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Speaker(s): Melinda A. Gaboury, CEO and Jennifer Osburn, RN, HCS-D, COS-C, Clinical Consultant
About the Speaker(s)
Melinda A. Gaboury, with more than 30 years in home care, has over 22 years of executive speaking and educating experience, including extensive day to day interaction with home care and hospice professionals. She routinely conducts Home Care and Hospice Reimbursement Workshops and speaks at state association meetings throughout the country. Melinda has profound experience in Medicare PDGM training, billing, collections, case-mix calculations, chart reviews and due diligence. UPIC, RA, ADR & TPE appeals with all Medicare MACs have become the forefront of Melinda’s current impact on the industry. She is currently serving as the Chair of the NAHC/HHFMA Advisory Board and Work Group and is currently serving on the Board of Directors for both the Home Care Association of Florida & Tennessee Association for Home Care. Melinda is also the author of the Home Health OASIS Guide to OASIS-E and Home Health Billing Answers, 2023.
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About the Event
Tuesday, April 16:
Hospice Special Focus Program (SFP) & Provisional Period of Enhanced Oversight (PPEO)
Speaker: Melinda A. Gaboury, CEO
1:45 pm – 3:15 pm EST
Major scrutiny of the Hospice Benefit is well underway nationwide. This session will review the details of both programs and what Hospices can expect. The Special Focus Program (SFP), will monitor hospices identified as poor performers based on selected quality indicators. Hospices selected for the SFP will be under additional oversight to enable continuous improvement. This required program includes the development and implementation of enforcement remedies for noncompliant hospice programs, as well as procedures for appealing determinations regarding these remedies. These enforcement actions can be imposed instead of, or in addition to, termination of the hospice program’s participation from the Medicare program. Through the PPEO, new providers or suppliers are subject to prepayment medical reviews designed to address improper billing practices right out of the gate. This program is for newly certified hospices as well as change of ownership. This is a must attend session.
Medicare Advantage: Digging in the Details
Speaker: Melinda A. Gaboury, CEO
3:30 pm – 5:00 pm EST
Home Health providers are grappling with the shift in the Medicare eligible population into Medicare Advantage Plans (MA Plans). Providers are asking: What are the implications of current demographic trends? What operational and financial issues should providers expect as their payer mix shifts to mostly Managed Care? Being successful in this environment of these payer mix changes requires agencies to understand their costs of treating these patients and other impacts on their operations on an individual contract basis.
Wednesday, April 17:
How Well Do You Know Your GG’s?
Speaker: Jennifer Osburn, RN, HCS-D, COS-C, Clinical Consultant
10:15 am – 11:45 am EST
Prepare now for the 2025 Discharge Function Score- the change from current outcomes measures based on the M1800 OASIS items to a single measure that relies on the GG OASIS items and impacts 20% of the VBP Total Performance Score. Despite having a full set of GG0130 and GG0170 OASIS items for five years, home health clinicians and clinical leadership staff often remain unable to accurately assess and score (code) the GG items. This session will cover interpreting how the calculation of the Discharge Function Score works for administrators and clinical leadership, as well as instructions for accurately coding the GG items using real-world scenarios and focusing on the most misunderstood aspects of the GG items for clinical leadership and clinicians.