Legislative/Policy

5 Things to Know about the Recent Opioid Regulations for Medicare Part D

In June, the House of Representatives passed legislation that will impact the already complex Medicare Part D requirements. Spurred in part by a Department of Health and Human Services report that showed one-third of Medicare Part D beneficiaries received an opioid prescription in 2016. For the approximately 13 million people enrolled in Part D, nearly 80 million opioid prescriptions were written. More than 501,000 people received “high” amounts of opioids and 69,563 received “extreme” amounts, some as a result of…

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Shaping Home Health and Hospice Through Advocacy

One thing that’s constant in healthcare is change. Both home health and hospice industries are certainly no stranger when it comes to making adaptions and adjustments on a regular basis. With ever-changing policies and regulations such as pre-claim review, electronic visit verification, home health groupings model, continuous reimbursement cuts and more, it’s important for providers to have a voice in the direction of the industry. After all, you have boots on the ground, seeing day in and day out the…

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Fully-Informed Care: Legislation Updates Law and Protects Privacy

Netsmart has been a strong advocate for passage of the Overdose Prevention and Patient Safety Act (H.R. 3545) in the U.S. House and a companion bill, the Protecting Jessica Grubb’s Legacy Act (S. 1850), in the Senate. The legislation would closely align decades-old 42 CFR Part 2 regulations with HIPAA, helping assure fully-informed diagnosis and treatment for persons with a substance use disorder or history of SUD treatment. Gerald “Jud” DeLoss, Netsmart’s healthcare privacy counsel, testified on Netsmart’s behalf at…

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Netsmart Responds to SAMHSA’s 42 CFR Part 2 Listening Session

In January 2018, the Substance Abuse and Mental Health Services Administration (SAMHSA) held a public listening session to request information concerning 42 CFR Part 2. The listening session provided an opportunity for the public to offer feedback to SAMHSA regarding Part 2’s influence on patient care, health outcomes and privacy. Currently, 42 CFR Part 2 obliges providers to set aside substance use treatment information from a person’s health record to prevent it from being disclosed to other providers not in…

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Netsmart Talks Post-Acute Legislative and Policy Advocacy with Home Care and Long-Term Care Associations

Fast-evolving convergence in healthcare was the common theme of recent Netsmart public policy advocacy meetings with key national home care and long-term care (senior living) associations in Washington. Netsmart Executive Vice President Kevin Scalia, Industry Relations Strategist Dave Kishler and Post-acute Strategy and Solutions Team Members Teresa Craig, Jeremy Mercer and Robert Love met with five key associations representing post-acute providers: the National Association for Home Care & Hospice (NAHC), the National Hospice and Palliative Care Organization (NHPCO), LeadingAge, ElevatingHOME and…

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People With Addiction Issues Should Be Able to Control Their Own Health Data

In case you missed it, our own Executive Vice President Kevin Scalia and The Kennedy Forum Founder Patrick J. Kennedy were featured in The Hill over the weekend. Together, they collaborate on why it is important and fair to give individuals with a history of substance use equal control over their health information as those with other conditions. Click here to read the full article.

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November White House Opioid Commission Report

The White House Opioid Commission has released its first official report to the Trump administration. There are four main categories of recommendations in the report: federal funding and programs; opioid addiction prevention; opioid addiction treatment, overdose reversal and recovery; and research and development. You can click here to read the full report, but we wanted to highlight the portion of the report describing 42 CFR Part 2 privacy regulations in their current form as a “particular hindrance to comprehensive healthcare.”…

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Home Health Groupings Model: The Future of Home Health

In our previous installments of this CareThreads blog series, we examined the Home Health Groupings Model and the reaction it’s currently getting from the home health industry. Today, we’ll get a glimpse of what it means for home health going forward. The rule modifies the way home health agencies would be reimbursed for care, categorizing patients into six groups based on diagnosis. It also proposes moving from the current 60-day episode of care to 30-days, which is expected to create…

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Home Health Groupings Model: Industry Reaction

In the first blog of our series, we’ve discussed, at a high-level, upcoming payment changes for CY 2018 and beyond. The biggest, most talked about change is the Home Health Groupings Model, or HHGM. In a nutshell, the model proposed by Centers for Medicare and Medicaid Services (CMS) would end the impact to reimbursement based on the number of therapy visits. Reimbursement would then be based on newly modified mix of patient and case characteristics, such as episode timing, admission…

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Home Health Groupings Model: What is it?

If you’ve been keeping up with the latest in the home health industry this year, you’ve most definitely heard the term Home Health Groupings Model (HHGM) floating around at one point or another. Since the introduction of the home health prospective payment reimbursement model, the HHGM is a significant and controversial proposal, shaking up the home health industry. So what does this new payment model proposal mean for you, your organization and the industry? In this three-part blog series, we’ll…

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