The Academy of Senior
Health Sciences, Inc.
17 South High Street
Suite 770
Columbus, OH 43215
614.461.1922
800.999.6264
Fax: 614.461.7168
cmurray@seniorhealthsciences.org



 

The Academy of Senior Health Sciences, Inc. (formerly The Ohio Academy of Nursing Homes, Inc.) seeks to provide public education and awareness initiatives to the long-term care community in Ohio. Our membership represents a true cross-section of the skilled nursing facility profession, from small sole proprietorships to larger Ohio-based multi-facility companies, as well as those businesses that service our industry. Through our public education and awareness efforts, the Academy brings the collective influences of the members together into a single voice on vital issues affecting our profession.

Founded in 1966, the Academy then identified one of its core purposes as "To foster a spirit of goodwill among those persons engaged in the nursing home industry, to promote ethical practices in their relationships with each other, their employees, and the general public to the end that all interests may be served fairly..." Though the organization has undergone several transformations over the years, most notably in 2011, its dedication and commitment to Ohio's most frail and elderly remains the same.

 The Academy Weekly Headlines from 2 Weeks Ago
OCHCH announces support of MLTSS at recent committee meeting —  The Long-Term Services and Supports Study Committee: Person-Centered Medicaid Managed Care met for the second of four times this week. The committee is tasked with determining the merits of moving Medicaid LTSS into managed care. This meeting allowed the non-state committee members to testify on four focus areas related to what has been learned about managed care and LTSS. The Academy testified on barriers to improving quality and health outcomes. The focus of Academy testimony was on MCO behaviors and the need to have MCOs in MLTSS that pay claims and are willing and able to implement VBP strategies. The Academy also noted that rate protections need to be in place as rate cutting is a common tool utilized by MCOs. In a surprise move, the Ohio Council on Home Care and Hospice (OCHCH), which opposed the move to MLTSS during the budget process, has joined the growing number of interested parties in supporting a move towards MLTSS. OCHCH noted the willingness by ODM to create a new system for providing HCBS under MLTSS as a key factor in the switch. The next meeting will take place this summer. The committee will hear testimony from beneficiaries in managed LTSS. A report will be completed by the end of the year.

ICF/IID reimbursement work group moves on to quality data  —  ICF/IID reimbursement work group moves on to quality dataWhile the workgroup assigned to develop the latest ICF/IID reimbursement formula is ironing out the rules, many of the members have moved on to the work group dedicated to the quality payment part of that formula. The workgroup met late last week to review the quality measures found in statute. The quality payment will begin in SFY2021 (July 1, 2020) and will be funded using the current direct support personnel add-on. A significant amount of time was dedicated to discussing the data that is to be collected and by what means. Ideas included using the cost report or creating a standardized form to be submitted separately by providers. The group then delved into the first measure to help focus the discussion. The first measure is about providing meaningful choice of activities to residents. The group discussed the details of the measure, including if residents had to participate or just provided the option of attending an activity related to their personal care plan. Ideas for data collection ranged from self-reporting as a check box with supporting documentation to a spreadsheet listing activities offered and those that participated. (Click here to view an Excel Spreadsheet with measures and proposed interpretation/data.) The group will continue to work through the measures and develop a consensus on the data required and how best to collect the data and verify that a provider meets the quality measure.

PL solution on the horizon? Maybe... —  The Ohio Department of Medicaid met with the LTCSS associations and health plans to discuss a possible solution to the patient liability conundrum that has resulted from the move to MyCare Ohio. The first objective is to "clean-up" the mess that was created when MyCare started so providers can rectify their accounting. ODM is looking into the ability to essentially allowing providers to write-off PL discrepancies as of some date. There was also discussion on having the MCOs create a dedicated person and process for resolving PL discrepancies. A decision has yet to be made, so keep those MIT screenshots and accounts. Looking forward, The Academy pinned the discrepancies on the MCOs, noting how the data sent daily in the 834 to the plans matched what is in MITs. ODM confirmed that they audit the data sent to the MCOs frequently and have not found any discrepancies. Thus, any problem appears to be how the MCOs use the 834 data or their systems' processing of the data. One solution is to have the MCOs use the PL amount that the provider puts on the claims. This amount, taken from MITS (take that screenshot) does match the 834 data and MCOs should easily be able to process claims using that data. The option of ODM handling the PL has been tabled because of concerns raised by CMS. So do we have a solution for PL right now? No. Is one in the near future? We intend to make that happen.

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