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Home Care Week

Patient-Driven Groupings Model:
Final Rule Lowers Behavioral Cut — But Not Enough
Expect the cuts to keep on coming in the future. Home care providers are having a hard t... Read more
Reimbursement:
HHA Rate Increase Holds Steady At 1.3%
PDGM to create winners and losers. A payment rate increase that would usually draw prais... Read more
Billing:
That’s A Wrap For RAPs
Medicare will eliminate advance payments altogether in 2021. If you aren't on top of the... Read more
Billing:
This Good RAP News Is Actually Bad News
NOA delay to 2022 isn't the solution providers hoped for. If there was an idea commenter... Read more
Regulations:
Watch For Expansion Of OASIS To All Patients In Future Rule
Plus: Burdensome SPADE implementation, a maintenance therapy change, and more are on deck ... Read more
Hospice:
Is A 20% Cut To The Hospice Cap On The Horizon?
Reduction would disproportionately affect for-profit, freestanding hospices. If you butt... Read more
Industry Note:
Don’t Look For PDGM Changes In 2020 Final Rule
You may find reasons, but not revisions. A sweeping new home health payment system takes... Read more
Industry Note:
Kansas HHA Owes Millions After Audit, OIG Says
Once again, the HHS Office of Inspector General has backed off the number of claims it sai... Read more
Industry Note:
Hospices May Accept Drug Orders From PAs
While the red tape keeps mounting for hospices, there is a small snip to lend some relief ... Read more
Industry Note:
Celebrate This Month
In the flurry of PDGM preparations, holiday scheduling, Review Choice Demonstration implem... Read more
Industry Note:
Tap New OASIS Training On GG0130A
While Medicare officials have just finalized plans to expand OASIS significantly with a ho... Read more
Industry Note:
CHOWs Count Too For RAP Suppression
The official word is in: Provisional enhanced oversight does affect home care providers un... Read more
Industry Note:
OASIS-D Specs Are Out
After a long wait, the OASIS-D data specifications have finally arrived. “The new versi... Read more
Review Choice Demonstration:
Industry Cheers Surprise Review Choice Demo Delay
CMS listens to reason just weeks after setting burdensome start date. You may be getting... Read more
Medical Review:
RCD Isn’t Going Away
When will the medical review program go nationwide — if ever? If you think the burden ... Read more
Quality:
CMS Wants To Add New OASIS Items, Health Info Transfer Measures
Commenters push back on OASIS burden. If the mountain of new SPADE elements proposed for... Read more
OASIS:
Check Out The Details For New Info Transfer OASIS Items
Start looking ahead to OASIS-E. You may be worry about the transition to OASIS-D1 in Jan... Read more
Industry Note:
Don’t Get Tricked By Home Office Cost Statement Switch This Month
You still have a few weeks to submit comments. If you submit a home office cost statemen... Read more
Industry Note:
Official Data Specs For OASIS-D1 Still Not Out
The OASIS-D1 tool is out, but the data specifications have yet to be released. Keep an eye... Read more
Industry Note:
Secure Your Rightful Pay For Claims Returned Due To Entitlement Data Glitch
Don't miss out on reimbursement because you fail to resubmit claims that were incorrectly ... Read more
Industry Note:
AIC Threshold To Rise
The amount in controversy (AIC) thresh- old amounts for Administrative Law Judge hearings ... Read more
Industry Note:
An ‘Unusual Pairing’ Results In Blockbuster Sale
Private equity firm Towerbrook Capital Health and health system Ascension Health have comb... Read more
Industry Note:
NC Hospices Merge
In North Carolina, Hospice of the Piedmont in Asheboro and Hospice of Randolph in High Poi... Read more
Industry Note:
New York Acquisition Moves Forward
Spring Valley, New York-based Marquis Home Care's $1.5 million acquisition of Albany, New ... Read more
Industry Note:
5 Rural HHAs To Pay Millions After Therapy Stats Triggered Scrutiny
Don't ignore warnings that your billing statistics are sticking out like a sore thumb. Fi... Read more
OASIS:
OASIS For All A Bad Idea, Commenters Warn CMS
Watch for this issue in next year's rulemaking cycle. The 2020 proposed rule for home he... Read more
Assessment:
Get Ready For Your OASIS Burden To Increase — In SPADEs
New cross-setting OASIS items will overwhelm beleaguered HHAs, commenters warn CMS. If y... Read more
Quality:
Take A Look At New OASIS Items On Deck
New items on topics from high-risk drugs to social determinants of health will add to HHAs... Read more
OASIS:
You Can Opt Out Of These OASIS Items Under PDGM
That only goes for Medicare, new question-and-answer set clarifies. The Patient-Driven G... Read more
HIPAA:
Don’t Let Social Media Mistakes Haunt Your Agency
Remember to train staff on your policies and procedures. If you're not careful, instead ... Read more
Industry Note:
GAO Tallies Disposable Wound Device Price Tag
Report highlights generous Medicare coverage. If law- or policymakers are looking for pl... Read more
Industry Note:
This Court Decision Is Not A ‘Free Pass’
The recent court decision in the AseraCare case is good news, but providers shouldn't get ... Read more
Industry Note:
Recoupment Of RAP Auto-Cancels Changes
If you've got a high RAP auto-cancel rate, new overpayment procedures related to Requests ... Read more
Industry Note:
MBI Usage Creeps Up
Use of the new Medicare number continues to inch up. For the week ending Sept. 27, provide... Read more
Industry Note:
Texas Doc Convicted Of Home Health Kickbacks
The feds' crackdown on physicians involved in Medicare fraud continues. In Texas, a jury h... Read more
Industry Note:
Revamped Post-Acute Data Files Debut
A new wealth of data is now at your fingertips. The Centers for Medicare & Medicaid Se... Read more
Industry Note:
Nonprofit Plans Buy In Ohio
The Visiting Nurse Association of Ohio in Brooklyn Heights plans to acquire Ideal Home Hea... Read more
Patient-Driven Groupings Model:
Leave RAPs In Place Or Risk Access, Commenters Urge CMS
Waiting on physician documentation will exacerbate cash flow crunch. If Medicare moves f... Read more
Reimbursement:
RAP Reduction, Elimination Hit Small Providers Hardest
PDGM, RCD, and more deal multiple blows to many agencies. While the Request for Anticipa... Read more
Billing:
30-Day Billing Periods Will Strain HHAs’ Billing Capacity
Prepare to tackle confusion as billing switches to 30 days, but other requirements don't. ... Read more
Regulations:
HHAs Wait To See Whether They’ll Have To File NOAs
Notice of Admission content still in flux. When RAPs go away, Medicare wants home health... Read more
Medical Review:
One RCD Request Isn’t All That Helpful
Problem: Reviewers for same cert may disagree. A clarification from CMS about how the Re... Read more
Industry Note:
Don’t Miss This PDGM Training From The MACs
Get more payment system details. As the clock counts down to PDGM's implementation Jan. ... Read more
Industry Note:
New Executive Order From Trump Pushes Medicare Advantage
A new executive order signed by President Trump could bring you some regulatory relief —... Read more
Industry Note:
Feds Propose Updates To Stark Self-Referral Law
Home care providers running into Stark Law barriers when crafting retirement plans for ESO... Read more
Industry Note:
Here’s How To Fight Billing Deactivation
As Medicare tightens up its enrollment procedures, it also is issuing official instruction... Read more
Industry Note:
Note This LCD Coding Change
Don't expect to get diagnosis coding specifics in your Local Coverage Decisions going... Read more
Industry Note:
HH Chain Launches Hospice Division
A home health holding company is branching out into hospice. AngMar Medical Holdings Inc. ... Read more
Review Choice Demonstration:
Surprise! RCD Will Launch In Texas In December
PDGM + RCD will close doors, expert warns. An Oct. 2 announcement from Medicare has dash... Read more
Medical Review:
Texas HHAs Must Get Down To RCD Business
With the Review Choice Demonstration start date announced in Texas, agencies there must ki... Read more
Discharge Planning:
Start Preparing For Your New Discharge Planning Duties
Step 1: Decide on your definition of ‘all necessary medical information.' If you are co... Read more
Compliance:
Educate Yourself To Educate Your Patients
Discharge planning rule puts patients in the driver's seat, CMS maintains. Don't overloo... Read more
Regulations:
Patient Steering Concerns HHAs In Discharge Planning Rule
CMS encourages hospitals to highlight quality, cost info for referrals. The new discharg... Read more
Industry Note:
Overtime Exemption Final Rule Shouldn’t Rock Your World
Check your salary levels to see who may become overtime-eligible Jan. 1. After years of ... Read more
Industry Note:
Hospitals Must Plan For Hospice Discharges
Hospices may see some effect from Medicare's new discharge planning rule, too. The final r... Read more
Industry Note:
HH Compare Sneak Peak Now Available
Now's your chance to get a look at your data that will go up on Home Health Compare in Jan... Read more
Industry Note:
Watch For Pay-Reducing Letter
You now can find out whether you're slated to get less in Medicare payments starting in Ja... Read more
Industry Note:
ABN Changes For Dual Eligibles On Deck
Don't let an ABN change sneak past you. While the Centers for Medicare & Medicaid Serv... Read more
Industry Note:
MAC Targets GIP, NCLOS Stats For Review
If you're wondering what hospice topics are catching medical reviewers' attention at HHH M... Read more
Conditions of Participation:
HHAs Get Unexpected Gift In Aide Competency Reversal
CMS offers a helping hand out of the blue. Just when it looked like CMS had dug in on no... Read more
Compliance:
Proposed Deregulation Shot Down
Bad news: You still have to furnish the patient rights verbal notice on the next visit. ... Read more
Patient-Driven Groupings Model:
Home Care Industry Decries 8% Behavioral Adjustment Cut
Will fewer comment letters mean fewer concessions? It's surely no surprise to Medicare o... Read more
Diagnosis Coding:
CMS Goes Overboard On Coding Adjustments In PDGM
Coding must adhere to the medical record, commenter points out. A big part of the calcul... Read more
Reimbursement:
PDGM Threatens Existence Of Vulnerable Agencies, Access
Commenters: The doors of the most-needed HHAs will close under the new payment system. M... Read more
Industry Note:
CMS Tosses List Of 22 Items For Discharge/Transfer Summaries
Medicare rule takes a step back on many proposed discharge requirements. Nearly four yea... Read more
Industry Note:
Failure To Recertify DDE Access Can Lead To Painful Payment Problems
If you've failed to recertify your DDE user access by Sept. 30, prepare to lose your cash ... Read more
Industry Note:
iQIES Rollout To Start Small — But You Still Need A New Account
Put iQIES signup on your already crowded to-do list for the new year. Home health agencies... Read more
Industry Note:
New Private Equity-Backed Hospice Chain Starts Acquisition Spree
A private equity-funded hospice launched in Dallas has made three new acquisitions. Three ... Read more
Industry Note:
4 Charged In Hospice Kickback, Fraud Schemes
Four individuals face criminal charges in two separate California hospice fraud cases. An... Read more
Reimbursement:
Heed These PDGM Clarifications
Warning: RAP instructions may boost your cancel rate. As the Jan. 1 implementation date ... Read more
Regulations:
This Type Of Payment Suspension Won’t Hurt You Under New Rule
Most affiliations are harmless, CMS official assures forum attendees. Home care provider... Read more
Hospice:
Watch Out For These Addendum Trouble Areas
Figure out effective signature procedures or risk your reimbursement. Like it or not —... Read more
Whistleblowers:
Court Ruling A ‘Death Knell’ For Most Hospice FCA Cases
AseraCare appeals court ruling shoots down feds' favorite strategy. A long-running whist... Read more
HIPAA:
Pay Attention To This HIPAA Settlement Case
Hint: This might be the first right to access case, but it won't be the last. With so ma... Read more
Industry Note:
Follow These Steps To Avoid Bad Marks Under CERT
A little staff education is likely in order. With calls for using CERT to target high-ri... Read more
Industry Note:
Stay Informed About Forthcoming Hospice Patient Assessment Tool
If you're hoping to keep up to date on the new hospice patient assessment tool but missed ... Read more
Industry Note:
4 Out Of 5 Of Your Peers Are Submitting Claims Using The MBI By Now
Hop on board the Medicare Beneficiary Initiative train before it's too late. For the week ... Read more
Industry Note:
Florida Hospices Tussle Over Name
A legal fight over a hospice's name continues in Florida. Background: In June, children's... Read more
Industry Note:
OIG Opens 50th MFCU
The HHS Office for Inspector General has opened a new Medicaid Fraud Control Unit in North... Read more
Industry Note:
Tap This Data Source
If you're looking for relevant Medicare data, you might find it in the Medicare Payment Ad... Read more
Enrollment:
New Program Integrity Rule Burdens Legitimate Providers
Affiliation reporting requirements will be a bitter pill for home care providers to swallo... Read more
Compliance:
The Bar For Affiliation Is Surprisingly Low
There may be a lot more people and entities than you expect on your affiliation list. Me... Read more
Regulations:
Here’s What Falls On The Disclosable Event List
Watch out: It doesn't matter how long ago the event happened. Once you figure out who yo... Read more
Enrollment:
Name Switch Will Result In Enrollment Denial
Feds are on the lookout for fraudster tactics. It's not only affiliation-related violati... Read more
Mergers & Acquisitions:
Home Health M&A Forges Ahead In Face Of PDGM
One national chain has been on a buying spree. The uncertainty of the home health reimbu... Read more
Hospice:
Hospice Facilities Are Positioned To Capture Higher Inpatient Payments
Reminder: Oct. 1 will bring lower RHC rates, higher GIP and inpatient respite rates. Mul... Read more
Industry Note:
30 Charged In Wide-Ranging HH, Hospice Kickback Scheme
Bribes included NBA game tickets, designer bags, and cold hard cash. Doctors, nurses, an... Read more
Industry Note:
Virginia Hospice Agrees To $3.1M Settlement
Hospice and palliative care provider Capital Caring in Falls Church, Virginia, has agreed ... Read more
Industry Note:
Will CMS Use CERT Data To Target High-Risk HHAs?
Your CERT results could land you in hot water, if CMS listens to the OIG. The Centers for... Read more
Industry Note:
Preview Newest Hospice Compare Data By Oct. 11
Hospice provider preview reports and Hospice Consumer Assessment of Healthcare Providers a... Read more
Industry Note:
Unlock N793 RARC
Wondering what that new N793 Remittance Advice Remark Code on your RAs means? With the Me... Read more
Industry Note:
Notify Vendor When This CAHPS Scenario Occurs
If you assume you can just skip contacting your CAHPS vendor in months where you don't hav... Read more
Industry Note:
New Nonprofit Hospice Network Launches
Local hospice networks continue to gain traction. In California, Elizabeth Hospice in San ... Read more
Industry Note:
Regional Chain Opens Another New Location
St. Croix Hospice has opened an office in Cedar Falls, Iowa, marking its seventh branch in... Read more
Audits:
OIG Slaps HHA With $1.26 Million Overpayment
Feds' extrapolation practices are ‘flawed and unreliable,' agency counsel blasts. Back... Read more
Hospice:
Prepare To Make These Election Statement Changes Next Year
Consider the statement step 1 in a new 2-part election process. You have extra time to a... Read more
Elections:
Medicare Presses Ahead With Burdensome Addendum
You'll have to wade into the messy gray area of what's unrelated. The optional second pa... Read more
Regulations:
Here’s What Medicare Expects To See In Your New Election Statement Addendum
You'll need to become an expert on what's related — and what's not. Get ready to take ... Read more
Emergency Preparedness:
Dorian Tests Emergency Preparedness
Public health emergencies declared in 3 states and Puerto Rico so far. At press time, ho... Read more
Industry Note:
Bene-Sharing Medical Review Topic Will Examine Outliers
Watch out for what patients do behind your back. If you're curious about Palmetto GBA's ... Read more
Industry Note:
Don’t Overlook This Important Consideration When Scoring GG0130E
Clinicians continue to struggle with completing the new GG OASIS questions. For example: ... Read more
Industry Note:
Having Trouble Keeping Your HHCCNs, ABNs, And NOMNCs Straight? Turn To This New Resource
If you have questions about Medicare beneficiary notices that no amount of research seems ... Read more
Industry Note:
CMS Sends MACs The Final Hospice Numbers In New Transmittal
The hospice rates and other payment changes taking effect next month have been officially ... Read more
Industry Note:
There’s An App For That — Learn About Blue Button 2.0 And The ‘Data At The Point of Care’ Pilot In CMS’ Latest Podcast
The Centers for Medicare & Medicare Services' latest podcast takes on the topic of ele... Read more
Billing:
Decode HIPPS Digits Under PDGM
Watch out: The fourth digit is changing completely. When the new HIPPS codes under the P... Read more
Patient-Driven Groupings Model:
Get Ready For These PDGM Billing Changes
Warning: Leaving off this occurrence code will result in claims returns. The clock is st... Read more
Hospice:
Hospices Are Shirking Drug Coverage, OIG Report Suggests
The feds' interpretation is ‘overly broad,' attorney suggests. More hospice claim audi... Read more
Compliance:
Take These 4 Steps To Protect Against Drug-Related Risk Areas
You might want to expand your use of prior auth form. In light of the ongoing focus on h... Read more
Industry Note:
OIG Shines Spotlight On Background Checks
National background check contractor is pending. You might find you have to step up empl... Read more
Human Resources:
Boost Your Career By Finding A Mentor
You don't need to do it on your own. Leading an organization, department, or team involv... Read more
Industry Note:
Will One MAC’s New Home Health Audit Topic Land You On Review?
One MAC has added “Home Health Bene Sharing” to its list of active medical review topi... Read more
Industry Note:
Check In On Your Hopes For HOPE Tool
Get the latest update about the Hospice Outcomes & Patient Evaluation (HOPE) tool in a... Read more
Industry Note:
More PDGM Material Added To Manual
Check out Medicare's latest Patient-Driven Groupings Model update to its manuals in a tran... Read more
Industry Note:
Security Gets Tougher For Medicare Systems
Medicare's new requirement to use multifactor authentication (MFA) in the Identity and Acc... Read more
Industry Note:
Tap Latest MBI Card Info In This Call
Dial in to receive an update on new Medicare cards. The Centers for Medicare & Medicai... Read more
Industry Note:
Know Your HIPAA Duties During A Disaster
With hurricane season already in progress, you should know the four situations where shari... Read more
Patient-Driven Groupings Model:
Focus On Occurrence Codes For PDGM Reimbursement Success
Be prepared to back up your code usage in medical review. You'll be at risk of losing yo... Read more
Reimbursement:
Here’s What Counts Toward The Institutional Pay Bump — And What Doesn’t
Watch out for tricky swing bed patients. Designating a 30-day period as “institutional... Read more
Payment:
Take A Look At Latest PDGM Clarifications
Learn the latest instructions on how to count Medicare Advantage periods. Time for the P... Read more
HIPAA:
Are You Using The Right HIPAA Contract With The Right Partner?
For example: Don't go overboard with a BAA contract for your cleaners. With so many duti... Read more
Compliance:
Here’s Why You Should Review Your Contracts Annually
Warning: Evolving cyber criminals may necessitate contract changes. You can't just start... Read more
Industry Note:
Providers’ MBI Usage Continues To Trend Up
Over three-fourths of providers now use the new patient numbers. Time is running out for... Read more
Industry Note:
Use New ACO Case Study To Inform Your Agency’s Future Strategy
If you're wondering how you may fit into the changing Medicare landscape that includes Acc... Read more
Industry Note:
MACs, MA Plans Can Review Your Claims Simultaneously
Getting put on medical review for your Medicare Advantage claims won't get you out of regu... Read more
Industry Note:
Expect Some Differences In Medicaid Rates
Now that Medicare has finalized its 2020 hospice payment rates, Medicaid has issued its ra... Read more
Industry Note:
New Measure Debuts On Hospice Compare
If you haven't done so yet, head over to Hospice Compare to see your newly updated quality... Read more
Industry Note:
Unaffiliated Hospice Houses Gain In Popularity
Hospices often furnish services in patients' homes, assisted living facilities, and nursin... Read more
Industry Note:
More Health Departments Close HHAs
Health department-based home health agencies are continuing to become more scarce, multipl... Read more
Hospice:
Care Level Rebalancing Creates Winners, Losers
Which category will you fall into? As of Oct. 1, Medicare will pay significantly more fo... Read more
Reimbursement:
Expect More RHC Cuts Ahead — Maybe Big Ones
MedPAC isn't helping. While Medicare is rebasing its advanced care levels, the same isn'... Read more
Cost Reports:
Put In The Cost Report Effort
Your data is leading to RHC cuts. With all the regulatory and billing pressures on hospic... Read more
Payment:
Advance Planning For Wage Index Swings Goes Away
Multiple areas will see double-digit index changes. Hospices will become more like other... Read more
Payment:
Are You One Of 2020’s Wage Index Winners Or Losers?
Take a look at the top 10 areas with the biggest swings. The volatility of wage index ch... Read more
Compliance:
Hospices Get Some Small Breathers On New Election Statement, Addendum
Plus: Final rule also addresses assessment tool, quality. One of the most commented-upon... Read more
Industry Note:
OIG Pushes HHA Surety Bonds
CMS has lost millions by not requiring bonds. In yet another move that would burden legi... Read more
Industry Note:
Pay Attention To This RCD Requirement
Illinois home health agencies shouldn't forget to include the Unique Tracking Number (UTN)... Read more
Industry Note:
Get Answers From CMS On GG Bathing Question
Nail down the ins and outs of GG0130E — Shower/bathe self with new guidance from the Cen... Read more
Industry Note:
Reconsideration Deadline Is Almost Here
If you received a notice of noncom­pliance with hospice quality reporting requirements, a... Read more
Industry Note:
SMRC Launches New Review On GIP In SNFs, ALF Services
Hospices are set to undergo even more scrutiny of GIP claims, thanks to a newly announced ... Read more
Hospice:
CMS Proceeds With Care Level Pay Rebalancing, Hospice Election Addendum
Agency turns a deaf ear to many criticisms in 2020 final rule. Hospice providers that re... Read more
Review Choice Demonstration:
You’re Up: Ohio Is Next State To Start RCD
HHAs may be reaching their breaking point. Medicare is launching the Review Choice Demon... Read more
Review Choice Demonstration:
Which Option Will Ohio Agencies Favor?
Industry reps clears up some TPE confusion. Ohio home health agencies have a big choice ... Read more
Therapy:
Beef Up Maintenance Therapy Documentation For Proposal
Therapist-assistant collaboration will be critical. In a rule covering sweeping changes ... Read more
Medical Review:
You May Be Furnishing Maintenance Therapy, And Not Even Know It
Ward off denials by adopting the maintenance mindset. If you think a new provision chang... Read more
Fraud & Abuse:
OIG Reports May Result In Tougher Scrutiny
Lawmakers demand CMS take action. Hopes that two recent reports from a government watchd... Read more
Industry Note:
CMS Sets PDGM Call
Tune in for new info. You may be able to kick your PDGM preparation into a higher gear a... Read more
Industry Note:
Hospice Assessment Tool Focus Groups To Form
If you'd like to influence the development of the hospice patient assessment tool, now's y... Read more
Industry Note:
Note This Important Hospice Compare Date
Aug. 15 is the freeze date for the next Hospice Compare refresh, a Centers for Medicare &a... Read more
Industry Note:
Physicians Indicted In Relation To Home Care
Three medical clinic personnel in Houston have been indicted on fraud charges related to h... Read more
Industry Note:
Patient Recruiter Convicted In Detroit
A Detroit federal jury has convicted a patient recruiter of fraud in a $1.3 million scheme... Read more
Industry Note:
Senior Living Company Expands HHA
Senior living company Friendship Village in Chesterfield, Missouri, has acquired a Medicar... Read more
Patient-Driven Groupings Model:
Behavioral Adjustment Cut Gets Worse, Not Better, In 2020 Proposed Rule
PDGM rates will be 8% lower due to cuts. Most home health agencies are in full-on prep m... Read more
Reimbursement:
HHA Rates To Increase 1.3% Next Year — Or Will They?
CMS wants to hear from you on wage index woes. Home health agencies will see an addition... Read more
Billing:
Say Goodbye To RAPs Forever
And 2020's RAP payments will be reduced by 2/3. Medicare is finishing what it started wh... Read more
Regulations:
New Notice Of Admission Requirements Slated For 2020
HHAs will be hit with double whammy — losing RAP pay and incurring NOA late filing penal... Read more
Compliance:
You’re Off The Reimbursement Hook For Certain CoP Violations
But make sure advanced directive info is in your patients' POCs. Medicare's annual rulem... Read more
Therapy:
Therapy Assistants May Get Bigger HH Role In 2020
Patients Over Paperwork-related change on deck. Many home health agencies are making ser... Read more
Infusion:
Home Infusion Benefit Proposal Needs Major Work
Paying only when clinician is present is a mistake. The advent of a home infusion benefi... Read more
Industry Note:
Erroneous ZIP Code Edit Leads To Return Trip For NOEs
You have multiple options to cope. A claims system glitch has been returning numerous No... Read more
Industry Note:
Watch For This Letter
As promised in this month's Open Door Forum, the Centers for Medicare & Medicaid Servi... Read more
Industry Note:
Hospice Reveals Another HIPAA Breach
Alive Hospice in Nashville is reporting another HIPAA breach, about a year after one invol... Read more
Regulations:
PDGM Grouper Testing Coming Up Sooner Than Usual
Plus: When will the 2020 rule be out? For home health providers accustomed to spending t... Read more
Survey & Certification:
OIG Slams Hospice Compliance In 2 New Reports
Hospice horror stories may chill referrals. When mainstream press outlets like the Washi... Read more
Know Your Facts:
Are You A ‘Poor Performer’ In The OIG’s Eyes?
If you meet certain survey criteria, the watchdog agency wants extra eyes on you. Policy... Read more
Hospice:
Posting Survey Info On Compare Tops OIG Rec List
Accrediting organizations may have to cough up more survey info. The current hospice sur... Read more
Assessment:
Hospice Assessment Tool Creeps Closer To Implementation
Plus: Watch for APU notification letter. Medicare's work on the hospice patient assessme... Read more
Industry News:
Senators To CMS: No PDGM Cuts In 2020
CMS is not following the law's intent, lawmakers tell Verma. Four influential lawmakers ... Read more
Industry News:
Access Your Newest Benchmarks In Updated PEPPER Report
You can now download your new home health agency PEPPER report. The free benchmarking repo... Read more
Industry News:
Medicare Reveals More Review Choice Demo Details In New Q&As;
If you're wondering how the 5 percent spot check option will work under the Review Choice ... Read more
Industry News:
New ICD-10 Codes Are Out For 2020 — Start Using Them Oct. 1
Your staff responsible for coding may be preparing furiously for the Patient-Driven Groupi... Read more
Industry News:
Review OASIS Validation Reports To Avoid These Claims Errors
The relatively recent requirement for an OASIS to be present to process a claim may b... Read more
Industry News:
Fourth-Largest HH Provider Settles False Claims Charges For $48 Million
Encompass Health Corp. has settled charges that it upcoded inpatient rehabilitation facili... Read more
Patient-Driven Groupings Model:
Majority Of HHAs Expect To Decrease Therapy Under PDGM, Survey Says
Providers also plan to drop therapists — both contract and directly employed. The elim... Read more
Therapy:
Consider These Strategies When Devising Your PDGM Plan
Cutting therapy brings serious compliance risks, industry leader warns. Home health agen... Read more
HIPAA:
Now The Fine Will Fit The HIPAA Crime — Or At Least Violation
Don't forget to add inflation updates to the final fine amount. Experiencing a HIPAA bre... Read more
Human Resources:
Create Or Bolster Your Employee Handbook Now
A well-written handbook can ensure consistency. Now's the time to make sure you have a c... Read more
Industry Note:
New PEPPER Reports Expected Next Month
Sign up for training on how to use the free benchmarking info. Next month you'll have a ... Read more
Industry Note:
Check Your RAP Numbers
PEPPER reports aren't the only Medicare sources for seeing how you stack up to your peers.... Read more
Industry Note:
Prepare For Switch To HETS
The first step of the elimination of ELGA, ELGH, HIQA, and HIQH inquiries is here. Effect... Read more
Industry Note:
CMS Continues Its Medicaid Fraud-Fighting Campaign
A year into its Medicaid Program Integrity Strategy, the Trump administration is ready to ... Read more
Industry Note:
HHS Awaits Permanent Inspector General
The Department of Health & Human Services has yet to fill its Inspector General positi... Read more
Industry Note:
Watch For Safe Harbor Rule This Month
In addition to fireworks and the highly anticipated 2020 home health payment proposed rule... Read more
Industry Note:
Heed NPWT Change
If you bill for Negative Pressure Wound Therapy (NPWT) Using a Disposable Device, don't ov... Read more
Industry Note:
Tap Free Video Training
If watching videos is your preferred mode of education, HHH Medicare Administrative Contra... Read more
Industry Note:
Note Appeals Changes
On July 8, multiple changes to Medicare appeals rules will take effect. Those revisions ra... Read more
Industry Note:
State To Give Home Care Workers Back Pay
At press time, more than 49,000 Illinois home care workers were scheduled to get back pay ... Read more
Industry Note:
Former Hospice Owner Sentenced In Arkansas
A former hospice owner has been sentenced in state court to five years in prison after ple... Read more
Industry Note:
Fight Readmissions With Nutrition
If you're trying to whittle down your hospital readmission rates, you may want to look to ... Read more
Payment:
MedPAC Continues To Beat The Unified Payment System Drum
Commission accuses HHAs of gaming assessments for financial, quality gains. The impact m... Read more
Reimbursement:
Don’t Forget MedPAC’s Call For Cuts On Top Of HH Cuts
PDGM rate reduction necessary, Commission says. If you're hoping the imminent Home Healt... Read more
Know Your Facts:
Watch Out: Falling HHA Indicators Still May Not Result In Behavioral Adjustment Elimination
‘For-profit' seems to be a dirty word to MedPAC. Lawmakers will be checking out the da... Read more
HIPAA:
Amped-Up HIPAA Enforcement Should Put You On Notice
Enforcement actions in 2018 netted nearly $30 million. With PDGM on home health agencies... Read more
Industry Note:
Watch For Nondiscrimination Compliance Changes
Trump administration rolls back Obama-era nondiscrimination requirements. If you changed... Read more
Industry Note:
Use Training To Help Avert Verbal Abuse
The shortage of home care aides isn't being helped by the likelihood of abuse in the home ... Read more
Industry Note:
Hold Off On Resubmitting Claims, MAC Says
If National Government Services is your HHH Medicare Administrative Contractor and you rec... Read more
Industry Note:
MAC Highlights Physicians’ Home Care Duties
One HHH Medicare Administrative Contractor is laying out docs' referral responsi­bilities... Read more
Industry Note:
Get Ready For This Change July 1
Expect your Direct Data Entry screens to look different come July 1. That's when a system ... Read more
Industry Note:
State Poised To Allow Patient Poaching
State legislation to ban non-compete and non-solicitation clauses in home care workers' co... Read more
Industry Note:
CA OKs Joint Commission For Hospice
The California Department of Public Health has approved Joint Commission accredi­tation a... Read more
Industry Note:
MAC Sorts Out Some RCD Operational Details
Review Choice Demonstration contractor Palmetto GBA has a few reminders for providers that... Read more
Industry Note:
Help Protect Patients Against New Medicare Scam
If your patients ask your staff questions about cheek swabs for tests that their referring... Read more
Diagnosis Coding:
Take These 10 Steps To Bolster Coding Under PDGM
Your reimbursement will depend on diagnosis coding more than ever before. With the Patie... Read more
Patient-Driven Groupings Model:
Cope With Your Boomerang Codes Before You Get PDGM Denials
Now's the time to start examining your coding practices. Most home health agencies' chie... Read more
Diagnosis Coding:
Brainstorm Alternatives To These Top 10 RTP Codes
These codes won't cut it any more under PDGM. You need to be scrutinizing your current c... Read more
Quality:
Delayed Readmissions Quality Measure To Debut In October
You'll get an advance look at your stats this month. Four new quality measures went up o... Read more
Review Choice Demonstration:
RCD Agencies Will See More Review Choices Soon
Don't expect to bill patients for denied services. Illinois home health agencies that di... Read more
Fraud & Abuse:
OIG Estimates $10.5 Million Overpayment From 38 Claims
Audited HHA blasts OIG for contracting out its claims review. A federal watchdog agency ... Read more
Industry Note:
Senior Medicare Patrol Fights Home Health Fraud
Project reached 1.7 million people last year. The fanfare over the Senior Medicare Patro... Read more
Industry Note:
Trump Administration Celebrates Reg Relief
You may feel like you're drowning in paperwork and red tape, but the Centers for Medicare ... Read more
Industry Note:
Get QIO Info Straight For Your Patient Notices
If you are unclear on whether Kepro or Livanta is your Beneficiary and Family Centered Car... Read more
Industry Note:
Tap This Free PEPPER Report Training
To help you use your new hospice PEPPER report to its fullest, you can now tune in to a re... Read more
Industry Note:
Keep Up With New PACE Program Changes
Medicare has made the first major changes to PACE regulations since 2006, the Centers for ... Read more
Patient-Driven Groupings Model:
RTP Codes Top List Of Coding Concerns For PDGM
Accuracy, specificity for comorbidity codes another looming problem. If you aren't beefi... Read more
Diagnosis Coding:
Are You Using These Codes That Will Doom Your PDGM Claims?
Check out 30 common codes that won't fly starting Jan. 1. Under the coming Patient-Drive... Read more
Review Choice Demonstration:
Illinois Agencies’ RCD Choices May Surprise You
Nearly half of high-performing HHAs didn't choose smaller-volume review options. Would y... Read more
Audits:
OIG Recants Some HH Denials
Watchdog agency audits three HHAs based on Medicare payment error rate. How would you li... Read more
Fraud & Abuse:
Florida, Texas, and Illinois Rack Up HH Fraud Cases
Patient recruiter draws 15-year prison sentence. Fraud and abuse scrutiny of home health... Read more
Industry Note:
Don’t Get Sloppy With Advanced Directives
Remain vigilant about this CoP requirement. Just because you haven't seen denials for pa... Read more
Industry Note:
Get A Grip On Hospice Compare Changes With New Resources From CMS
If the recent changes to Medicare's Hospice Compare website have left you confused, you ha... Read more
Industry Note:
Hospice Patient Assessment Tool May Have Lost Its Name, But Not Its Momentum
Get the latest on Medicare's efforts to generate a hospice assessment tool in a June 12 sp... Read more
Industry Note:
Latest CMS Podcast Focuses On Innovation Center
Tune in to the Centers for Medicare & Medicaid Services' newest podcast episode to fin... Read more
Industry Note:
Illinois’ Largest Nonprofit Buys Health System’s HH, Hospice Units
JourneyCare, Illinois' largest non-profit hospice and palliative care provider, has purcha... Read more
Patient-Driven Groupings Model:
Get On Top Of Your LUPAs Before PDGM Hits
Take these 4 steps to protect your agency. The Patient-Driven Groupings Model contains s... Read more
Reimbursement:
Check Out Your LUPA Rates
Pay won't come close to covering cost. Under the Patient-Driven Groupings Model, a 30-da... Read more
Hospice:
Expect 2 New Claims-Based Measures In Your Future
Care transitions, levels of care are focus of potential QMs. Medicare officials may have... Read more
Appeals:
Sidestep Appeals Pitfalls With Knowledge Of The Process
Warning: Don't skip rungs on the appeals ladder. If you've been ignoring many appeals as... Read more
Review Choice Demonstration:
Beware RAP Cancellations Under RCD
Medicare wants you to submit RAPs under RCD, but may punish you for it. Don't consider y... Read more
Industry Note:
Home Health, Hospice Providers Continue To Flunk TPE At An Alarming Rate
F2F, terminal prognosis are claim killers. The latest numbers for Targeted Probe and Edu... Read more
Industry Note:
Update Your Forms If You Reside In State Switching BFCC-QIOs
Medicare has reshuffled the territories its Beneficiary and Family-Centered Care — Quali... Read more
Industry Note:
MBI Usage Continues To Climb
Don't fall behind your peers in transi­tioning over to using Medicare Beneficiary identif... Read more
Industry Note:
Find Out How To Double Check Your Compare Data With This Report
Find out more about HQRP requirements with Medicare's upcoming webinar, “Hospice Quality... Read more
Industry Note:
Multi-State Chain Acquires Idaho Provider
Regional provider Jet Health Inc. has acquired Boise, Idaho-based First Choice Home Health... Read more
Industry Note:
Colorado Provider Sues Over Name
Just because you operate in a different geographic area doesn't mean you can use another c... Read more
Industry Note:
Doc Pleads Guilty In Home Health Scam
A Michigan physician has pled guilty to offering prescriptions for controlled substances t... Read more
Industry Note:
Hospice, Hospital Partner On Facility
CAMC Memorial Hospital and Hospice- Care will team up in Charleston, West Virginia, to ope... Read more
Patient-Driven Groupings Model:
Sidestep This PDGM Compliance Trap
Warning: Turning utilization on a dime is a major red flag. You may be contemplating som... Read more
Regulations:
OASIS Rules Won’t Change Under PDGM, CMS Stresses
But you'd better make sure your RFA 5 policies are in order. If you're confused about ho... Read more
Hospice:
Your CAHPS Data May Become More Important
Plus: Medicare wants you to submit NOEs electron­ically — but should you? Hospices ma... Read more
Lawsuits:
High Court Gives Whistleblowers More Time To File
Govt intervention not a factor, new ruling says. A new U.S. Supreme Court deci... Read more
HIPAA:
Revised Password Guideline Might Give Your Staff Some Relief
Password requirements make them less safe than you think. Question: How often should we ... Read more
Industry Note:
CMS Touts RAC Improvements
Bounty hunter fee remains, but is delayed. Recovery Audit Contractors have hounded some ... Read more
Industry Note:
Pay Attention To HHCCN Update
You have until July 1 to use up all your old HHCCN forms, but changing over to the new for... Read more
Industry Note:
Bill Aims To Avert PDGM Cut
Members of Congress have introduced a bill in the House that would head off the behavioral... Read more
Industry Note:
Here’s How To Handle Missing OASIS
Don't overlook an important instruction that applies now in Medicare's latest transmittal ... Read more
Industry Note:
Beware Adjustments For Physicians Missing From PECOS
If you've seen an uptick in claims adjustments, a claims system error may be to blame. ... Read more
Industry Note:
Hospice Staff Go Above And Beyond In Face Of Flood
A natural disaster is giving hospice nurses another reason to shine. Last month, two nurse... Read more
Industry Note:
Study Up On Hospice Carve-In For MA
If you want to respond to Medicare's call for comment on including hospice in the Medicare... Read more
Industry Note:
Move Your Eligibility Search To HETS
It soon will be time to change your procedures, if you use the Common Working File for ben... Read more
Industry Note:
States File Suit Over Union Dues Change
Attorneys General of five states have filed a lawsuit opposing the Trump administra­tion'... Read more
Industry Note:
2 HHA Owners Head To Jail Over Tax Fraud
Two home health agency owners in Massachusetts will see jail time after pleading guilty to... Read more
Patient-Driven Groupings Model:
Put These 14 Crucial Items On Your PDGM To-Do List
Don't fall behind in PDGM prep. If you aren't in the midst of serious preparations for t... Read more
Strategy:
Make Sure Lines Of Communication Are Open With Your Vendor For PDGM
How is your vendor handling extra diagnosis codes? You don't want problems with securing... Read more
Education:
Start Your PDGM Training Now
Referring docs should be at the head of the list. If you think you have at least a few m... Read more
Review Choice Demonstration:
Good News: RCD Means No TPE
Don't accidentally get on 100 percent postpay. Illinois home health agencies have only a... Read more
Industry Note:
Medicare Reveals More PDGM Billing Instructions
Code change doesn't necessarily trigger SCIC assessment — but could be red flag. Diagn... Read more
Industry Note:
Final Rule Nixes Automatic Diversion Of Wages To Union Dues
Nearly 10 months after proposing it, the Centers for Medicare & Medicaid Services has ... Read more
Industry Note:
Hospice Physicians Could Benefit From New Primary Care Model
Medicare's newly proposed “Primary Care First” payment model should benefit your patie... Read more
Industry Note:
Opioid Prescribing Guideline Clarification May Curb Access Problems
If you've run into problems securing coverage for opioids for your hospice patients, ... Read more
Industry Note:
National Chain Partners With Missouri Health System In Joint Venture
LHC Group Inc. and Capital Region Medical Center in Jefferson City, Missouri, plan to purc... Read more
Industry Note:
Ensign Group To Spin Off Home Health, Hospice Business
The Ensign Group Inc. plans to spin off its “home health and hospice agencies and substa... Read more
Industry Note:
Don’t Miss The Next Home Health & Hospice Open Door Forum
Tune in to Medicare's next Home Health, Hospice & DME Open Door Forum on Wed. May 15. ... Read more
Medical Review:
Even If You Get Off TPE, You’re Not All The Way Off
Successful TPE rounds are followed by 12 months of monitoring, MAC reveals. The Targeted... Read more
Hospice:
Will Election Statement Additions Deter Hospice Use?
Here are the 4 items Medicare wants you to add to your election statement. Hospices will... Read more
Compliance:
Election Addendum Would Contain These Elements
And the new addendum would have to be updated along with the plan of care. Hospices may ... Read more
Hospice:
Election Statement Addendum Proposal Riddled With Problems
Timeframe is one of the most obvious faults. While hospices are all for having their pat... Read more
Therapy:
Don’t Forget OT, SLP In Your Therapy Goals
Will your plan of care's therapy components stand up to scrutiny? Home care providers ar... Read more
Industry Note:
Can You Tick Off Everything On This RCD Checklist?
Plus: Make sure your billing staff can follow this how-to guide. With the Review Choice ... Read more
Industry Note:
Patient Assessment Submission Deadline To Change
You'll have less time to submit and correct OASIS and HIS data, under a new Medicare polic... Read more
Industry Note:
Take This Action On RAP Elimination Right Now — Even If You’re Not Yet Affected
If you're just watching and waiting to see whether Medicare eliminates Requests for Antici... Read more
Industry Note:
Medicare Interest Rate Changes For The Quarter
As of April 17, Medicare is using a new interest rate for under- or overpayments. Followin... Read more
Industry Note:
CMS Eyes Capitation, Other Strategies For Dual Eligibles
Stand by for potential changes to how you are reimbursed for your patients who are dually ... Read more
Industry Note:
MAC Updates Dysphagia LCD
If your staff provides surface electrical stimulation to treat dysphagia, check out the ne... Read more
Industry Note:
Physician Payment Test May Benefit Hospice
Medicare's newly proposed “Primary Care First” payment model should benefit your patie... Read more
Industry Note:
2 HHAs Pay $10 Million To Settle Fraud Charges
Massachusetts' ongoing crackdown on home health fraud has resulted in some big-dollar sett... Read more
Reimbursement:
Beware: New HHA Cost Report May Give Rise To Rebasing
New hourly wage calculation will prove crucial to future rate reductions, expert predicts.... Read more
Hospice:
CMS Pulls The Trigger On Hospice Payment Level Rebalancing
So-called ‘budget-neutral' rebalancing will really mean a cut to hospice pay. After ye... Read more
Finance:
Here’s Why Hospice Cost Reports Matter
HHAs, pay attention. While Medicare's proposal to rebalance hospice payment between care... Read more
Regulations:
Hospice Proposed Rule To Add Major Election Burden
Plus: Regulation also addresses wage index, HQRP, and alternative care models. Hospices ... Read more
Industry Note:
Check Out Your OASIS-D Tool
Are you ready to collect these 2 newly added items at Follow-Up? Medicare may have spell... Read more
Industry Note:
Personal Care Services Come Under The Microscope
Medicaid home care services have been on the HHS Office of Inspector General's hit list fo... Read more
Industry Note:
Medicare Board Of Trustees Gauges Cost Growth
Don't be surprised to see Medicare officials trying to tighten budget belts even further. ... Read more
Industry Note:
Medicare Makes Changes To LCD Process
You may be hearing more about Local Coverage Decisions from your Medicare Adminis­trative... Read more
Industry Note:
Yet More RHC Payment Errors Revealed
Many hospices are not surprised to see a recent Medicare message about Routine Home Care p... Read more
Industry Note:
ERS Procedures Undergo Overhaul
If you find yourself in a bind and needing an Extended Repayment Schedule from Medicare, y... Read more
Industry Note:
Broken Equipment Nets You A Fall For J1800
A new quarter has brought a new set of OASIS questions and answers from Medicare. The 15 n... Read more
Industry Note:
California Equity Firm Makes HH Investment
HCAP Partners, a California-based private equity firm, has made an undisclosed “investme... Read more
Industry Note:
Doc Gets 3 Years In Prison For Hospice Fraud
A former physician hospice owner and his business partner have been sentenced to nearly th... Read more
Industry Note:
Michigan HHA Owner Draws Lengthy Sentence
A former Michigan home health agency owner has been sentenced to seven years in federal pr... Read more
Review Choice Demonstration:
HHAs In RCD Demo States Should Start Prep Yesterday
Don't discount PDGM's exacerbation of the pre-claim review program's impact. Illinois ho... Read more
Targeted Probe & Educate:
MAC: Like It Or Not, You’re On The Hook For Physicians’ Documentation
Tip: Make sure claim is supported before you submit it. You may not be able to control y... Read more
Survey & Certification:
Make Sure Your Administrator Reports Directly To Gov. Body
Keep working on compliance with new CoPs. You could risk a survey deficiency if you don't... Read more
Conditions of Participation:
Know The CoPs Ruling Your Administrator Duties
Medicare surveyors cited hundreds of agencies on administrator CoP since new requirements ... Read more
Mergers & Acquisitions:
Publicly Traded Chain Buys 50-Year-Old Provider
Plus: Check out the latest deals from coast to coast. Acquisition of a longstanding agen... Read more
Industry Note:
Check Your RAP Stats With This Report From Medicare
Get familiar with Comparative Billing Reports. You can find out if your Request for Anti... Read more
Industry Note:
OIG Investigated Scores Of Hospices Last Year
Hospice oversight continues to ramp up, and a recent HHS Office of Inspector General repor... Read more
Finance:
Do You Know These New Cost Report Requirements?
If not, you could be risking payment suspension. You'll soon receive a cost report remin... Read more
Industry Note:
MBI Usage Rises Again
Providers submitting Medicare claims are closing in on the three-fourths mark for using MB... Read more
Industry Note:
Choose Who Signs Up For eServices Carefully
Illinois home health agencies getting ready to go under the Review Choice Demonstration ne... Read more
Industry Note:
CMS Adds Podcast Ep
You can check out the latest episode of the podcast from the Centers for Medicare & Me... Read more
Industry Note:
Download Your New Hospice PEPPER
The newest hospice PEPPER report is now available. The free benchmarking report from ... Read more
Industry Note:
GAO Pushes For More Prior Authorization
Don't count on Medicare seeing the error of its ways when it comes to preauthori­zation s... Read more
Industry Note:
HH DON Fraudster Gets 10 Years In Prison
A federal judge has handed down another relatively stiff prison sentence related to a Hous... Read more
Review Choice Demonstration:
Review Choice Demo To Launch June 1 In Illinois
Slowed cash flow poised to close more doors. The other shoe is finally dropping for the ... Read more
Payment:
Review This New Review Choice Demonstration Info
Beware: Not signing up puts you in postpay review. So far, the Review Choice Demonstrati... Read more
Reimbursement:
Take These 6 Steps To Avert RCD Disaster
Most agencies will want prepay review. The Review Choice Demonstration will be here in l... Read more
OASIS:
First Look At OASIS-D1 To Come In Early Summer
In addition to axing some items at followup, CMS will also add a few. Just when you are ... Read more
Regulations:
More PDGM Instructions Coming Soon
Plus: Don't lollygag on viewing Compare preview reports. With less than nine months to g... Read more
Assessment:
Your OASIS-D1 Load Will Lighten For 23 These Items
But 2 items' collection and reporting will increase under OASIS-D1. The Patient-Driven G... Read more
Hospice:
Measure For 7-Day Visits When Death Imminent On Hold
Plus: CMS improves Hospice Compare search function — finally. You can expect to see yo... Read more
Industry Note:
Lower HH Payment Error Rate Doesn’t Impress GAO
Watchdog agency focuses on documentation requirements Many home care providers feel that... Read more
Industry Note:
MAC Won’t Budge On 3-Day TPE Deadline
Home care providers hoping to see relief on submission timelines under Targeted Probe and ... Read more
Industry Note:
RAP Suppression Applies To CHOWs, CMS Confirms
Just who is going to be subject to RAP suppression under Medicare's “enhanced oversight... Read more
OASIS:
Beware OASIS-D Noncompliance When Clinicians Use Judgment
Will your staff's determinations stand up to scrutiny? Home health clinicians are three ... Read more
Fraud & Abuse:
HH Spending Down 12% In Fraud Hot Spots, OIG Crows
Plus: Here's how OIG changes may play out under forthcoming PDGM. A federal watchdog age... Read more
Labor Law:
NY Minimum Wage Decision Brings Relief
Expect many more aide lawsuits to come. A new decision from a New York state appeals cour... Read more
Leadership Corner:
Follow These 2 Tips To Achieve Your Goals
Don't miss these important steps. Successful people do more than set goals. They keep tho... Read more
Industry Note:
New Hospice Topic Shows Up On MAC Audit List
Check your LOS on Alzheimer's, Parkinson's, and other neuro patients. If you serve patien... Read more
Industry Note:
Medicare Updates Manuals For CoPs, Physician Estimate Revisions
The regulatory change that no longer requires a physician to estimate the length of time h... Read more
Industry Note:
Report: Don’t Let Managed Care Ruin Hospice
If just 20 percent of Medicare decedents used hospice for two weeks before death, the prog... Read more
Industry Note:
Make This Change Now For Spanish Language CAHPS
Home health agencies and their vendors that haven't updated CAHPS survey materials due to ... Read more
Industry Note:
No Joke: Random HIPAA Audits Launch In April
More HIPAA audits are on the way — but they won't affect you directly yet. The Centers ... Read more
Industry Note:
Hardworking Hospice Nurse Garners Positive Publicity
Winter may have officially wrapped up, but the goodwill generated by hard-working home car... Read more
Industry Note:
Minnesota HHA Pays $727K To Resolve False Claims
A voluntary disclosure has led to a nearly $727,000 repayment for a Minnesota home health ... Read more
Industry Note:
Health System Shutters Inpatient Hospice Unit
Family Hospice & Palliative Care, part of the UPMC health system based in Pittsburgh, ... Read more
Industry Note:
OIG Runs Hundreds Of HH Investigations A Year
If you are wondering just how deeply the feds are diving into home care fraud and abuse, a... Read more
Industry Note:
Beware NOE Impact On Sequential Billing
Don't let claims for your hospice patient's entire stay get derailed just because the firs... Read more
Payment:
MedPAC To Congress: Strip $10 Billion From HH Spending
Medicare profit margin falls once again to 15.2 percent. On top of PDGM and its nearly 6... Read more
Know Your Facts:
Profit Margin, Number Of HHAs, Episodes All Fell In Latest Year
Number of users, spending also are down, latest data shows. Law- and policymakers will b... Read more
Budget:
Keep An Eye On These Areas Highlighted In Trump Budget
PAC PPS remains a popular idea. There's a long way to go before lawmakers pin down the d... Read more
Hospice:
Highest Margin In A Decade Leads To Rate-Cut Rec
Wise providers will diversify revenue sources. Medicare's skyrocketing spending on hospi... Read more
Know Your Facts:
Key Indicators All Up For Hospices, MedPAC Report Shows
Medicare's hospice spending surpasses home health's. Hospices hoping to head off increas... Read more
Industry Note:
Don’t Be Shy With MAC Feedback
This year's MSI survey is underway. Tell Medicare what you really think — about its co... Read more
Industry Note:
Ratio Of Claims Using MBIs Climbs Higher
The percentage of claims using the new Medicare Beneficiary Identifier number instead of t... Read more
Industry Note:
Check Out Change To New Hospice Claim Edit
Medicare has tweaked new billing rules that soon will allow only a hospice actively servin... Read more
Industry Note:
Boomers Want To Stay At Home — But There Are Some Exceptions
A new survey from trade group LeadingAge appears to contradict the long-held notion that s... Read more
Industry Note:
Senior Living/Hospital Co. Gets Into Home Health
Cornerstone Healthcare Group Holding Inc., owned by Highland Capital Management, has purch... Read more
Industry Note:
Ensign Acquires Texas Agency
A subsidiary of Cornerstone Healthcare Inc., Ensign Group Inc.'s home health and hospice p... Read more
Compliance:
Advisory Opinion Gives Thumbs-Up To Free Home Care
Paramedic utilization problematic, legal experts say. A stamp of approval from a federal... Read more
Compensation:
Get Ready To Pay More Overtime Under New DOL Rule
Proposal leaves you with 3 options. A proposal to raise the minimum salary level for the ... Read more
Labor Law:
Review What Qualifies Your Employees As Exempt
Salary basis is key. If you avoid paying overtime to certain staff based on the white co... Read more
Finance:
Publicly Traded Home Care Companies Gear Up For PDGM
Nation's largest providers report increased profits, revenues for 2018. In the run-up to... Read more
Mergers & Acquisitions:
Home Care Chains Grow Through Acquisitions
Plus: Nonprofit hospices merge. The home care and hospice markets are busier than ever. ... Read more
Industry Note:
Study: HHAs Cost Less, But SNFs Prevent More Hospitalizations
More patients should be discharged home due to comparable outcomes, lower cost, editorial ... Read more
Industry Note:
Ramp Up PDGM Prep
The countdown is on, with less than 10 months to go until the Patient-Driven Groupings Mod... Read more
Industry Note:
Forget The Ides Of March — Beware Missing This Preview Deadline
Don't forget to check your two hospice provider preview reports by the March 31 deadline. ... Read more
Industry Note:
Tap New TPE Tool
One HHH Medicare Administrative Contractor is lending a helping hand to providers on Targe... Read more
Industry Note:
Medicare Gets Serious About Post-Acute Health Info Exchange
Tune in to a March 19 Medicare call to learn more about the Centers for Medicare & Med... Read more
Industry Note:
VNAA, ElevatingHome To Merge With LeadingAge Trade Group
Pending a vote by members of the Visiting Nurse Associations of America and its affiliate,... Read more
Industry Note:
Don’t Lose Your QIES — iQIES That Is
The QIES system is undergoing a revamp, including a modification to its name. “Quality ... Read more
Industry Note:
Small-Town Hospice Inpatient Center Set To Close
Community Health Professionals is shutting down its inpatient hospice center in Van Wert, ... Read more
Review Choice Demonstration:
Medicare Revs Its RCD Engine
CMS doubles down on pre-claim review. Don't be surprised to see Medicare's 100 percent m... Read more
Medical Review:
Review Your RCD Options While There’s Still Time
Reminder: A 90% approval rate gets you on reduced review. For Illinois home health agenc... Read more
Survey & Certification:
Keep An Eye On IJ Changes
Could IJ citations become less common? Newly issued changes to the State Operations Manu... Read more
Compliance:
6 More IJ Changes You Should Know About
Does your intent matter when it comes to an IJ determination? An immediate jeopardy dete... Read more
Hospice:
Fight To Get Sequestered Funds Excluded From Cap Overages Hits Roadblock
The math might be against you. If you think it's unfair that Medicare calculates your ho... Read more
Lawsuits:
Cap Sequestration Math May Be Hard To Beat
Should under- and over-cap hospices be treated the same? Hospices may have a tough time ... Read more
Industry News:
Review Contractor Trains Sights On Hospice Inpatient Care
Hospices can thank the HHS Office of Inspector General for new scrutiny on high-paying cla... Read more
Industry News:
Medicare Releases More Info About Transitional Infusion Payment
If you have questions about Medicare's new Home Infusion Temporary Transitional Payment po... Read more
Industry News:
Miami Home Health Fraudster Racks Up 7-Year Prison Term
Two home health fraudsters have received lengthy prison sentences following guilty pleas. ... Read more
Reimbursement:
‘Enhanced Oversight’ For All New HHAs Means No RAPs — At Least For A While
Do feds see RAPs as free loans? A new RAP suppression instruction shows why home health a... Read more
Billing:
Here’s How RAP Suppression Will Work
HHAs must continue to submit RAPs, despite receiving no reimbursement for them. Medicare ... Read more
Fraud & Abuse:
Kickback Schemes Lead To Guilty Plea, Conviction, Arrests
Therapy company staff fake notes, feds say. Illegal kickbacks are at the heart of three r... Read more
HIPAA:
No BAA Means No Business With That Vendor — Every Time
Failing to vet a vendor could cost you big. With so much on your plate, conducting HIPAA ... Read more
Industry Note:
Medicare Number Switch Gives Rise To Payment Glitch
MBI-HICN mismatch causes returned claims. Medicare has completed replacing benefi­ciarie... Read more
Industry Note:
CMS Issues Spending Projections
Spending on home care is projected to rise a whopping 83 percent from 2018 to 2027, climbi... Read more
Industry Note:
CAHPS Survey Mode Change Mulled
If you are frustrated by the difficulty of getting beneficiaries or their caregivers to re... Read more
Industry Note:
RHC Pay Problems Persist
Will the next Medicare claims system update finally clear up problems related to Routine H... Read more
Industry Note:
A/B Shift Error Requires Adjustments
Don't let an administrative glitch confuse your billing efforts. The problem: The allocat... Read more
Industry Note:
Don’t Forget Digits
Make sure you're inputting your county code correctly on your RAPs and final claims, or th... Read more
Industry Note:
Revisit Your Emergency Preparedness Plan
If the Zika virus, Ebola, and other types of infections aren't covered in your Emergency P... Read more
Industry Note:
Know Your ‘O’s From Your Zeroes
Don't forget that the new Medicare Beneficiary Identifiers do not contain “Os,” but in... Read more
Industry Note:
Check The Newest Hospice Compare Data
Take a look at your most updated Hospice Compare data, which is now up on the website, the... Read more
Industry Note:
HHQRP Training To Cover OASIS-D
Registration is still open for Medicare's two-day Home Health Quality Reporting Training e... Read more
Industry Note:
CMS Podcast Debuts
You can take a break from listening to Serial, Hidden Brain, and other popular podcasts to... Read more
Industry Note:
If The Holiday Rush Kept You From Tuning In
If the holiday rush kept you from tuning in to Medicare's training webinar on hospice qual... Read more
Industry Note:
Amedisys Grows Its Hospice Business — Again
Amedisys has agreed to purchase RoseRock Healthcare, a hospice in Tulsa, Oklahoma, the Bat... Read more
Industry Note:
Texas, Ohio Hospices Open Inpatient Units
The number of hospice inpatient facilities is increasing. In Texas: Hospice of Wichita Fa... Read more
Patient-Driven Groupings Model:
HHAs Start Their Engines For Runup To PDGM
Thirty-day billing period base rate 55.6 percent of 60-day rate. It soon will be time for... Read more
Legislation:
Resistance Continues Against Behavioral Adjustment Cut
HHAs have only months to secure legislative change. The home health industry is fighting ... Read more
Reimbursement:
Keep These Top Changes In Mind As PDGM Nears
Beware LUPA dangers. As you navigate the murky Patient-Driven Groupings Model waters, you... Read more
OASIS:
These 8 Items Will Help Determine Your PDGM Pay
2 items debut as case mix factors. Familiarize yourself with the OASIS items that will se... Read more
Billing:
CMS Starts Its RAP Phase-Out
Plus: Learn about these new occurrence codes that can bring you higher reimbursement. You... Read more
Payment:
PDGM HIPPS Code May Not Mean What You Think It Means
Get to know the new code. Whether you know the current HH PPS HIPPS codes inside and out,... Read more
Patient-Driven Groupings Model:
Use These Guidelines To Plan Your PDGM Launch Date
Episodes spanning Jan. 1 get 60-day rate. You should be starting your ramp-up to the Pati... Read more
Hospice:
Visits When Death Imminent Measure Closer To Going Public
HEART, public reporting also addressed. Competitors, referral sources, and others will so... Read more
Regulations:
Home Health Compare Looks Different
Education on OASIS-D continues. More than just your data looks new on the Home Health Com... Read more
Industry Note:
TPE Torpedoes Hospices — Again
Unsupported terminal prognosis causes most denials. One HHH Medicare Administrative Contr... Read more
Industry Note:
MBIs Now Used On Nearly Two-Thirds Of Claims
The percentage of claims using beneficiaries' new MBI numbers continues to grow. For the ... Read more
Industry Note:
Hospice Forks Over $27K CMP For Excluded Employee
Make your employee background checks a priority, a recent HHS Office of Inspector General ... Read more
Survey & Certification:
Verbal Order CoP Clarification Reassures HHAs
But not every new frequently asked question is as helpful. Home health agencies are welco... Read more
Targeted Probe and Educate:
TPE Round 2 Ramps Up At One MAC
Nearly all HHAs fail medical review again. Another quarter brings another round of dismal... Read more
Fraud & Abuse:
Medicare Lifts HHA Moratoria
Low-key announcement surprises industry. A new sign indicates that fraud and abuse scruti... Read more
Medical Review:
F2F Tops TPE Denial List Again
Therapy visit medical necessity breaks into top 5 reasons in latest quarter. Expect face-... Read more
Industry Note:
Proposed Safe Harbor Change Could Impact Your Patients
Change would ban drug rebates to PBMs, Part D plans, and Medicaid MCOs. Pharmacy benefit ... Read more
Industry Note:
HHAs’ Grace Period For CMPs Is Over
The Civil Money Penalties that home health agencies are now subject to can pack a serious ... Read more
Make The Most Of Your Eli’s Home Care Week Subscription
You have more than a decade's worth of information on a multitude of home health topics at... Read more
Industry Note:
Don’t Miss These Newly Posted HQRP Educational Resources From Medicare
You can get up to speed on recent Hospice Quality Reporting Program changes at your conven... Read more
Industry Note:
Provider Uses Baseline Wage Increase As Recruitment, Retention Tool
Looking for a way to recruit and retain aides? You may want to take a cue from one Virgini... Read more
Industry Note:
HIPAA Expert Busts Common Myth About Overseas Business Partners
If you think you can cut some bureaucratic red tape by partnering with vendors outside of ... Read more
Industry Note:
Nonprofit Health System Buys Hospice In Colorado
Nonprofit Banner Health has acquired TRU Hospice of Northern Colorado, which serves Weld C... Read more
Industry Note:
Holding Company Makes Hospice Buy In Texas
Traditions Health, a home health and hospice provider in Texas and California, has acquire... Read more
OASIS:
New IMPACT Act Items Weigh Down OASIS-D Transition
Warning: M1800 vs. GG items are big risk areas. If you're finding the road to OASIS-D imp... Read more
Assessment:
Use These 5 Tips To Tackle OASIS-D Challenges
Make sure staff know when rule of majority applies — and doesn't. You can bet even the ... Read more
OASIS:
Make Sure Staff Know When Rule Of Majority Applies — And Doesn’t
Clear up this point of M1800 vs. GG item confusion. Use the most recent OASIS-D guidance ... Read more
Survey & Certification:
New CoP Guidance Limits Administrator Grandfathering
CMS issues 48 FAQs on HH Conditions of Participation. The drastically revamped Home Healt... Read more
Human Resources:
Get The Most Out Of Your Employees By Sharpening Your Performance-Appraisal Skills
Help your staff to build on their competencies. Don't wait until the Patient-Driven Group... Read more
Industry Note:
New Law Benefits Home Care — For Now
Extenders Act addresses Money Follows the Person. Home health agencies may still be waiti... Read more
Industry Note:
Point Physicians, Discharge Planners To New CERT Task Force Sessions
If you'd like your hospital referral sources to hear more about their duties from Medicare... Read more
Industry Note:
Track Your HIS, CAHPS Reporting To Ensure Pay
Don't forget you need to fulfill two separate reporting requirements to qualify for your f... Read more
Industry Note:
Connect Patients, Caregivers With New Medicare App
Medicare has a new app that may be helpful to your tech-savvy patients and their caregiver... Read more
Industry Note:
MAC Warning May Press Your Buttons
Agencies served by CGS should beware this mistake commonly made by providers under medical... Read more
Industry Note:
Nonprofits Ally In Oregon
The alliance model is catching on for non-profit hospices. In Oregon, Care Partners Hospi... Read more
Industry Note:
VITAS Opens Facility
VITAS Healthcare has opened an inpatient unit in Rockledge, Florida, says spacecoastdaily.... Read more
Industry Note:
Michigan HHA, Senior Living Company Partner
Mary Free Bed at Home in Grand Rapids, Michigan, has partnered with West Michigan senior l... Read more
Industry Note:
Health System Sheds HH
Another hospital system has shuttered its home health and hospice units. Samaritan Health ... Read more
OASIS:
Considering Turns Is OK For These GG0170 Items
Another OASIS-D question shows how the IMPACT Act items aren't a perfect fit for the home.... Read more
Hospice:
Medicare To Test Hospice Inclusion In MA Plans
Changes takes effect in 2 short years. Hospices haven't had to encounter the headache of ... Read more
Bundling:
Voluntary Bundling Demos Benefit Providers, While Mandatory Ones Help CMS
Larger HHAs tend to participate in bundled payment tests. Is Medicare going to require yo... Read more
HIPAA:
Start Off The New Year With Updated HIPAA P&P For Firings
Make sure you don't face potential violations and fines as time marches on. Perhaps a yea... Read more
Industry Note:
Expect Audits To Get Even Tighter In 2019
When the feds decide you owe the government money, they want it paid back ASAP. A new rep... Read more
Industry Note:
MedPAC Finalizes Cut Recs
As expected, the Medicare Payment Advisory Commission has voted to recommend a 2 percent p... Read more
Industry Note:
Know NOTR Ropes To Avoid Unnecessary Work
Don't waste time and effort on filing unnecessary hospice Notices of Termination/Revocatio... Read more
Industry Note:
Telehealth Claims Accepted Again By Texas Medicaid
Telehealth providers in Texas can submit valid claims to the state Medicaid program again,... Read more
Industry Note:
LA Paper Skewers Hospices
The latest high-profile newspaper article lambasting the hospice industry comes in the for... Read more
Industry Note:
Private Equity-Owned Chain Makes Private Duty Buy
Private equity firm One Equity Partners, through its portfolio company Simplura Health Gro... Read more
Industry Note:
Hospice Deals Announced
The hospice market continues to expand, show these developments announced this month. In ... Read more
Industry Note:
OIG Finds Telehealth Billing Problems
Telehealth seems to be gaining ground as a politically popular idea, but it won't all be s... Read more
Industry Note:
ALJ Changes Afoot
Providers who have hoped to see a bit more impartiality from Administrative Law Judges may... Read more
Regulations:
HHAs Still Hanging On RCD
Tip: Use this new GG decision tree to help with OASIS-D confusion. Home health agencies h... Read more
OASIS:
You Have To Take A Hit For Falls At Doctor’s Office, Elsewhere
CMS issues another OASIS-D question-and-answer set. Home health staff performing OASIS-D ... Read more
Reimbursement:
MACs Issue Information On Advance Directive Procedure
MACs urge appeals for CERT denials. What steps you take to deal with possible claims deni... Read more
Hospice:
NOTR Problems Snarl Billing
New edit should clear up at least some problems occurring with transfer patients. Medicar... Read more
Quality Reporting:
New Visits Measure To Go Public In May
Plus: Now's the time to turn over a new leaf on HIS submissions. Medicare has pinned down... Read more
Industry Note:
Home Health Claims Lacking County Codes Bounce Back
Try this keying trick to get them through. Get up to speed on the new claims requirement ... Read more
Industry Note:
Payment Duplication Goes Under The Microscope
The HHS Office of Inspector General has added another home health item to its everexpandin... Read more
Industry Note:
Over Half Of Claims Use New Medicare Number Already
If you're not yet using the new Medicare Beneficiary Identifier numbers contained on your ... Read more
Industry Note:
Skipping 1st Medicare Appeal Level Doesn’t Get You Ahead
Don't waste your appeals time and effort by falling into a common trap. The problem: “R... Read more
Industry Note:
Home Visits Reduce Disabilities, Study Finds
Home care providers can add another item to their toolbox, proving how beneficial the serv... Read more
Industry Note:
Updated Manual Contains Specs For Hospice Visit Measures
Make sure you are using the updated version of the Hospice Quality Reporting Program Quali... Read more
Industry Note:
Upcoming MAC Webinar Schools Docs On HH Duties
You can use this free physician-focused webinar to nudge your referring docs onto the path... Read more
Industry Note:
Hospice Needs Require Opioid Prescribing Law Change
Federal officials don't have a monopoly on regulatory requirements that cause undue burden... Read more
Industry Note:
Chain Acquires Chicago-Area Provider
Arosa+LivHOME has acquired Partners in Senior Care in the Chicago area, reports the Los An... Read more
Patient Driven Groupings Model:
Take These 10 Steps To Prepare For PDGM Before It Rocks Your World
Don't let paradigm-shifting payment reform put you at risk next year. A year from now, yo... Read more
Education:
Use These Resources To Become A PDGM Expert
There's a wealth of information at your fingertips — for free. Make sure you are as inf... Read more
OASIS:
Avoid Dashes With This OASIS Coding Tip
Clear up early days confusion between dashes and Code 8. Medicare makes clear in the OASI... Read more
Human Resources:
How Employee Grief Policies Can Help Your Agency
Prepare staff to deal with death in the workplace. Just because you work in a health care... Read more
Hospice:
Use This MAC’s Tips To Get NOTRs Right
Learn the ropes of the new process for fixing erroneous notices. The many changes that ha... Read more
Industry Note:
DOL Offers Aide Compensation Guidance
Feds address travel time issue. If you don't want to risk a punishing lawsuit from your a... Read more
Industry Note:
Mind Cap Deadline
If you don't submit your self-determined hospice cap report to CGS by the Feb. 28 deadline... Read more
Industry Note:
More Targeted Probe And Educate Targets For Hospice Coming Down The Pike
The annual Comprehensive Error Rate Testing report may affect you more than you'd expect. ... Read more
Industry Note:
New State Audit Report Implies Upcoding In Eligibility Scoring
Missouri lawmakers are planning to make changes to the eligibility criteria for Medicaid h... Read more
Industry Note:
Busy Acquisition Year Makes Encompass 4th Largest Skilled Home Care Provider
Encompass Health, formerly Health-South, plans to continue its growth strategy in the comi... Read more
Industry Note:
Health System Buy Puts Regional Chain Into 16 States
Dallas-based AccentCare Inc. has acquired Steward Home Care and Hospice from Steward Healt... Read more
Industry Note:
Massive Claims Correction Burden Related To New CoPs Looms, Trade Group Warns
A potential huge claims headache has home health agencies scrambling. The new HH Conditio... Read more
OASIS:
Your OASIS-D Training Has Only Just Begun
Use new materials from CMS to further your staff 's OASIS education. Hopefully your OASIS... Read more
Assessment:
HHAs Not Thrilled With Intercepted Fall Addition
Anticipated vs. unanticipated is the key to qualifying for one exception. As home health ... Read more
Targeted Probe and Educate:
Every Single Hospice Fails TPE At One MAC
Would your claims fall into these TPE probes on non-cancer diagnosis, LOS, or site of serv... Read more
Compliance:
Don't Let Internal Auditing Fall Through The Cracks This Year
Crucial: Hold staff accountable for their documentation. With so many urgent issues deman... Read more
Industry Note:
Tune In For Info On Patient- Driven Groupings Model Pay Reform
Ask CMS your burning PDGM questions. Home health agencies may not have a lot of love for ... Read more
Industry Note:
Middle Initial Reason Code Stalks Home Health Claims Again
A claims glitch that home health agencies thought was fixed appears to be back. HHH Medic... Read more
Industry Note:
Kick This Bad SSN Habit
Medicare may have nearly finished distributing new Medicare cards to existing beneficiarie... Read more
Industry Note:
Cap Procrastination Could Cost You
If you've never accessed your own PS&R data to calculate your self-reported hospice ca... Read more
Industry Note:
Here's Who Pays Aides The Most
Visiting Nurse Association hospices pay certified nursing assistants nearly 10 percent mor... Read more
Industry Note:
Coming ACO Changes Could Affect You
Don't be surprised to see more pressure from your Accountable Care Organization partners a... Read more
Industry Note:
Medicaid Fraud Control Units Launch In 2 New Locations
The HHS Office of Inspector General has certified two new Medicaid Fraud Control Units. MC... Read more
Industry Note:
Health System, Chain Ready Joint Venture
Beaumont Health System in Michigan is forming a joint venture with Kettering, Ohio-based A... Read more
Industry Note:
Fraudsters Submit Claims For Visits During Travel
The feds' crackdown on Medicaid home care fraud continues. On Dec. 13, a federal grand jur... Read more
Make The Most Of Your Eli’s Home Care Week Subscription
You have more than a decade's worth of information on a multitude of home health topics at... Read more