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PART II - Key Features and Key Compliance Implications for Longterm Care Facilities and Home Health Agencies

In both the home health and skilled nursing facility industries, new payment methodologies are being introduced in 2019-2020. This creates new opportunities for optimizing revenue and improving patient and resident care, but may also introduce new compliance risks. In this webinar, we will provide an overview of key changes brought in by the Patient Driven Groupings Methodology (PDGM) under the Medicare home health prospective payment system (PPS), as well as the Patient Driven Payment Model (PDPM) under the Medicare skilled nursing facility PPS. Then, we will review items recently added to the Work Plan of the Department of Health and Human Services Office of Inspector General (HHS OIG) relating to Medicare payment to home health agencies and longterm care facilities, including issues relating to payment for dual eligible (Medicare-Medicaid) beneficiaries. We will identify both key revenue opportunities and key compliance touchpoints relating to the new payment methodologies. We have designed this webinar as a high-level overview of the payment changes and associated compliance risk areas.

Series Description

The regulatory landscape for providers of post-acute care has changed dramatically in recent months. New requirements of participation for longterm care facilities, promulgated by the Centers for Medicare & Medicaid Services (CMS) in 2016, have been implemented in three phases, with the last and arguably most significant set of changes implemented in November 2019. On October 1, 2019, and January 1, 2020, respectively, CMS implemented new “patient-driven” Medicare payment methodologies for skilled nursing facility services (SNF) and for home health services.

This series of four sixty-minute webinars will provide information and guidance to post-acute care providers on emerging topics relating to the revised requirements of participation and Medicare payment methodologies. Three of the webinars will focus on provider policies that will be under increased scrutiny as a result of the revised requirements of participation: compliance and ethics programs, emergency preparedness plans, and policies and procedures related to patient/resident privacy and information. One webinar will provide an overview of the Patient-Driven Payment Methodology (PDPM) for SNF services and the Patient-Driven Groupings Methodology (PDGM) for home health services, as well as identifying key compliance risks associated with the implementation of these methodologies. Each webinar will provide practical advice on how longterm care facilities and other post-acute care providers can most effectively develop and implement policies to respond to the new or revised requirements, and to strengthen the patient experience and patient care.