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Governor Brown Vetoes AB 1552 (Lowenthal) CBAS Preservation Bill
Calls it “Premature” in Advance of Waiver Amendments
SEPT 30, 2014 | CAADS Response
AB 1552 was an opportunity for the Governor to welcome in a new era, acknowledge the Legislature's unanimous support, and demonstrate the state's commitment to the CBAS program and to California's poor elderly, disabled and vulnerable citizens who need access to good healthcare. While we are heartened by the veto statement acknowledging the importance of CBAS to "help many thousands of frail adults remain independent," we are very disappointed that Governor Brown chose to veto AB 1552 and miss that opportunity.
Coordinated Care Initiative (CCI)
SEPT 29, 2014 | CCI Outreach Weekly Update | CalDuals Enrollment Data Online | CalDuals
Up Close: A Field Guide to Community-Based Palliative Care in California
SEPT 2014 | Field Guide | California HealthCare Foundation (CHCF)
In 2013 the California HealthCare Foundation (CHCF) launched the Palliative Care Action Community to promote collaboration among organizations working to strengthen or expand their community-based palliative care (CBPC) services. Participating provider teams represented diverse types of organizations, provided services in a variety of settings, and came with varying levels of CBPC experience. Read more. . .
CAADS 2014 Annual Meeting and Fall Conference
Adult Day Services: In the Center of Change
NOV 17-19, 2014 | Westin Hotel | Long Beach
Be a part of the CAADS Fall Conference -- here's how:
CAADS TO LAUNCH CLINICAL PROTOCOL CERTIFICATE PROGRAM AT CONFERENCE
Attention Nurses! Register for this specialized training from 4 to 6 PM on November 17:
Medication Reconcilation: Ensuring effective responses through standardized medication reviews
Westin Hotel Reservation Deadline: OCT 17, 2014 | 5 PM
Mention "CAADS" for Group Rate: $149 single/double occupancy; offered NOV 12-21, 2014
Room Reservations by Phone: (562) 436-3000 or (800) 937-8461
Room Reservations Online: Westin Group Room Reservations
For more information, contact Pam Amundsen: (916) 552-7400 | Pam@caads.org
THE NEW POLST: 6 Things You Should Be Doing To Prepare
SEPT 24, 2014 | Polst California | Coalition for Compassionate Care of California
Here are 6 things you should be doing right now to prepare for the new form.
- Order new POLST forms from Med-Pass
- Familiarize yourself with the new form: download a copy in English
- Learn about key changes to the form -- Read “Key Talking Points for Healthcare Providers” (1 Minute); Watch a recording of the “Changes to POLST in 2014” webinar for an in-depth look at the changes to POLST (1 Hour)
- Spread the word among your colleagues
- Replace old forms. Previous versions of POLST will still be honored after the 2014 form goes into effect; however, it is best practice to complete a 2014 version of POLST—and void older versions of the form—when a patient’s POLST is updated
- Download the 2014 POLST form in other languages -- Ask the responsible staff person to download all copies of POLST in other languages and have these forms ready for when you ned them. Get copies of the forms at http://capolst.org/2014polst. Order POLST in braille by sending a request to email@example.com.
Get more information about POLST by contacting your local POLST Coalition, or contact the Coalition for Compassionate Care of California at (916) 489-2222 or info@caPOLST.org.
Data Briefs Released for 2012 National Study of Long Term Care Providers
SEPT 2014 | National Study of Long Term Care Providers (NSLTCP)
The Long-Term Care Statistics Branch released adult day services-specific state web tables, using data from the first wave of the National Study of Long-Term Care Providers (NSLTCP) conducted in 2012. NSLTCP is a new initiative by the National Center for Health Statistics (NCHS) to provide reliable, accurate, relevant and timely statistical information to support and inform long-term care services policy, research, and practice. Read more. . .
Can Reality Match Rhetoric? Person Centered Service Planning in Managed Long-Term Services and Supports
AUG 2014 | National Senior Citizens Law Center (NSCLC)
Person-centered planning is critical to the well-being of consumers of long-term services and supports. It works by identifying the strengths preferences, needs, and desired outcomes of the individual. In order for person-centeredness to be more than an empty slogan, it must be accompanied by substantive standards set forth in managed care organization (MCO) contract language. Some states have begun to include person-centered planning requirements in their contracts, but more work is needed before all states have a full framework. Read more. . .
Medicare Part D Open Enrollment Fast Approaching!
AUG 18, 2014
Open enrollment is an opportunity for beneficiaries to review and update their Part D prescription drug coverage. New healthcare plans become available each year that may offer better coverage or save money, so it’s important for participants to take the time to carefully review their options. This year, open enrollment starts on Wednesday, October 15 and closes on Sunday, December 7.
Download Part D Open Enrollment Toolkit -- Share this tool kit with patients, constituents and stakeholders. With a wide variety of prescription drug plans to choose from, Medicare Part D has a plan that will fit any patients’ needs.
Medicare Part D saves and improves patient lives at a low cost, expanding access to treatment for patients in a dramatic way. With an 86 percent patient satisfaction rate according to a recently released survey and total costs coming in at $349 billion, 45 percent less than 10-year projections, it’s an American success story.
To learn more about the prescription drug plans that are available in your area, check out the Medicare Plan Finder at www.medicare.gov/find-a-plan. You can also call Medicare at 1-800-MEDICARE (1-800-633-4227) or visit www.medicare.gov to enroll.
Balance Billing Dual Eligibles Violates Federal and State Law
AUG 8, 2014 | NSCLC
Advocates continue to report attempts by providers, particularly physicians, to ”balance bill” dual eligible beneficiaries (those who qualify for both Medicare and Medi-Cal) for charges not covered by Medicare or Medi-Cal. Balance billing violates both federal and state law. Providers may not balance bill any Medi-Cal patient who presents a Medi-Cal card. In other words, a provider must accept as payment in full whatever amount the provider receives from Medicare, other insurance (if any), and Medi-Cal.
The balance billing protection remains even if Medi-Cal pays nothing to the provider. The only exception is that providers may bill Medi-Cal beneficiaries who have a monthly share of cost obligation, but only until that obligation is met for the applicable month. If a provider bills a patient in error, the provider must stop immediately upon proof of Medi-Cal enrollment and must call off any collection efforts that have begun. Upon receiving proof of Medi-Cal eligibility, debt collection agencies and/or providers also must correct any erroneous information sent to credit reporting agencies.
Providers also are prohibited from asking a beneficiary to enter into a private pay agreement or otherwise waive balance billing protection. Advocates who encounter balance billing issues may find that, in some cases, providers are genuinely confused about their obligations and unaware of procedures for processing crossover Medicare claims through Medi-Cal.
The following resources can be helpful in addressing these situations:
- Physician’s Toolkit
A new resource prepared by the California Department of Health Care Services particularly around the Coordinated Care Initiative but containing explanations that apply to providers and advocates in non-CCI counties as well. Look especially at “Physician services and payment under the CCI” and “FFS Medicare and the CCI”, both of which explain the prohibition and assist providers in understanding how they can properly process claims with Medi-Cal.
- Crossover Only Provider Authorization Information
Advocates can direct providers to this page on the DHCS website where they can complete an abbreviated form in order to submit crossover claims to Medi-Cal without enrolling as full Medi-Cal providers.
If you are seeing balance billing issues for your clients, please let NSCLC know. Contact Georgia Burke, firstname.lastname@example.org.
Updated HIPAA Manual Available From CAADS
Is your ADHC in compliance with the "HIPAA Omnibus Rule?"
New Requirements! || Order Form
Don’t forget, as of September 23, 2013, all ADHCs need to be in compliance with the “HIPAA Omnibus Rule” which implements changes required by the HITECH Act of 2009. Failure to have internal guidelines in place that comply with the new Rule can lead to fines and other sanctions. CAADS worked with Allan Jergesen of Hanson, Bridgett to produce a HIPAA Compliance Kit to help you quickly come into compliance with new HIPAA rules.
California Association for Adult Day Services, a 501 (c) 6 non-profit grassroots-driven organization, advocates for the growth and development of adult day services in California and nationally. CAADS was the first state association formed in the United States for the purpose of advancing adult day services. CAADS member-centers provide innovative day programs that support individuals with physical or mental disabilities and older adults with Alzheimer's disease and their families.
A nationally recognized leader in the field of aging, the Association is governed by the CAADS Board of Directors and provides advocacy, timely information, analysis, technical assistance, education, and networking opportunities for member organizations. CAADS members agree to abide by the Association's Bylaws and Code of Ethics. For more information on CAADS Membership click here!
CAADS Members Only page features Adult Day Services specific information:
- State Budget Proposals
- Medi-Cal Issues
- Medicare and Medi-Cal Dual Beneficiaries News
- Medi-Cal Managed Care Health Plans
- Coordinated Care Initiative (CCI) and CalDuals Updates
- CA Dept of Managed Health Care Updates
- CA Dept of Public Health ADHC Licensing & Regulations
- CA Dept of Social Services ADP Licensing & Regulations
- Legislative Alerts and Advocacy
- Funding Sources
- Technical Assistance
- Education / Training Materials / Webinar Recordings
- CAADS Membership Roster
The Alliance for Leadership and Education (A.L.E.) is a non-profit 501(c)(3) public benefit arm of CAADS. The A.L.E. mission is to advance innovation and quality in Adult Day Service through research and analysis, education and training, and leadership for the benefit of consumers and their caregivers. The organization is governed by the 7-member A.L.E. Board of Directors.
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California Association for Adult Day Services
1107 9th Street, Suite 701 || Sacramento, California 95814-3610
TEL: (916) 552-7400 || FAX: (866) 725-3123 || EMAIL: email@example.com