Issue: June 19, 2014

Published on June 19, 2014

Articles in this issue:

HCSF Comments From Chip Wheelen

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Chip Wheelen, Executive Director of the Health Care Stabilization Fund, has provided us with the sixth installment of comments on the upcoming changes.  (Don't forget you can view past installments of the newsletter to see previous comments).

 

The third article in this series focused on the provisions of Kansas Statutes Annotated 40-3402. Among other things, K.S.A. 40-3402 stipulates that health care providers defined as such in K.S.A. 40-3401 must purchase their professional liability insurance from “an insurer duly authorized” by the Commissioner of Insurance “to transact business in this state.” In insurance industry jargon, these companies are referred to as “admitted carriers” whereas, excess and surplus lines insurance companies are not admitted carriers. Similarly, captive insurance companies organized by out of state corporations exclusively for the purpose of insuring subsidiaries of the corporation are typically not admitted carriers.

If a nursing facility, assisted living facility, or residential health care facility is currently insured by a company that is not an admitted carrier, one of two things must occur prior to January 1, 2015. Either the insurance company must submit the necessary application and documents to become an admitted carrier authorized by the Commissioner of Insurance, or the facility must obtain a new professional liability insurance policy with a January 1, 2015 effective date that is issued by an admitted carrier. The primary policy must be a claims made policy with limits not less than $200,000 per claim subject to a $600,000 annual aggregate limit.

There may be some facilities that for whatever reason are considered extraordinary risks. If these health care providers are not able to obtain their primary professional liability insurance from an admitted carrier, they are eligible for coverage via the Health Care Provider Insurance Availability Plan. The plan is a joint underwriting association created exclusively for health care providers defined as such in K.S.A. 40-3401. The following information regarding the Availability Plan is excerpted from the HCSF General Information Brochure which can be downloaded from the HCSF website at http://hcsf.kansas.gov/news/Pages/default.aspx.

Obtaining Basic Professional Liability Coverage from the Availability Plan

The Health Care Provider Insurance Availability Plan is one of the principal features of the Act.  Without this Availability Plan, some individual health care providers would not be able to obtain professional liability insurance. Any defined health care provider who has an active license to render professional services in Kansas may obtain basic professional liability insurance from the Health Care Provider Insurance Availability Plan if the provider has been denied basic coverage from the commercial insurance market. 

Any licensed insurance agent should be able to provide assistance in making application to the Availability Plan. At the time this document was published, the Availability Plan was administered by the Kansas Medical Mutual Insurance Company of Topeka, Kansas (telephone 785-232-4740 or 1-800-232-2259).

HCBS Final Rule

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KDADS officials have been hosting meetings across the state this week seeking public comments on the Home and Community Based Services (HCBS) Final Rule and Transition Plan. States participating the in the HCBS program must submit and plan to CMS that details their efforts to allow participants in the Medicaid waiver programs to live in settings of their choice in the lest restrictive manor possible. Of special interest to KCAL is the Frail Elderly waiver which addresses consumers 65 years and older.

KDADS in cooperation with Wichita State University is conducting a survey of current HCBS providers. The information isgathered is designed to help the department design the transition plan and give providers a first step in proving that they meet HCBS appropriate standards as outlined in the final rule. Although the survey listed a deadline for completion as May 30, 2014, KDADS is encouraging providers to complete the survey if they have not done so. Commissioner Joe Ewert said, “Please encourage your members to complete them.  It is looking more likely that we will use the results of those surveys to identify which facilities need on site visits.  Will likely have to visit all facilities that don't provide us a survey with information that allows us to weed them out of the heightened scrutiny category.”

Click here to complete the survey.

Click here for a look at the AHCA/NCAL analysis of the Final Rule and here for NCAL’s report

Click here for comments from KHCA/KCAL’s general Council Harvey Tettlebaum from HuschBlackwell.

NAC Meeting and Facility Standards Call- Friday, June 20, 2014

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Join us for the monthly NAC and Facility Standards call, June 20, 1014, 1030am and 11am respectively. 

In preparation for the call, please download and read the following:

May Survey Findings

May Survey Review

 

Call in information:

888-450-5996

Passcode:946659

KHCA/KCAL Annual Convention and Trade Show Registration Open! Register Now!

Author:

Passport to Quality!

Embark on a journey around the world as we seek the highest quality care!

Registration for the 2014 KHCA/KCAL Annual Convention and Trade Show in Wichita, Kansas, October 22-24, now open!

 

Convention pricing is as follows:

For ONE TRANSACTION per member facility: $300 for the first attendee, $150 for every subsequent attendee

$50 for unlicensed direct care staff (does not include administrative corporate staff)

 

 

Register Online Today!!

 

Click here to secure your hotel room!

If you need additional assistance from the Hyatt Regency, please call 1-888-421-1442


2014 KHCA/KCAL Awards Nomination Packets Now Available

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KHCA/KCAL

64th Annual Convention & Trade Show

2014 Awards Nomination Packet are now available.

Winners will be honored in Wichita, KS on Thursday, October 23, 2014.

The 2014 Award and Recognition Program will be one of our best yet!  Our yearly awards ceremony is just a small way of honoring some of the great men and women that we work with throughout the year.  Please take the time from your busy schedules to nominate folks from your home.

Thank you,

Fred Benjamin, KHCA Chairmen

Shelley Gromer, KCAL Chair


Have an employee you want to nominate?  Click here to download the nomination packet with details!

CMS Announced Establishment of Provider Relations Coordinator

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The Centers for Medicare and Medicaid Services (CMS) recently announced the establishment of a Provider Relations Coordinator to help increase program transparency and offer more efficient resolutions to providers affected by the medical review process (here). 

The Provider Relations Coordinator’s purpose is to improve communication between providers and CMS.  While providers should continue to take questions about specific claims directly to the Recovery Auditor or Medicare Administrative Contractor (MAC) who conducted the review, providers can raise larger process issues to the Coordinator.  For example, if a provider believes that a Recovery Auditor is failing to comply with the documentation request limits or has a pattern of not issuing review results letters in a timely manner, CMS encourages providers to contact the Provider Relations Coordinator.  Prior to the establishment of this new CMS initiative, AHCA members often contacted AHCA staff to help facilitate an escalation of their medical review issues with CMS.  Hopefully this new process will help streamline the resolution of such issues.   

CMS indicted that providers can also send suggestions about how to improve the Recovery Auditor or MAC medical review process to the CMS Provider Relations Coordinator. 

The CMS Provider Relations Coordinator is Latesha Walker, and she can be contacted at:

 

 

If you have any questions or are not satisfied with CMS follow-up when using this new process, please contact Dianne De La Mare or Dan Ciolek at AHCA.

OSHA Issues Brochure on Safe Patient Handling in Nursing Homes

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OSHA has issued a brochure on safe patient handling in nursing homes:

The U.S. Occupational Safety and Health Administration (OSHA) recently published a new brochure titled “Safe Patient Handling: Preventing Musculoskeletal Disorders in Nursing Homes.” In the brochure, OSHA recommends strategies to reduce musculoskeletal disorders (MSDs) in nursing homes. OSHA recognizes that nurses and other healthcare workers experience some of the highest rates of non-fatal occupational injuries and illnesses of any industry sector.

Read Full Report

2014 AHCA/NCAL Convention and Expo

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AHCA/NCAL Announces Convention General Session Keynotes

 

This year’s AHCA/NCAL Annual Convention speaker lineup includes a national military commander and a heroic ship captain who inspired an Academy Award-nominated film. To hear them, sign up for the AHCA/NCAL 65th Annual Convention & Expo.

 

General Colin L. Powell (Ret.) is the Opening General Session keynote speaker. For over fifty years, he has devoted his life to public service. His deep commitment to democratic values and freedom has been felt throughout the world. Powell has received numerous military awards and decorations, as well as multiple civil awards including two Presidential Medals of Freedom, the President’s Citizens Medal, the Congressional Gold Medal and the Secretary of Energy Distinguished Service Medal. In addition, he has received awards from over two dozen countries that include a French Legion of Honor and an honorary knighthood bestowed by H.M. Queen Elizabeth II of Great Britain.

 

Hear what Powell has to say and get inspired.

 

Captain Richard Phillips, who came to national attention in April 2009 when Somali pirates hijacked his ship, will address attendees during the AHCA/NCAL Closing General Session & Awards Celebration.

For five days in April 2009, the world watched as Captain Richard Phillips became the center of an extraordinary international drama. A small gang of Somali pirates hijacked his ship, the Maersk Alabama, and ultimately, Phillips made a conscious decision to put himself in harm's way to save his 20-member crew by offering himself as a hostage. The drama that played out over the next five days kept American audiences glued to their television sets. President Barack Obama, who spoke with Captain Phillips by phone after he was freed, said, "I share the country's admiration for the bravery of Captain Phillips and his selfless concern for his crew. His courage is a model for all Americans."

 

His address will bring out the leadership and selfless qualities in each of us, and provide you with a renewed sense of purpose and energy to take back with you.

 

Register at www.AHCAconvention.org or www.NCAlconvention.org. Early bird registration ends July 18.