2021 includes much uncertainty for home care, hospice and Managed Long Term Care (MLTC) financing. As anticipated, the proposed 2021-2022 Executive Budget is aimed to reconcile a $15 billion deficit in the wake of COVID-19 and is contingent upon New York receiving $6 billion in federal aid that is needed to avoid additional across-the board Medicaid cuts. This coincides with the state implementing multiple budget actions that have already reduced premium rates for MLTC plans, along with the 2020 rollout of a completely new Medicaid cost report that has presented many challenges for CHHAs, LHCSAs and Fiscal Intermediaries who are currently going through the audit process in 2021. Meanwhile, the U.S. Centers for Medicare and Medicaid System (CMS) has implemented a no-pay Request for Anticipated Payment (RAP) under PDGM that has already experienced numerous claims processing glitches in 2021.

This is a lot to navigate, and HCA is here to help senior finance managers, CFOs and executives do so. Join us for this popular program which will help you understand and oversee the full scope of finance issues in home care, hospice and Managed Long-Term Care.

Thursday, March 18, 2021

9:00AM – 10:00AM

State and Federal Payment, Rate Updates

HCA Policy Staff

HCA’s policy team is a singular resource for all payment, rate and reimbursement matters affecting New York’s home care, hospice and Managed Long Term Care organizations. Our team will provide an update on the impact of the Governor’s proposed 2021‐22 Executive Budget, federal developments related to PDGM and no-pay RAPs, as well as our advocacy efforts in Albany and Washington. We’ll also highlight our annual industry financial condition report as well as discuss other state and federal legislative and regulatory activities. 

10:05AM – 11:05AM

The New Medicaid Cost Report: Changes for Home Health, Home Care & Fiscal Intermediaries

Mark Tsiames, CPA, CGMA, CVA, Principal, Simione Healthcare Consultants

Simione Healthcare Consultant Mark Tsiames CPA, CVA, CGMA, will review the challenges experienced in year one of the new Medicaid cost report for Certified Home Health Agencies (CHHAs), Licensed Home Care Service Agencies (LHCSAs), and Fiscal Intermediaries (FIs). He will also go over the schedules and discuss the challenges in completing them and how to best prepare for future cost report filings. The session will cover those schedules identified as the most difficult to complete and provide suggestions on how to address certain areas of expenses and requested information.  Finally, Mr. Tsiames will discuss cost allocation methodologies, allowable versus non-allowable costs, the treatment of related party costs citing federal and state regulations where necessary.

11:05AM – 11:25AM

Get Up to Par with Mutual of America

Join Mutual of America’s Financial Group and guest Golf Pro while they take you to St. Andrew’s for some tips on improving your golf game as we head into Spring. The MoA team will also share some of their tips for ‘upping your game’ on retirement services to recruit and retain top-notch employees because they know that as financial leaders in the home care industry it’s critical to sharpen your game on and off the course.

11:25AM – 11:35AM

Brain Break

11:35AM – 12:35PM

Clinical and Financial Lessons Learned for a Stronger Revenue Cycle

J’non Griffin, President, Home Health Solutions – A Simione Coding Company

Rob Simione, Director, Simione Healthcare Consultants

At its core, PDGM requires strong coding and OASIS review and coordination with clinicians to achieve billing success. Simione Healthcare Consultants and Home Health Solutions, a Simione Coding company, will identify and address common billing and coding issues that cause decreased revenue. They’ll also help agencies understand the best ways to get the final claim out the door in a timely fashion.

12:35PM – 1:15PM

Lunch Break

1:15PM – 2:00PM

DOH Office of Health Insurance Program (OHIP) Update on MLTC Reimbursement and 2021-22 State Budget Actions

Daniel Carmody, Director, OHIP, Bureau of Managed Long Term Care Rate Setting

Kevin Wright, OHIP, Bureau of Managed Long Term Care Rate Setting

During this session, representatives from DOH’s OHIP will provide updates on the following: provisions in the 2021‐22 Executive State Budget that impact Medicaid MLTC plans and home care providers as well as premium rate revisions, including: the COVID-19 adjustment; risk score/acuity factors; CDPAP benchmark; withhold and penalties. They’ll also give a status update on the State Fiscal Year (SFY) 2021-22 rates, the Quality Incentive Vital Access Provider Pool (QIVAPP), and the minimum wage reconciliation adjustment.

2:00PM

HCA Closing Remarks & Adjourn 

Participants will have access to all available session recordings for 2 weeks following the event. 

Registration Rate (per person)

HCA Members: $149 (*Group discounted rate of $120)

Non-Members: $249 (*Group discounted rate of $220)