medicare contractors that review medical records, including Medicare Administrative Contractors (MACs), the Comprehensive Error Rate Testing (CERT) review contractors, Recovery Audit Contractors (RACs), and Unified Program Integrity Contractors (UPICs). In all cases, regardless of whether the documentation is maintained or submitted in paper or electronic form, any medical records that contain amendments, corrections, or addenda must:

  1. Clearly and permanently identify any amendment, correction or delayed entry as such
  2. Clearly indicate the date and author of any amendment, correction, or delayed entry
  3. Not delete, but instead, clearly identify all original content

For paper medical records:

  • Making corrections, in keeping with these principles, generally entails using a single line strike-through so the original content is still legible
  • The author of the alteration must sign and date the revision
  • Amendments or delayed entries must also be signed and dated by the author upon entry

For electronic medical records:

  • Amendments, corrections and delayed entries must be distinctly identified as such
  • The record must provide a reliable means of clearly identifying the original content, the modified content, and the date and author of each modified record

Medicare contractors, including Palmetto GBA, cannot consider entries in medical records that do not comply with the established recordkeeping principles described above. For example, we must disregard undated or unsigned entries handwritten in the margins of a document.

 

Reference: CMS Change Request 8105 which updates the CMS Program Integrity Manual (Pub. 100-08), Chapter 3, section 3.3.2.5. : https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R442PI.pdf

and  https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/pim83c03.pdf.  

 

Hospice Medical Necessity Tips for Medical Record Review

When a beneficiary’s record is selected by a Medicare contractor for review, it is the responsibility of the hospice provider to demonstrate in the documentation that the services rendered and billed were medically necessary. In the case of hospice, this means that the documentation should show that the individual has a medical prognosis that his or her life expectancy is six months or less if the illness runs its normal course. Here are some tips to accomplish this. For more information, go to:  https://palmettogba.com/palmetto/jmhhh.nsf/DID/9UNMPGR5MI#ls  and https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/bp102c09.pdf .

 

 

 

New Mexico News and Information

 

Department of Health

 

POLICIES FOR THE PREVENTION AND CONTROL OF COVID-19 IN NEW MEXICO

The purpose of this document is to provide the most current guidance for the public, healthcare providers, and employers who may be involved in a COVID-19 public health investigation or have general questions about what to do if they or someone they know tests positive for COVID-19 or may have been exposed to someone who has COVID-19.  This guide:

  • Sets forth the New Mexico Department of Health (NMDOH) policies for containing and preventing COVID-19 throughout New Mexico.
  • Provides a basic overview of key containment policies. Additional technical resources for healthcare providers, NMDOH staff

The State of New Mexico published All Together New Mexico, a guide for individuals and businesses on COVID Safe Practices. That guide is an important additional resource, especially for employers.

Both documents will be updated as needed.  To access, go to:

 

Texas News and Information

 

Health and Human Services Commission (HHSC)

 

Visitation Reminder for Long-term Care Providers

This alert reminds assisted living facility, intermediate care facility, nursing facility, and inpatient hospice providers that all visitations must be allowed.  Essential caregiver and end-of-life visits must be allowed for all residents with any COVID-19 status.  A facility or agency may be cited if visitation is not allowed.  Review visitation rules:

 

Providers please check the list as it is a new updated listing of providers who do not comply!

SB 809/Rider 143 COVID-19 Reporting

The Health and Human Services Commission is posting the list of healthcare institutions who must submit reports in compliance with Senate Bill 809 or Rider 143. The list shows providers who haven’t submitted a SB 809 / Rider 143 Report as well as those HHSC staff are helping complete the report.  The list can be found on the Provider Finance website under SB 809/Rider 143 COVID-19 Reporting Healthcare Institution List. This list was updated Jan. 10 and covers January 2020 – October 2021.

 

HHSC has authority to pursue disciplinary actions for facilities that fail to report. The health and safety of those we serve is always our top priority.

 

SB 8, from the 2021’s third special session, authorizes grants to rural hospitals, nursing homes, home health agencies, intermediate care facilities and community attendants from the Coronavirus State Fiscal Recover Fund, established under the American Rescue Plan Act. We are required to prioritize grants to grantees who are compliant with the reporting requirements identified above. Failure to submit reports required by Senate Bill 809 or Rider 143 could limit the funding a provider may receive from the grants or disqualify them completely.

 

Providers must submit this form, which includes funding and cost data covering the period January 2020 through August 2021. Providers must also submit this monthly form every month. The reports are due one month after the reporting period ends (for example, the report for December 2021 data will be due Feb. 1).

 

To access reporting information, go to:

Reach out to provider finance if you have questions or cannot rectify any information provided to you.

 

COVID-19 Cases Continue to Rise – Guidance for LTC Providers

COVID-19 cases continue to increase across Texas. HHSC reminds providers to follow the guidelines listed below and ensure their emergency plan is up to date. Staff must be aware of what to do in the event of any sort of emergency, including an outbreak of flu or COVID-19.

 

Please review the following rules, guidelines and policies:

  • COVID-19 mitigation and visitation rules for your provider type
  • Any applicable COVID-19 response plans for your provider type
  • Your organization’s infection prevention and control policies

All provider types must continue to screen residents, clients, staff and visitors for signs and symptoms of COVID-19.

 

Staff for all provider types must continue to use appropriate personal protective equipment (PPE) as outlined under: https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control-recommendations.html.

 

Where required by rules for your provider type, providers must continue effective cohorting of residents based on COVID-19 status.

 

Find COVID-19 resources for your provider type online:

Your maintaining vigilance in following infection control requirements makes a difference in protecting vulnerable Texans.

 

LTC providers are always required to provide services to residents before, during and after any emergency. Your organization’s emergency plan or policy must include:

  • Planning for staff shortages
  • Back-up plans to ensure operations and care of residents or clients continues

 

Read program-specific rules related to staffing, emergency preparedness and infection control:

  • Assisted Living Facilities
  • Day Activity and Health Services Facilities
  • Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions
  • Home and Community-based Services
  • Home and Community Support Services Agencies
  • Nursing Facilities
  • Prescribed Pediatric Extended Care Centers
  • Texas Home Living

To access specific program COVID information, go to:  https://www.hhs.texas.gov/providers/long-term-care-providers.

 

The U.S. Department of Health and Human Services has developed a COVID-19 Healthcare Planning Checklist (PDF) that you can use to assist you in creating a plan for dealing with an outbreak of flu or COVID-19.  Go to:

https://www.phe.gov/Preparedness/COVID19/Documents/COVID-19%20Healthcare%20Planning%20Checklist.pdf.

For questions, email LTCR Policy at:  [email protected]

 

HCSSA Response to COVID-19 Emergency Rules Extended

HHSC Long-term Care Regulation has extended the HCSSA Response to COVID-19 Emergency Rules.   The rule extension is effective Jan. 23 and will expire on March 23, 2022.  To access the rules, go to: https://www.hhs.texas.gov/sites/default/files/documents/govdelivery/hcssa-emergency-rules.pdf.   The emergency rule covers:  PPE, screening of staff, patients and families/caregivers, documentation of screenings, essential and non-essential visits, documentation on missing visits and supervisory visits.

 

Certified Nurse Aide (C.N.A) Backlog Update

HHSC staff continues to work on the C.N.A. back log for the processing of renewals.  The Governor’s waiver is still in effect which allows C.N.A.s to work beyond their expiration while the paperwork is processing at HHSC.

 

New Credentialing System for C.N.As, Medication Aides and Nursing Facility Administrators

A new credentialing system will come online February 28, 2022.  This new registry system will be part of TULIP.  Please be aware that the current system will be frozen beginning February 11, 2022 so the data can be migrated over to the new system.  The exam process is NOT part of this migration and will continue as normal.  If you have any questions or concerns, please email Stephanie Allred at:  [email protected].

 

End of Temporary Suspension of Certain LTCR Requirements- Reminder Only

PL 2021-29 (Revised) End of Temporary Suspension of Certain LTCR Requirements During COVID-19 Outbreak was released on January 26, 2022.  This is just a reminder to our members that the suspensions continue and it is always good to go back and review provider letters periodically.  To access the letter, go to:  https://www.hhs.texas.gov/sites/default/files/documents/providers/communications/2021/letters/PL2021-29.pdf.

 

 

Disclaimer:  The Texas and New Mexico Hospice Organization publishes the Regulatory Update as an information only item.  TNMHO has no attorneys nor does it represent the state and federal governments.  All legal questions or concerns should be directed to your attorney or the governments involved.