Overview
On Thursday, March 12, IHCA hosted its monthly Home Care Provider Update Call to discuss the most recent changes for the home health and home care profession.
The meeting covered several key updates and discussions:
- Annette Lee of Provider Insights presented changes to OASIS data collection, including new transportation questions and updated risk adjustment items, while explaining the transition to OASIS E-2 starting April 1.
- IHCA’s Brandon Hagen provided legislative updates on two key bills — HF2641 (Elderly Waiver) and HF2680/SF2366 (a CMA bill) — that have passed through the Iowa House and are moving through Senate committees, along with a discussion of rural travel reimbursement for waiver services.
- IHCA’s Hannah Freund promoted the upcoming Spring Conference, highlighting Annette’s CMS Report Workshop and other home care sessions on March 26.
- The conversation ended with discussions about CMS value-based purchasing (VBP) adjustments for Medicare Advantage plans, with members sharing concerns about how these adjustments are being applied differently than traditional Medicare claims.
Hosts
- Annette Lee of Provider Insights and IHCA Home Care Consultant
- Brandon Hagen, SVP, Reimbursement and Policy Advisor, IHCA
Summary
OASIS E-2 system updates
The meeting focused on updates to the OASIS assessment system, with Annette explaining the transition to OASIS E-2 starting April 1. She outlined key changes including a new transportation item with a 12-month timeframe, the addition of hearing, vision and language to resumption of care assessments and modifications to how falls and injuries are reported. Annette emphasized that if a patient declines to answer a question, only “patient declines” can be recorded, unless the patient is unable to respond, in which case a proxy answer can be used.
Patient care measures update meeting
Annette discussed upcoming changes to patient care measures and surveys starting in May, including updated CAHPS surveys and a new checklist for patient safety, pain and medication documentation. She clarified that CMS now allows two different providers in the community for face-to-face compliance, provided there is evidence of collaboration, especially if they are from different practices. Annette emphasized the importance of obtaining a sufficient number of completed CAHPS surveys to avoid negative impacts on overall scoring and reminded participants to use the CMS-approved form for patient home folders.
Iowa legislative update on IHCA bills
Brandon provided a legislative update, focusing on two key IHCA bills: HF2641, which addresses Elderly Waiver and assisted living services and HF2680/SF2366, a CMA bill aimed at aligning definitions and creating an online catalogue. Both bills have passed the House and moved to the Senate, with the CMA bill appearing funnel-proof. Brandon also highlighted HF2716, which includes provisions for rural waiver service reimbursement and the creation of a high-acuity pediatric work group. He also mentioned ongoing efforts to secure $3 million for home health LUPA rates and $5 million for Elderly Waiver services.
Spring Conference updates and preparations
The meeting covered updates on IHCA’s upcoming Spring Conference, which begins next week and includes sessions on home care, with Annette scheduled to lead two CMS sessions. IHCA’s Education Director Hannah Freund announced that Spring Conference registration is near capacity and that participants are encouraged to register soon. Annette discussed the importance of reviewing CMS reports and highlighted a new final report for home health VBP, as well as a review and correct report to improve five-star VBP measures. Additionally, Hannah shared that the webinar, Documentation Reimagined: How AI is Reshaping Home Health Operations, is now available on-demand and Annette mentioned that Quarter 2, Quarter 3 and Quarter 4 survey results from the Iowa Department of Inspections, Appeals and Licensing (DIAL) would be released within the next week, with no significant changes noted in deficiencies.
Medication error reporting and denials
The meeting concluded with a discussion on two topics: reporting requirements for medication administration errors and issues with Iowa Total Care denying aid services for patients in group homes. Annette agreed to consult with Barb Rasmussen of Iowa Department of Inspections, Appeals and Licensing (DIAL) about guidelines for reporting errors to DIAL, as there are currently no specific requirements for in-home health reporting. The group also discussed concerns about Iowa Total Care and other payers denying aid services for patients in group homes, with members reporting recent denials that required appeals. Additionally, another member raised a new issue about Medicare Advantage plans applying VBP adjustments based on 2024 data, which Annette agreed to investigate further with her contact at the National Alliance.
Next steps:
- Annette will reach out to Barb Rasmussen of DIAL to clarify if home health agencies are expected to self-report medication administration errors to DIAL and where to find relevant regulatory language. She will share findings and distribute to all members via the association.
- Annette will consult the Medicaid manual to determine if there are additional reporting requirements for Medicaid patients regarding incident reporting and share findings with the group.
- Annette will distribute Quarter 2, Quarter 3 and Quarter 4 DIAL survey results from 2025 to members within the next week or so.
- Annette will contact Katie Weary at the National Alliance to inquire if Medicare Advantage plans applying VBP penalties (but not rewards) is a known issue and will share the response with the group.
Education Opportunities
Upcoming education:
- IHCA Spring Conference | March 25-26
On-demand education:
- Documentation Reimagined: How AI is Reshaping Home Health Operations
- Home Health Final Rule 2026 Webinar
- CNA In-Service Training Series
- Home Health Star Ratings
- Home Health In-Service Training Series
Please submit any education topic or speaker suggestions to IHCA’s Education Director, Hannah Freund.