May 2021 Newsletter
Upcoming Events
RAP Rules Webinar
May 24th
12:00pm-1:00pm (PST)
Cost: Free for members, $15 for non-members
The early months of 2021 have been challenging for home health providers due in large part to the new RAP rules put in place by Medicare. These new regulations have impacted billing practices, agency operations, and ultimately cash flow. During this discussion we will take a look at the latest updates on the various processing and operational issues that have led to these challenges. We will also provide recommendations on how to maximize cash flow and minimize bad debt while adhering to these RAP rules throughout the year.

Key Objectives:
Brian Harris, Consulting Director
BlackTree Healthcare Consulting
  • Review what issues have occurred since the transition on January 1, 2021
  • Analyze the cash flow impacts these changes have had on agencies
  • Provide some recommended operational changes that may assist in the process
  • Discuss what to expect for the rest of 2021 and beyond

2-Day Virtual Workshop - Medicare Home Health Reimbursement
June 8th & 9th
6:00am-2:00pm (PST)
Cost: $140 for members, $165 for non-members
The PDGM has brought many changes to home health and the PDGM is not all that reimbursement is made up of. In addition to working through the fine details of the PDGM changes, the workshop will also cover extensive examples for Low Utilization Payment Adjustments (LUPAs), Partial Episode Payments (PEPs), and outlier adjustments. There will be a discussion of pre-billing claim reviews and the significance of them.

The impact of OASIS, ICD-10 coding, and medical review programs have the potential to more directly impact reimbursement than some of the other aspects of the PDGM, and this workshop will get you up to date on all of that as well. Additionally, with cash flow being one of the gravest areas of concern for providers in recent months, this workshop will take you through the basics of cash flow projections and how best to make that work in your organization.

2-Day Virtual Workshop - Hospice and Palliative Nurse Certification Review
June 15th & 16th
6:00am-2:00pm (PST)
Cost: $110 for members, $125 for non-members
This course, designed for nurses preparing to take the certification exam for hospice and palliative nurses. However, if you are already certified you can use this class as part of your continuing education requirement. The program is additionally intended to benefit any nurse working in hospice, home health, oncology or other settings who are caring for patients with end stage disease processes.

The Hospice and Palliative Nurses Association offers a “Clinical Review for The Generalist Hospice and Palliative Nurse” as a means of preparing the practitioner for certification. Nurses who participate in this 2-day review can expect a general presentation of the course material via multi-media tools, handouts and lectures, as well as individual and group exercises to reinforce the information. 

In The News
Click on the topics below for more information
Covid-19 Updates

  • The Occupational Safety and Health Administration (OSHA) has begun implementing a National Emphasis Program (NEP) to ensure that employees in high hazard industries or work tasks are protected from the danger of contracting the novel coronavirus COVID-19, in a development that could impact in home service providers. Read more here: OSHA Targets Home Health Care on COVID-19 Compliance – NAHC Report

  • The Occupational Safety and Health Administration (OSHA) is seeking public comments on its Blood-borne Pathogen Standards. Comments are due June 14, 2021. Here is the link to the proposed updated standards via the Federal Register: 2021-07695.pdf (
Medicare FFS Claims: 2% Payment Adjustment (Sequestration) Suspended Through December

The Coronavirus Aid, Relief, and Economic Security (CARES) Act suspended the sequestration payment adjustment percentage of 2% applied to all Medicare Fee-for-Service (FFS) claims from May 1 through December 31, 2020. The Consolidated Appropriations Act, 2021, extended the suspension period to March 31, 2021. An Act to Prevent Across-the-Board Direct Spending Cuts, and for Other Purposes, signed into law on April 14, 2021, extends the suspension period to December 31, 2021.

Medicare Administrative Contractors will:

  • Release any previously held claims with dates of service on or after April 1
  • Reprocess any claims paid with the reduction applied
  • You don’t need to take any action.  
Survey Readiness
The Department of Health’s Office of Investigation and Inspection (OII) is responsible for ensuring that licensed in-home services agencies comply with all applicable state and federal requirements. The OII survey and investigation teams conduct routine state and federal surveys as well as complaint investigations. Washington State licenses more than 400 in-home services agencies to provide home-based personal care and health services to clients and patients within the minimum health and safety standards established in chapter WAC 246-335. The OII survey team is required to survey applicants as part of the initial licensing process, and to survey licensees once during each licensure period. Initial surveys are scheduled and announced; on-going surveys are unannounced. Check out this link to find helpful resources to help you have a successful survey. (Remember – if your agency is Medicare certified you will also be surveyed against applicable Conditions of Participation (COPs)).

Compliance Corner
The updated CMS Manual State Operations Manual Appendix Z – Emergency Preparedness effective April 16, 2021 can be found here. Bundle 1-Appendix Z-Final for Clearance ( CMS announced the release of the updated Appendix Z in a March 26, 2021 QSO Memo (QSO-21-15-ALL). These changes are applicable to all provider types. Remember, if you are a Medicare Certified Home Health Agency you are accountable for meeting all applicable items in Appendix Z as well as the Medicare Conditions of Participation at 484.102 Condition: Emergency Preparedness. If you are state licensed only (home care, home health or hospice) you should be familiar and follow the IN HOME SERVICES WACs at:

246-335-415 (10) Home Care
246-335-515 (10) Home Health
246-335-615 (10) Hospice
246-335-720 Hospice Care Centers
The Wisconsin Association for Home Care wants Wisconsin to increase the reimbursement rate hiked to just over $94 a visit — about $9 more than the current rate.

Read more here:
HCAW Membership
We want you to join our community of members! Here's why.....

  • We offer a community, resources, and strong voice for professionals providing care in the home.
  • Our membership is for your entire team! Members include managers, directors, aides, nurses, dietitians, finance managers, c-suite executives, and all other professionals who support care in the home. 
  • Free and reduced cost premium education that impacts your work.
  • Tools and resources to improve your agency.
  • HCAW advocates for our members and industry both here in Washington state and throughout the nation.
  • Up to date news that impacts you.
HCAW Website and Social Media
We are excited to announce our new website is now live!

We've got some new features (On-Demand ProgramsEvent Calendar & more!), an updated Member Portal and just overall new looks. But most importantly, we want to make sure you have all the information you need to navigate our new site.

Some things you should know:

  • Member Portal: Our member portal is password protected - our new updated password for the page is: HCAWMember21
  • Clearing Caches: It's important that you clear your cache on all your devices so that you are able to view and navigate the site without issues. Click here for more instructions on clearing your cache for your browser/device
And remember to follow us on social media!