MHCA Informer 7/2/2025
Thursday, June 26, 2025
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YOUR BIMONTHLY SOURCE FOR HOME CARE NEWS
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Wednesday, July 2, 2025
Official Publication of Minnesota Home Care Association MHCA's office will be closed July 4 for the holiday.
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Inside the Informer
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MEMBER NEWS
MHCA IN ACTION
MEMBER CORNER
COMPLIANCE CORNER
STATE NEWS
FEDERAL NEWS
EDUCATIONAL OPPORTUNITIES
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Member News
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MHCA Board Nominations Open
The MHCA Leadership Development Committee is now accepting nominations for the Board of Directors. The committee places a priority on individuals that have leadership skills, are strategic thinkers, and have experience
serving on MHCA committees. Have you considered this leadership opportunity for yourself, or do you know a provider member that fits this description? The 3-year term would begin January 1, 2026.
The nominees will be voted on at the Annual Meeting on October 1, and all primary contacts of Provider Members will be eligible to vote (secondary contacts can vote in their absence), so don’t miss out on your chance to
lend your voice to MHCA’s 2025 leadership!
All nominations must be submitted by August 13, so nominate yourself or a colleague today!
Learn More and Nominate
here.
Join us for an AI Management Webinar on July 30
Join our expert speakers to explore the potential risks of AI use in the workplace and how to establish effective policies, procedures, and training to protect your organization while leveraging the benefits of AI.
Register here.
Register for Blueprint for OASIS – E1 Accuracy on August 4-5
Join the comprehensive and nationally acclaimed 2-day Blueprint for OASIS Accuracy workshop and learn to confidently teach, audit, and collect OASIS-E1 items accurately. Make plans to attend with the dedicated OASIS Answers
team as we master the guidance for 2025 together.
Register here.
Need to take the COS-C Exam? Register now!
Administered the day following the Blueprint for OASIS Accuracy training, the scope of the COS-C exam is similar to the Blueprint workshop agenda, covering current CMS OASIS data collection rules and guidance related to
OASIS time points, regulations, patient populations, and OASIS item specific scoring. Candidates who successfully pass the examination are awarded the COS-C designation.
Register for the exam here.
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MHCA IN ACTION
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U.S. Senators Pen Letter to CMS Calling for Pause to Cuts
Last week, Senators Marsha Blackburn (R-TN) and Susan Collins (R-ME) sent a joint letter to the Centers for Medicare and Medicaid Services (CMS) Administrator Mehmet Oz calling on the agency to pause further cuts to
the Medicare home health benefit in the upcoming CY 2026 proposed rule. Through engagement from MHCA and the National Alliance for Care at Home, this letter strongly reinforces the concerns the Alliance has continued
to raise about the threat that continued payment reductions pose to home health access.
This support from Senators Blackburn and Collins is appreciated and highlights the power of advocacy that comes from providers like you. With the Proposed Rule published (see article below), there is an even greater need for Congress to hea
r from you – these proposed cuts will be detrimental to you and your cents!! Please watch for email alerts regarding messaging for the MN Congressional Delegation.
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Member Corner
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Kudos to Emplify Health Scrubs Camp Team
Colleen Drenkhahn, from Emplify Health (formerly Gundersen - St. Elizabeth Home Health), has led a team at the Winona Scrubs Camp for several years. Colleen serves on the MHCA Workforce Workgroup and is passionate about piquing the students’ interest in trying home health as a career.
The Winona Scrubs Camp staff requests their return each year and were especially grateful for the MHCA volunteers this year! This year, an emergent situation arose in the MHCA session, with a student fainting. The home care team from Emplify took charge, obtaining vitals and medical history for the EMT crew, while clearing the other students out of the room and alerting the Scrubs Camp leadership, who noted a lesson learned for next year – when they will have an instant phone contact procedure in place.
Kudos to the Emplify team for managing this unexpected situation with expertise!!
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COMPLIANCE CORNER
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OASIS Privacy Notice
As required by the Home Health Conditions Of Participation (COP), an OASIS privacy notice must be provided to all patients for whom the OASIS data is collected. Effective January 1, 2025, all patients for whom the HHA collects
OASIS, regardless of payer, should be provided Atachment A – Statement of Patient Privacy Rights, and the Privacy Act Statement – Health Care Records.
These documents are available on the Home Health Agency (HHA) Center
. Both documents are available in English and Spanish.
Beginning January 1, 2025, and until further notice, Attachment C – Notice About Privacy for Patients Who Don't Have Medicare or Medicaid should not be provided to patients.
If you have questions, please reach out to MHCA’s Regulatory Affairs Manager Paulette Duncan for assistance.
CMS Releases Update to Policy & Memos to States and CMS Locations Page
The Centers for Medicare & Medicaid Services (CMS) released a memo with an update regarding CMS-2567: Statement of Deficiencies and Plan of Correction (CMS-2567) form. According to this memo the following has been updated.
- CMS will make these forms publicly available within 14 days after receipt by the provider/agency.
- The timeframe an agency has to review and respond has not changed.
- The guidance also applies to Accrediting Organization (AO) survey findings related to Home Health and Hospice agencies.
Read the full article.
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STATE NEWS
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Minneapolis VA Home and Community Based Services Newsletter
The Minneapolis VA released the latest edition of the Home and Community Based Services Newsletter and Directory.
View the newsletter.
View the directory
CFSS Cost Reporting Team Demonstration and Q&A Webinar
The Minnesota Department of Human Services’ CFSS Cost Reporting Team will host two webinars that will include a demonstration and Q&A session about cost reporting for PCA and CFSS agency model providers. Participants only
need to attend one of the webinars, which will be held July 9 and August 6.
Learn more and register.
New MHCP Information
The following information changed on the MHCP Provider website:
The MHCP Provider Manual has updated the questions and answers section of the Community First Services and Supports (CFSS) Provider Agency Enrollment Criteria and Forms.
The link to register and attend the questions and answers sessions is also updated.
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FEDERAL NEWS
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2026 Home Health Prospective Payment System Rate Proposed Rule
On June 30, the Centers for Medicare & Medicaid Services (CMS) issued the calendar year (CY) 2026 Home Health Prospective Payment System Rate and Durable Medical Equipment, Prosthetics, Orthotics, and Supplies Competitive
Bidding Program Updates proposed rule. CMS has also released a fact sheet
accompanying the proposed rule. The National Alliance for Care at Home (the Alliance) issued a statement i
n response, “…If implemented, this rule will further cut the Medicare benefit and have catastrophic impacts on home health care access by forcing providers to close their doors, expanding existing and creating new
home health care deserts, and leaving patients without the essential care they need…Since the inception of the new payment system in 2020, total Medicare home health expenditures have declined year-over-year,
a fact that is directly at odds with CMS’s assertion that aggregate expenditures under the new system are higher than they otherwise would have been prior to the 2020 changes.”
Key Provisions Include:
- For CY 2026, CMS proposes to reduce payments to HHAs by 6.4%, or $1.135 billion, which reflects the impact of a 2.4% increase in payments due to the statutorily-required annual payment update, a 3.7% reduction in payments
due to a proposed budget neutrality permanent adjustment, a 4.6% reduction in payments due to a proposed budget neutrality temporary adjustment, and a 0.5% decrease in payments related to a proposed update to the
Fixed-Dollar Loss (FDL) ratio.
- Proposes changes to who may conduct the Face-To-Face encounter policy.
- Updates the Home Health (HH) Quality Reporting Program (QRP) by removing COVID-19 and several assessment items.
- Proposes a new Home Health Consumer Assessment of Healthcare Providers and Systems® (HHCAHPS) survey beginning April 2026.
- Includes an update to the Home Health Value Based Purchasing Program (HHVBP) to reflect the new HHCAPHS survey and proposes four new measures.
- Proposes Medicare provider enrollment changes.
- Includes three Requests for Information – Advance Digital Quality Measurement, Future Quality Measure Concepts, and Changes to the HHVBP.
MHCA Medicare Workgroup will review the proposed rule and collaborate with the Alliance on comments that are due by August 29, 2025. The overall impact of the rule is an estimated $1.135 billion decrease in payments relative to CY 2025. View
the full proposed rule and its wage index tables.
Veteran Affairs Audits
The Veteran Affairs (VA) has been conducting additional LUPA audits for 2021-2024. It appears agencies are continuing to receive letters requesting that the provider repay episodes (take-backs). MHCA is following up with
the VA, Optum and TriWest Healthcare Alliance. If you have any questions or comments on the VA audit, please reach out to Paulette Duncan.
Health Insurance Prior Authorization Initiative
U.S. Health and Human Services (HHS) Secretary Robert F. Kennedy, Jr. and Centers for Medicare & Medicaid Services (CMS) Administrator Dr. Mehmet Oz met with industry leaders to discuss their
pledge to streamline and improve the prior authorization processes for Medicare Advantage, Medicaid Managed
Care, Health Insurance Marketplace®, and commercial plans covering nearly eight out of 10 Americans.
In a roundtable discussion hosted by HHS, health insurers pledged six key reforms aimed at cutting red tape, accelerating care decisions, and enhancing transparency for patients and providers. Participating health insurers
have pledged to:
- Standardize electronic prior authorization submissions using Fast Healthcare Interoperability Resources (FHIR®)-based application programming interfaces.
- Reduce the volume of medical services subject to prior authorization by January 1, 2026.
- Honor existing authorizations during insurance transitions to ensure continuity of care.
- Enhance transparency and communication around authorization decisions and appeals.
- Expand real-time responses to minimize delays in care with real-time approvals for most requests by 2027.
- Ensure medical professionals review all clinical denials.
Adapted from the National Alliance for Care at Home
Alarming Delays and Declining Access to Medicare Home Health Contribute to Worse Outcomes
Medicare beneficiaries are waiting longer—and too often going without —the home health care they were referred after a hospital stay. This growing gap in access harms vulnerable seniors, is associated with higher mortality,
leads to more preventable ER visits and hospital readmissions, and increases Medicare costs. Access to home health for Medicare beneficiaries has deteriorated as CMS has pushed ahead with payment cuts at the same time
providers are navigating workforce shortages and Medicare Advantage growth that have had destabilizing effects on the home health system.
Medicare Fraud Scheme Involving Phishing Fax Requests
The Centers for Medicare and Medicaid Services has identified a fraud scheme targeting Medicare providers and suppliers. Scammers are impersonating CMS and sending phishing fax requests for medical records and documentation,
falsely claiming to be part of a Medicare audit.
Important: CMS doesn’t initiate audits by requesting medical records via fax. Protect your information. If you receive a suspicious request, don’t respond. If you think you got a fraudulent or
questionable request, work with your Medical Review Contractor
to confirm if it’s real.
MedPAC June 2025 Report: Medicare and Health Care Delivery System
The Medicare Payment Advisory Commission (MedPAC) issued its June 2025 Report to Congress: Medicare and the Health Care Delivery System, which includes chapters with implications for Medicare Advantage (MA) and home health
and hospice providers. Particularly, MedPAC issues its findings in three relevant areas for home-based care providers: home health care use in MA, MA supplemental benefits, and Medicare quality measurement for rural
providers. A few of the MA related highlights include:
- Among those discharged from a hospital, MA enrollees were somewhat more likely to receive home health care (41.7% of MA patients vs. 40.4% in FFS). MedPAC indicates this may reflect MA plans using home health as a substitute
for higher-cost institutional care.
- Among beneficiaries without a recent hospitalization, home health use was significantly lower in MA—only 3.7% of non-hospitalized MA enrollees used home health in 2021, compared to 4.2% in FFS.
Among beneficiaries who received home health, MA enrollees received about 11% fewer visits per year on average than FFS beneficiaries.
Access the full report.
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Educational Opportunities
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Upcoming MHCA Events - Register Today!
On-Demand Opportunities
Click on the logos below for a list of courses offered!
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Find on-demand education here!
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FREE FOR MEMBERS!
RCTCLEARN Resources:
RCTCLEARN’s OASIS-E1-Integrating Data Collection into Patient Care Training Series is available and consists of 8 comprehensive Online Modules.
Please visit
https://rctclearn.net/oasis
to order your OASIS-E1 Training Series Package. New
and returning OASIS Training Series clients will receive access to the OASIS-E1 Training
Series after payment is made.
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P: 651.635.0607 | F: 651.635.0043 | www.mnhomecare.org | membership@mnhomecare.org
Mission: MHCA represents and supports Minnesota home care providers committed to high quality home care services.
Vision: MHCA will shape the home care landscape to improve and sustain quality home care services.
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