On August 24, 2023, CMS released the final MDS Item Sets version 1.18.11v5 and on August 22, 2023, they released the final MDS 3.0 RAI User’s Manual version 1.18.11. AHCA has developed tools to assist with implementation of the new changes. These tools cover the changes to the MDS 3.0 Final Item set as well as incorporate the RAI manual guidance into considerations for application. 

Registration is free to AHCA/NCAL Members 

Follow the Instructions Below to Register: 

• To avoid technical problems, use Google Chrome. 
• Members will need to log in using their existing email and password first. 
• Once you are logged in to the website you will be able to register by clicking the green register button at the top of the page. 
• If you have forgotten your password click here. 
• If you are new to the site, you can create an account here. Answer all fields on the create an account page- especially locating your company name. You can search by name or zip code. After creating an account, you will be able to register.

Email educate@ahca.org if you need assistance.

© 2023 American Health Care Association. All rights reserved. Materials subject to this copyright may be photocopied or distributed for the purpose of nonprofit or educational advancement. The use, photocopying, and distribution for commercial purposes of any of these materials is expressly prohibited without the prior written permission of American Health Care Association.

New CMS SNF VBP measures effective 10/1/2023 will determine Medicare Part A rates beginning 10/1/2025. Understand the new skilled nursing value-based purchasing changes now or start writing your excuses for losing future Medicare reimbursements.  Learn how: 

• CMS calculates VBP measures, risk adjustment, facility score and payment adjustment.
• How CMS will apply the incentive payment multiplier
• To use a SNF VBP prediction calculator to estimate the financial impact of quality measures on Medicare Part A revenue.
• Adopting best practices now helps avoid Part A payment penalties and can boost future incentive payments.

Presenter: Kiran Sreenivas, Vice President, Research, Integrated Networks & Research, AHCA

Cost: $40 AHCA Members | $80 Non-Members

1.25 NAB CEs and 1.0 contact hour through the Iowa Board of Nursing are available upon course completion.

© 2023 American Health Care Association. All rights reserved. 

All SNF VBP Essentials materials subject to this copyright may be photocopied or distributed for the purpose of nonprofit or educational advancement. The use, photocopying, and distribution for commercial purposes of any of these materials is expressly prohibited without the prior written permission of American Health Care Association.

Since March 2020, States ceased Medicaid eligibility determinations and have been unable to disenroll any Medicaid beneficiaries from the Medicaid program.  The freeze on redeterminations and prohibition on disenrollment were based upon federal statutory requirements States had to meet to receive the increased federal Medicaid funding of 6.2% over the course of the pandemic.  Now, with the Public Health Emergency (PHE) ending, States are returning to “regular” Medicaid redeterminations schedules. 

Why This Matters

• States – State Medicaid Agencies have over 87 million redeterminations to conduct before May 2024.  Most states have not conducted redeterminations in over three years.  Over that period, beneficiary information has become out of date (contact information, financial information, etc.) and State Agencies have had significant staff turn over and shortages.  In many States, their State and/or County eligibility units may have few or no staff with redetermination expertise.  Despite CMS guidance and support, this could result in notable breaks in Medicaid coverage; and
• Providers – If a beneficiary loses Medicaid eligibility, Medicaid payments stop, and beneficiaries have very clear protections in federal law for when these breaks occur despite the loss of Medicaid payments.  Additionally, while at first glance waves of nursing facility (NF) and assisted living (AL) Medicaid redeterminations may seem of little concern, it is probable that the following are problematic: a) staff turnover in NF and AL business offices resulting in little to no Medicaid redetermination experience; and b) while older adult and persons with disabilities functional criteria to meet Medicaid Levels of Care are highly unlikely to change, the people involved with managing their finances likely have changed. 

For a more in depth discussion of Medicaid Unwinding, click here.

AHCA/NCAL Resources

The Association has prepared an array of resources aimed at supporting NFs and ALs to manage significant numbers of Medicaid Redeterminations.  Working with partner organizations, AHCA/NCAL has developed three modules and related tools. 

Disclaimer – Of note, these materials do not constitute business or legal guidance.  They are for general education and planning efforts, only.  For in depth support, please contact your information technology contractor, third party consultants or attorneys.

Course Outline:

• Module 1:  Medicaid Unwinding – Provider Action Steps and Tools
• Module 2: Financial Care Plan Development and Management
• Module 3:  Medicaid Application Development and Submission

This course is free to AHCA/NCAL members only. 

Follow the instructions below to register. 

• To avoid technical problems, use Google Chrome. 
• Members will need to log in using their existing email and password first. 
• Once you are logged in to the website you will be able to register by clicking the green register button at the top of the page. 
• If you have forgotten your password click here. 
• If you are new to the site, you can create an account here. Answer all fields on the create an account page- especially locating your company name. You can search by name or zip code. After creating an account, you will be able to register. 

Need further assistance? Email educate@ahca.org

A certificate of completion will be available upon completion. There are no CEs available for this training. 

© 2023 American Health Care Association. All rights reserved. 

All Medicaid Unwinding – Return to Regular Medicaid Redetermination: Ensuring Resident Medicaid Coverage materials subject to this copyright may be photocopied or distributed for the purpose of nonprofit or educational advancement. The use, photocopying, and distribution for commercial purposes of any of these materials is expressly prohibited without the prior written permission of American Health Care Association.

Who Should Register: Billing/Accounts Receivable Staff, Staff with Revenue Cycle Management Roles, Administrators 

As reimbursement models move away from fee-for-service and toward value-based reimbursement, managed care, and more complex patient characteristic-based methodologies, ensuring your billing and/or accounts receivable staff have clear and consistent claims submission and claims follow-up guidance is critical. Without such structure, SNFs may receive less than the appropriate and accurate payment amounts as well as overall revenue targets. Developing Revenue Cycle Management processes will help facilities coordinate clinical and administrative functions necessary for successful revenue cycle management systems and improve patient outcomes while saving time and lowering administrative costs. 

In this Revenue Cycle Management Academy, will learn about topics such as claims submission, third-party follow-up, securing prior authorization, strategies to navigate managed care appeals processes, and best practices associated with coordinating with MDS coding leads.

• Learn how to implements systems to assure proper and timely payment from all payers.     
• Learn about the attributes of a high-performing RCM Team. 
• Learn How to Use AHCA’s Medicare Advantage reimbursement management tools.

6.75 NAB CEs awarded upon successful completion of the program:

Price: 

$350 AHCA/NCAL members

$650 Non-members

© 2023 American Health Care Association. All rights reserved. 

All Revenue Cycle Management Academy materials subject to this copyright may be photocopied or distributed for the purpose of nonprofit or educational advancement. The use, photocopying, and distribution for commercial purposes of any of these materials is expressly prohibited without the prior written permission of American Health Care Association.

Group Discounts Available for Individuals from the Same Facility or Corporate office: $300 per person

Email educate@ahca.org for more information. 

Please use Google Chrome for the best user experience. 

One individual can purchase multiple registrations for more participants by adding them to their cart during the checkout process. Please note, for this option to work, every participant will need to have an ahcancalED account first. 

To add several participants, please click the green button in the cart that says: 

  . 

You will then be able to search for more than one participant using their email address. If the person making payment should not have access to the course, then you can remove yourself by clicking the red "remove" button by your name.

*Payment Tip: The price of the training will be based on each registrant’s member type (member or non-member). please be sure when you are paying with a credit card the bill-to and shipping address are the same* 

If you need assistance, please email educate@ahca.org

How To Access the Webinar:

Revenue Cycle Management Academy participants can log in to their course to access the live webinar and/or listen the subsequent recording. These additional 2023 webinars are bonus content and not mandatory to receive the CEs offered upon successful completion of the RCM Academy curriculum. 

 Not Yet Registered for RCM Academy…If you would like to view this webinar and have access to the entire RCM Academy curriculum and bonus RCM webinars throughout 2023, you can enroll at RCMacademy.ahcancal.org. AHCA’s Revenue Cycle Management (RCM) Academy online training program takes a holistic interdisciplinary approach toward SNF revenue management. RCM Academy helps develop concrete strategies to secure earned dollars and to “stay paid” when thinking about managed care payment recoveries. RCM Academy helps SNFs: Prepare for the eventual phase down of COVID-related government assistance Stabilize and better manage a predictable revenue flow relative to overhead Stay paid when considering Medicare Advantage Plan payment recovery trends.

This first recording provides expert insights from Certified Public Accountants (CPA) who consult with many of our members. The 90-minute webinar overs a road map and tips on: a) revenue management and opportunities; b) expense management strategies; and c) compliance strategies to mitigate recoveries. Also available are three model checklists associated with each of the three sections noted above. The webinar also provides guidance on how to tailor these three template checklists to your needs. 

© 2022 American Health Care Association. All rights reserved. 

All Independent Owner In-Focus Series: Maximizing Cash Flow and Enhancing Net Income materials subject to this copyright may be photocopied or distributed for the purpose of nonprofit or educational advancement. The use, photocopying, and distribution for commercial purposes of any of these materials is expressly prohibited without the prior written permission of American Health Care Association.

AHCA/NCAL now has available a pre-recorded webex on the January 15, 2021 PRF Reporting Registration instructions as well as the updated reporting guidance.  The video recording includes:   

• Detail on registration 
• Important registration FAQs 
• Recommended Terms and Conditions Compliance Controls 
• PRF Reporting Update Overview  

AHCA /NCAL will provide updates to this information as HHS provides additional detail.   

This webinar is available to AHCA/NCAL members only. 

How to Register: 

• To avoid technical problems, use Google Chrome. 
• Members will need to log in using their existing AHCA/NCAL username and password first. 
• Once you are logged in to the website you will be able to register by clicking the green register button at the top of the page. 
• If you have forgotten your password click here. 
• If you are new to the site, you can create an account here. Answer all fields on the create an account page- especially locating your company name. You can search by name or zip code. After creating an account, you will be able to register for the webinar. 

Need further assistance? Email educate@ahca.org

© 2022 American Health Care Association. All rights reserved. 

All PRF Reporting Requirements – Updated January 25th materials subject to this copyright may be photocopied or distributed for the purpose of nonprofit or educational advancement. The use, photocopying, and distribution for commercial purposes of any of these materials is expressly prohibited without the prior written permission of American Health Care Association.