Compliance • Audits/Analysis • Reimbursement/Regulatory/Rehab • Education/Efficiency • Survey
1. COVID-19 Point-of-Care Testing Devices and Supplies
COVID-19 Point-of-Care Testing devices and supplies to be used for residents and staff will be delivered to all SNFs starting July 20th. Nursing homes in hot spots ranked as being at risk due to community spread will receive the antigen testing devices first.
This initiative was announced at a press conference on 7.14.20 by Seema Verma and Admiral Brett Giroir of HHS who explained that these testing devices provide rapid on the spot tests, at a rate of 20 tests per hour. Critics have pointed out that error rates can be as high as 20%.
Learn more directly from CMS Administrator Seema Verma today, 7.15.20 at 5:30 PM EDT. Call 1-833-614-0824, use the Conference ID 9391146. Or join the audio webcast by registering here.
PEPPER (Program for Evaluating Payment Patterns Electronic Report) Reports are expected to be released on July 29th, a delay from the original release date of April 6th due to the COVID-19 pandemic. This year the reports have a new target area, 3-to 5-Day Readmissions that provides data on the percent of readmissions just after the 3-day gap of non-coverage.
This new measure is intended to monitor the impact of the new CMS policy on interrupted stays related to discharge/readmission patterns. Other data elements are related to RUG-IV areas that could be at risk for improper Medicare payment prior to PDPM.
3. Medical Record Reviews
Medical Record Reviews by Medicare Administrative Contractors (MACs), by the Supplemental Medical Review Contractor (SMRC), and the Recovery Audit Contractor (RAC) are resuming on August 3, 2020. This includes prepayment reviews under the Targeted Probe and Educate Program (TPE). Most medical reviews have been suspended since March 30th.
4. COVID-19 Testing Healthcare Staff
CDC Guidance for Healthcare Workers about COVID-19 Testing was updated on July 14th and is available at https://www.cdc.gov/coronavirus/2019-ncov/hcp/testing.html
FY 2021 ICD-10-CM Official Coding Guidelines for Coding and Reporting have been released early. See Chapter 1, page 28 -29, regarding additional instructions for coding COVID-19 instead of Chapter 22 (U00 – U85). The Guidelines are available at ICD-10-CM Guidelines.
6. SNF Quality Reporting Program (QRP) Non-Compliance Notifications
SNF Quality Reporting Program (QRP) Non-compliance notifications for Calendar Year 2019 that will affect the Fiscal Year 2021 Annual Payment Update have been placed in the CASPER folders of the QIES as of July 13th and some are being distributed by the MACs. Requests for reconsiderations must be received by August 18th.
7. Ombudsman Communication
QSO-20-28-NH REVISED memo from 7.9.20 includes a new section on access to ombudsman. It reminds facilities that they must facilitate resident communication with the ombudsman. A Q&A (#2) regarding ADA laws now has an example regarding an interpreter when onsite staff or effective communication cannot be provided without an in-person visit.
8. Extension of the Public Health Emergency
CMS Office Hours (7.14.20) addressed questions regarding SNFs billing Medicare for specimen collection related to COVID testing and the Extension of the Public Health Emergency. All indications are to extend the COVID-19 Public Health Emergency before it expires. A 90-day extension would last until late October. No official announcement from CMS has been made yet. Listen to it when posted at https://www.cms.gov/Outreach-and-Education/Outreach/OpenDoorForums/PodcastAndTranscripts.
Please feel free to connect with Harmony Healthcare International (HHI), for further information on these or other regulatory updates.
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