ARRM's Daily Dispatch

DHS Provider Enrollment offering webinars on new enrollment process

DHS Provider Enrollment is offering two opportunities every month through June for providers to participate in a webinar on the new provider enrollment process. The training is titled "Provider Record Review-Waiver/AC Program Services". Each webinar session will include one hour of instruction/presentation and one hour for questions and answers.

Visit the training webpage for further information.

If you have any questions please contact Barb Turner at bturner@arrm.org.

 

--Barb Turner COO

 

 

Salary survey opportunity available for providers.

Last year ARRM provided members an opportunity to participate in a salary survey, being conducted by HR Advisors. This comprehensive wage and benefit survey is being made available to our members again this year.

In order to maintain the privacy of our members, ARRM is sending the survey out on behalf of HR Advisors. Completion of this survey is voluntary and is not connected directly to any work being done at ARRM.  

Participants will receive the final report at no cost. ARRM members who previously participated in the survey found the results very useful.

Additional information is included in the invitation, see link below. Feel free to contact HR Advisors at 507-399-1240 or wes@hradvisors.biz  if you have questions.

 

Invitation to participate

Survey Instructions

Salary & Benefits Survey 2013

 

--Barb Turner, COO

Reminder: Regular registration for ARRM’s Annual Spring Conference ending Wednesday, April 24th.

ARRM’s 2013 Annual Conference is fast approaching. On May 15 and 16, ARRM will be traveling to Duluth to host our annual conference, this year’s conference being properly themed “Building Bridges.”

As providers continue to operate in an uncertain climate, it is important to make sure your staff are up to speed on new and innovative processes as well as properly trained on current and changing rules and regulations.

The regular rate for conference registrations will expire after Wednesday, April 24th. Following this date, registration price will increase by $25 for each conference attendee.

Click here to download the conference brochure, along with a registration form, and send your registration in today!

Please contact Nancy Peterson at npeterson@arrm.org with any questions or concerns.

--Nancy Peterson, Director of Member Services and Education

DHS presents information on Mental Health Certification

The Family Systems Unit of the DHS Licensing Division recently did a presentation on the adult foster care mental health certification requirements. Many ARRM members have had questions about this new optional certification.

The PowerPoint presentation used by DHS contains good information that should help answer questions members may have. You can access the PowerPoint document here: Adult Mental Health Certification 2 13

Please contact Barb Turner at bturner@arrm.org with any questions.

---Barb Turner, COO

Maintain the grassroots momentum; Huntley now pushing for more COLA money

As we continue to move forward in the 2013 legislative session it is important to maintain the momentum that our grassroots efforts are gaining with legislators.

The House and Senate have released budget proposals that, despite budget targets calling for reductions of around $150 million for health and human services, provide for a modest cost of living adjustment for long term care providers as well as a buy-back of the 1.67% cut.

Yesterday, a Rep. Huntley amendment in the House Ways and Means Committee increased the nursing home COLA from two percent to three percent.  However, he noted that a drafting error left us out and that the increase is intended for our services as well.  He told ARRM after the hearing that we are “first in line” for additional money into his target.  He said he expects the tax bill to collect more revenue than needed and hopes that excess revenue will bolster his funding target.  Indeed, the money he found for nursing homes yesterday is still insufficient to cover even nursing homes alone.

The bills will continue to move through the committee process before heading to the House and Senate floors next week and finally ending up in conference committee.

Because of the low target a number of legislators are unhappy with the low increase for disability and elder services and how the health and human services bills rely on surcharges to hospitals, health plans, nursing homes and ICFs/DD to make up for the $150 million cut in the target.

In the meantime House and Senate leaders – along with the governor – will agree on final targets for each spending area.  ARRM and our allies will mount a grassroots effort to increase the health and human services target.  We’ll develop strategic messages and calls for action in the next few days.  So please stay tuned!

There will be several opportunities next week to get involved at the Capitol during what folks in the disability community are dubbing “Disability Week at the Capitol.”

Monday April 22-26: MN CCD Presents: Faces of Disability 2013- visit an exhibit of photos, art and stories of Minnesotans with disabilities in the North Corridor of the State Capitol. For more information click here: Faces of Disability 2013 Poster
Tuesday, April 23rd, 10:00 am: MN CCD Tuesday at the Capitol, State Office Building Basement Cafeteria.
Tuesday, April 23rd, 11:00 am: Press conference hosted by the Arc MN and MN Brain Injury Alliance
Thursday, April 25th: Disability Matters Day at the Capitol, rally at 12:00 pm: Sponsors include: Advocating Change Together, Direct Support Professional Association of MN, Metropolitan Center for Independent Living, MN Brain Injury Alliance, MN State Council on Disability, People First of MN, Self-Advocates MN, The Arc MN. For more information click here: Disability Matters Day at the Capitol 2013_updated 

Please contact Sara Grafstrom at sgrafstrom@arrm.org with any questions.

--Sara Grafstrom, Director of Advocacy and Community Relations

HHS Budget Position Comparison

The Governor, House, and Senate have all introduced or adopted their initial positions on the FY 2014-15 Health and Human Services Budget. Here is a quick summary of what each of them does:

• Governor: Increases spending compared to current law without increasing surcharge revenue and with limited use of Health Care Access Fund (HCAF- MinnesotaCare) balances. Does not include a COLA, has increased reimbursements in the FY 2016-17 biennium tied to a yet-to-be-developed quality measure. Includes $3.2 million of new fee revenue tied to 245D implementation.
• House: Reduces spending compared to current law by increasing hospital and ICF/DD surcharge; limiting managed care reserves; and more use of HCAF balances. Includes a 2 percent COLA for HCBS & ICF/DD providers at the start of FY 2014-15, and $3.2 million of new fee revenue tied to 245D implementation.
• Senate: Reduces spending compared to current law by increasing health plan, nursing home and ICF/DD surcharge; and limiting managed care rate growth; and more use of HCAF balances. Includes a 1 percent COLA for HCBS & ICF/DD providers for 6 months at the end of FY 2014-15 and 1 percent at the start of FY 2016-17, and $1.6 million of new fee revenue tied to 245D implementation.

For a detailed breakdown of budget changes (things like the 1.67 percent cut, low needs/congregate care reduction) directly impacting members, a document further outlining them is available here: HHSComparison041613

As always, if you have questions or feedback, please contact Craig Wieber or Bruce Nelson at the ARRM office at (651) 291-1086, or via email at cwieber@arrm.org or bnelson@arrm.org.

--Craig Wieber, CFO

Senate HHS budget released

On Monday, the Senate Health and Human Services (HHS) Finance Committee released its budget proposal for the upcoming biennium. What they released today is their plan to meet the $150 million target for reducing spending for the upcoming biennium’s budget.

Like the House, the Senate target was significantly lower than what the governor proposed. To meet it, they rely on two main items to bring additional revenue in: increases to provider surcharges and transfers of surpluses in the Health Care Access Fund (HCAF). The House proposal raises about $102 million from increasing the HMO, nursing facility, and ICF/DD surcharges; about $54 million by limiting the growth in manage care rates, and about $406 million in transfers from the HCAF. It is different than the governor or House positions in that it spends more from the general fund, rather than moving expenses into the HCAF.
 
In terms of spending, the Senate budget proposal includes a number of items directly impacting members:

• Cost of Living Adjustment: The Senate provides a 1 percent increase to payment rates for home and community based service providers effective the January 1, 2015 (FY 2015); and another 1 percent increase effective July 1, 2015 (FY 2016). No funding was included for the governor’s recommendation for a quality reimbursement system ($7.3 million spending)
• 1.67 Percent Reduction: The Senate buys back the 1.67 percent reduction set to take effect July 1, 2013 ($12.8 million spending)
• Congregate Care Reduction: There is no funding in the Senate position to buy back any portion of this reduction.
• Intensive Services for Children with Autism: The Senate proposal does not add any funding for the governor’s recommended services changes for autism treatment
• ARMHS Payment Rates: The Senate includes funding for the governor’s proposed increase for these providers (No net increase in spending, moves funding from grants to Medical Assistance)
• 245D Provider Fees: The Senate includes half of the governor’s recommended revenue and funding levels to implement 245D standards. The provider base fees and per person amounts are cut in half ($1.6 million revenue)
• Waiver Provider Standards, Phase II: The Senate includes the language to develop these standards, but does not add the additional funding for staff.  This means DHS would have to go forward with implementation within their existing administrative resources.

The Senate will be taking testimony on their proposed budget, and will be taking amendments and marking up the bill on Tuesday. The House HHS Finance Committee passed its budget bill last week on Friday, and it is moving on to the Ways and Means Committee for its next hearing before going to the floor for full House approval.
 
Given their difficult target, the Senate managed to make reductions and raise revenue without reducing funding for waivered services. Both the Senate and the House provided rate increases for providers, just at different levels. We’ll be preparing a side by side comparison of these issues for members and will post that shortly. We’ll review each position and see where we can make additional progress as we move into conference committee. None of these issues are done until the final budget is passed and signed into law.

As always, if you have questions or feedback, please contact Craig Wieber or Bruce Nelson at the ARRM office at (651) 291-1086, or via email at cwieber@arrm.org or bnelson@arrm.org.

--Craig Wieber, CFO

House HHS budget released

Yesterday, the House Health and Human Services (HHS) Finance Committee released its budget proposal for the upcoming biennium. Back in late March, we updated members about the budget targets legislative leadership assigned to committees they had to meet. For the House, the HHS Finance Committee had to reduce spending by $150 million compared to spending under current law. What was released yesterday was their plan to meet that target.
 
The House target was significantly lower than what the governor proposed. To meet it, they rely on two main items to bring additional revenue in: increases to provider surcharges and moving health care expenditures off the general fund and into the health care access fund (HCAF). The House proposal raises about $110 million from increasing the hospital and ICF/DD surcharges, and about $47 million by limiting the reserves of health plans.
 
In terms of spending, the House budget proposal includes a number of items directly impacting members:

• Cost of Living Adjustment: The House provides a 2 percent increase to payment rates for home and community based service providers and nursing facilities, effective the first year of the biennium. No funding was included for the governor’s recommendation for a quality reimbursement system ($65.0 million spending)
• 1.67 Percent Reduction: The House buys back the 1.67 percent reduction set to take effect July 1, 2013 ($12.8 million spending)
• Congregate Care Reduction: The House budget includes funding to buy back at least a portion of the 10 percent cut to individuals in congregate care settings. At this point, we don’t believe the proposal buys this back in full. We’ll update members when we’ve got more information. There was legislation introduced to buy back the cut for individuals with a primary diagnosis for mental illness ($5.8 million spending)
• Intensive Services for Children with Autism: The proposal includes funding for the governor’s recommended services changes for autism treatment ($12.7 million spending)
• ARMHS Payment Rates: The House includes funding for the governor’s proposed increase for these providers (No net increase in spending, moves funding from grants to Medical Assistance)
• 245D Provider Fees: The House included the governor’s recommended revenue and funding levels to implement 245D standards ($3.2 million revenue)
• Waiver Provider Standards, Phase II: The House delays funding to DHS for providing online training for providers to meet the new 245D standards, and additional staff at the department to monitor performance and outcomes of the new system. The House adds funding for this in FY 2015, the second year of the biennium ($747 thousand spending)
 
The House will be taking testimony on their proposed budget, and will be taking amendments and marking up the bill on Friday. The Senate is still working through its proposals, and we expect they’ll be releasing their budget early next week.
 
Given their difficult target, the House managed to make reductions and raise revenue without reducing funding for waivered services. In fact, they provide a two percent COLA and a buy back of the 1.67 percent reduction and meeting their reduction target – not easy to do. We view the House proposal as a step in the right direction, and we will look to build on the gains made as the process continues.
 
As always, if you have questions or feedback, please Craig Wieber or Bruce Nelson contact at the ARRM office at (651) 291-1086, or via email at cwieber@arrm.org or bnelson@arrm.org.

--Craig Wieber, CFO

ARRM Affordable Care Act task force presents first of a series of webinars

Last Friday the ACA Task Force sponsored the first of a series of webinars on the ACA requirements. Will Steinke, Senior Vice President from the Christianson Group and Jodi McLennon CEO of Partnerships for Minnesota Futures did an excellent job of presenting some preliminary timelines and definitions for members.

A recording of this presentation can be found on the ARRM website, in the "member only" section under First Friday Phone In -ACA Webinar. You can also access the power point slides here: ACAPRESENTATION

The next ACA webinar will be presented April 19, 2013 at 11:00. Watch next week for an email message with information on the topics and call in information.

Contact Barb Turner bturner@arrm.org with any questions.

--BarbTurner COO

Information released on provider payment delay.

DHS has released information and guidance on how the provider payment delay will be implemented. For some quick background, in 2012, the final HHS budget included a temporary rate cut of 1.67 percent as well as shifting of provider payments to make up for savings lost because CMS wouldn’t allow the implementation of the revised nursing facility level of care standards. The effective date of the 1.67 percent reduction is July 1, 2013. and the payment shift moves spending from June 2013 until July 2013 for disability and elderly waivered services, and ICF/DD’s.

DHS will apply the payment delay to Home and Community-Based Services FFS (fee for service) claims by reducing the claim line payment by 20% for claims submitted and scheduled to be paid on both the June 4, 2013, and June 18, 2013, payment dates. DHS will report the reduction as a legislative cutback on the claim and will report Group/Adjustment Reason Code CO 45 on the remittance advice. The amounts delayed will be paid with claims on the July 2, 2013, payment date.

You can view the entire announcement on DHS’s website, as well as a complete list of services impacted, here.

Now that we’ve gotten more information on the specifics of how the payment delay will function, please contact us if this methodology creates issues for your agency. There is still time between now and implementation to clarify the policy if there are major issues for members.

As always, please contact Craig Wieber at (651) 291-1086 x9 or at cwieber@arrm.org if you have other questions or concerns.

--Craig Wieber, CFO