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Home Care Week

Targeted Probe and Educate:
About Half Of HHAs Flunk Palmetto TPE Review
Major discrepancy between MACs shows in results. If you consider a 50 percent failure rat... Read more
Medical Review:
Big Chunk Of TPE Denial Reasons Still A Mystery
Are you taking these 4 steps before submitting every claim? No matter which HHH Medicare ... Read more
Reimbursement:
Are Latest Payment Error Numbers Delaying RCD?
Home health errors account for 10% of overall Medicare improper pay rate. Dec. 10 came an... Read more
Hospice:
Hospice Payment Error Rate Dips
Bad news: Hospices had the highest rate of erroneous claims. The heavy hand that the feds... Read more
Regulations:
See Where Your State Falls On Improper Payment Rate Spectrum
High claims volume doesn't necessarily translate to high error rates. Wondering where the... Read more
Fraud & Abuse:
OIG Doubles Down On Hospice Crackdown
Plus: Senior Medicare Patrol investigation leads to $2 million hospice settlement. Home h... Read more
Industry Note:
OIG Highlights Medicaid, Physician-Centered Home Health Cases
Medicaid agency settles fraud charges for $3.3 million. The HHS Office of Inspector Gener... Read more
Industry Note:
Rate Of Spending Growth Down 1%
Health care spending continues its slow and steady growth. “Overall national health spen... Read more
Industry Note:
Take A Look At Your Next Hospice Compare Data
Don't miss your chance for a sneak preview of your Hospice Compare data. Hospice provider ... Read more
Industry Note:
Therapy Caps Transition To Therapy Thresholds
Home care providers that also furnish Part B outpatient therapy in the home should take no... Read more
Industry Note:
That U5181 Return You Think Is An Error May Be Legit
Beware an ongoing payment system glitch that could be hanging up your hospice claims — b... Read more
Industry Note:
Alaskan Providers Can Use Offered Regulatory Relief
Check out regulatory flexibility offered to providers affected by the Alaskan earthquake a... Read more
Industry Note:
Tap This Updated HIPAA Education Tool
Find out more about HIPAA with the Centers for Medicare & Medicaid Services' newly upd... Read more
Industry Note:
Massage Therapist, HHA Owner Plead Guilty
A Miami home health agency owner and a massage therapist masquerading as a physical therap... Read more
Medical Review:
Nearly All HHAs Flunked TPE Review In Latest Round
Medicare needs to examine its requirements, experts charge. The latest results from the T... Read more
Reimbursement:
Take These Steps To Combat TPE
Don't forget about appeals. Home health agencies affected by Targeted Probe and Educate r... Read more
Medical Review:
TPE Performance Is Going The Wrong Way
More HHAs wind up in ‘significant' error category in latest results. When Medicare laun... Read more
Documentation:
Face-To-Face Tops Latest TPE Denial List
Good news: One of the most common denial reasons will go away in the new year. You don't ... Read more
Fraud & Abuse:
Fraud Enforcement Focuses On Medicaid
Charges include fake time sheets. Twelve people, including two sisters who are home healt... Read more
Compliance:
Beware These Gift-Giving Taboos At Holiday Time
Remember, Medicare is a whole different world when it comes to gifting to your associates.... Read more
Industry Note:
Check Out Your New Hospice Compare Measure
Attend upcoming webinar for more info. Hospices' scores for the newest Hospice Compare me... Read more
Industry Note:
Review Choice Demo Continues To Loom On Horizon
Illinois agencies are waiting on pins and needles to see when the Review Choice Demonstrat... Read more
Industry Note:
Watch Out For This Glitch Suspending HH Claims
You might not get the result from your claim adjustment that you were hoping for, if a new... Read more
Industry Note:
Monetary Threshold For ALJ Hearing Stays Steady
Good news: The threshold that will allow you to bring an appeal before an Administrative L... Read more
Industry Note:
Heads Up: Overlappping Claims Rejections May Be Errors
Beware a new payment glitch hitting hospice claims. “Hospice claims are incorrectly reje... Read more
Payment:
Home Health Pay Error Rate Drops Dramatically To 17.6%
Don't expect the lower rate to translate to easier oversight, however. After years of bei... Read more
Hospice:
Tougher Surveys May Be Ahead, Thanks To OIG Probes
Are you ready for your survey results to end up on Hospice Compare? With Medicare hospice... Read more
Billing:
Get Familiar With New Claims Requirement For County Code
Don't let new claim element slow your cash flow in the new year. Make sure you add new st... Read more
Fraud & Abuse:
Dallas & Detroit Cases Rack Up Convictions, Guilty Pleas, And Prison Sentences
Three more guilty pleas entered in Novus case. Nine defendants are on track for a trial n... Read more
Reimbursement:
Polish Your Appeals Practices To Rescue Reimbursement
Investing in your appeals process is worth the payoff. Receiving some denials may be all ... Read more
Industry Note:
Mind Your POC Signatures Or Face Denials
Reviewers want to see it all, MAC emphasizes. Make sure you aren't committing this common... Read more
Industry Note:
HIS Guidance Has Changed, But HIS Items Have Not
Access new guidance on completing Hospice Item Set questions accurately in the updated HIS... Read more
Industry Note:
See Your HH PPS Rates For 2019
You can see a summary of your 2019 HH PPS payment rates and policies in a new MLN Matters ... Read more
Industry Note:
Accessing CWF To Get More Complicated
If you want to use the Common Working File, soon you'll need to undergo verification of th... Read more
Industry Note:
Wildfire-Impacted Agencies Qualify For OASIS Waiver
Home health agencies affected by the wildfires in California can take advantage of a blank... Read more
Industry Note:
Enrollment Application Fee Makes Big Jump
If you thought $569 was a hefty application fee for Medicare enrollment for institutional ... Read more
Industry Note:
OCR Updates HIPAA Audit Protocols
With little fanfare and no release, the HHS Office for Civil Rights has updated its Phase ... Read more
Industry Note:
Record-Breaking HIPAA Settlement Announced
As 2014 ended and 2015 began, private payer Anthem Inc. suffered the biggest HIPAA violati... Read more
Patient-Driven Groupings Model:
PDGM's New Admission Source Factor Could Bust — Or Boost — Your Reimbursement
Source of admission might add thousands of dollars to your episode. Whether you sink or s... Read more
Prospective Payment System:
Industry Protests Institutional/Community Case Mix Element
Warning: ED visits and observational stays do not count. Home health agencies gave Medica... Read more
Billing:
Be Ready To Pounce On Institutional Billing Details
Pointer: Start checking HETS reports for hospital billing ASAP. Not only does the new cas... Read more
Hospice:
New Hospice Compare Measure Debuts This Month
Plus: New preview reports will be here soon. Will you be thankful for the new measure Med... Read more
Review Choice Demonstration:
RCD Agencies In Holding Pattern, Waiting On PRA Approval
Home health agencies eager to move ahead with their Review Choice Demonstration preparatio... Read more
Industry News:
Hospice PA Changes Set To Take Effect Jan. 1
Plus: Do you know this exception to NOE timely filing requirements? The regulatory langua... Read more
Industry News:
When Templates Are OK — And When They're Not, According To CMS
Not sure if your certifying physicians should use templates to support your patients' home... Read more
Industry News:
New Location Data Reporting On Claims Applies To All HHAs — Not Just Rural Ones
Stay tuned for details on how you are supposed to submit your location data on claims in l... Read more
Industry News:
Find Out Latest About Medicare's Efforts To Standardize Data Collection Across PAC
Get an update on Medicare's efforts to standardize data collection across post-acute care ... Read more
Industry News:
Medicare Catches Last MBI Card Wave
Medicare has finished mailing new MBI-based Medicare cards to Medicare beneficiaries who l... Read more
Industry News:
Michigan Hospital To Close Failing Agency
Add another hospital-based home health agency to the closure list. Sturgis Hospital in St... Read more
Prospective Payment System:
2019 Rate Increase Largest In More Than A Decade
Plus: Outlier formula tweak will make them a little easier to obtain. Not surprisingly, h... Read more
Reimbursement:
CMS Hangs Onto Behavioral Assumption Adjustment Cuts, Despite Industry Outcry
  Industry needs Congress' help. While the Patient-Driven Groupings Model is suppos... Read more
OASIS:
Focus On These 8 PDGM-Impacting OASIS Items
Accuracy will be paramount. These OASIS items will make up PDGM functional levels: ... Read more
Finance:
New Clinical Groups Complicate PDGM Impact Estimation
The payment reform plan contains a whopping 432 case mix groups. Trying to figure out how... Read more
Patient-Driven Groupings Model:
Find A Patient's PDGM Case Mix Group With These 4 Steps
MMTA expansion also affects comorbidity groups. While some of the details have changed, t... Read more
Billing:
PPS Rule Finalizes First Step Of RAP Elimination
New HHAs no longer will receive RAP payments under PDGM. Despite many strident industry c... Read more
Billing:
Eliminated RAPs May Lead To Notice Of Admission Requirement
Beware possible penalties for late NOAs. Home health agencies don't like the idea of impl... Read more
Regulations:
Ready Or Not, 30-Day Billing Periods Are On The Way
Medicare officials claim switch won't increase burden. It's no surprise that the Patient-... Read more
Hospice:
Use NOTRs To Head Off Missed Reimbursement
Beware the edit that prevents NOEs for some readmissions. To make sure you don't miss out... Read more
Industry Note:
Burdensome Discharge Planning Reg Still Looms
CMS puts reg off at least a year. Home health agencies have one less regulatory burden to... Read more
Industry Note:
Commemorate National Home Care, Hospice Month
It's not too late to celebrate Home Health and Hospice month with your staff, referral sou... Read more
Industry Note:
MAC Holds RCD Calls
Review Choice Demonstration contractor Palmetto GBA has started monthly calls aimed at upd... Read more
Industry Note:
TX Fraud Headed To Trial
Four men accused of home health fraud have pleaded not guilty and will face trial in Janua... Read more
Prospective Payment System:
HH PPS Final Rule With PDGM Payment Reform Is Out
Retained behavioral adjustment provision ruins new model, trade group insists. Medicare i... Read more
OASIS:
Don't Let OASIS-D Sneak Up On You
Put the OASIS-D pedal to the metal right now. Whether you've been painstakingly preparing... Read more
Assessment:
Ramp Up On These Major OASIS-D Additions, Revisions
The changes included in OASIS-D are: a significantly expanded GG0170 (Mobility) item; ... Read more
Strategy:
Follow These 9 Tips To Get Ahead Of OASIS-D Switch
Make sure clinicians understand dashes. While it's not too late to get where you need to ... Read more
Education:
Use These OASIS-D Resources To Smooth Your Transition
Medicare is offering free OASIS-D training. Here are some places you can turn for informa... Read more
Industry Note:
Use This Data To Gauge Your Medical Review Risk
MAC issues NCLOS comparative billing report. Regulators and reviewers are zeroing in on h... Read more
Industry Note:
Study Shows PT's Value With ADLs
With the newly issued HH PPS final rule eliminating therapy as a case mix factor, therapis... Read more
Industry Note:
Understand Reopening Vs. Adjustment
Don't waste time on a clerical error reopening when you can submit your own provider adjus... Read more
Industry Note:
Hospice Cap Season Begins
With the 2018 hospice cap reporting year ended as of Sept. 30, now's the time for hospice ... Read more
Industry Note:
CMS Launches eMedicare
Your current and future patients will be able to take advantage of some new online options... Read more
Industry Note:
Medicare Encourages Innovative Telehealth In MA Plans
A proposed rule regarding Medicare Advantage might pave the way for more telehealth in Med... Read more
Industry Note:
DOJ Announces New Fraud Strike Force Location
After adding a new Medicare Fraud Strike Force city just a few months ago, another one is ... Read more
Industry Note:
Circle Back To These Incorrectly RTP'd Claims
A glitch hanging up home health and hospice claims in error has been fixed, but you'll sti... Read more
Industry Note:
Star Rating Info Available
If you'd like more information about coming changes to Medicare's Home Health Quality of P... Read more
Industry Note:
You Can Still Submit Electronic Cost Report Outside MCReF
If you weren't quite ready to submit electronic cost reports to the Medicare Cost Report e... Read more
Emergency Preparedness:
Your Emergency Preparedness Duties Will Get Lighter Under Proposed Rule
Recent hurricanes emphasize why EP changes matter. Some actual regulatory relief might be... Read more
Regulations:
EP Review, Education, Collaboration Could Ease Up
Emergency preparedness changes would save $143 million annually. Reducing home care and h... Read more
Hospice:
MCCM Participation Barriers Hamper Demo
One-quarter of demo hospice agencies have withdrawn. The findings of a new evaluation rep... Read more
Demonstration Projects:
Know Your Facts MCCM Demonstration
Nearly 40 percent of demo enrollees also receive HHA services. Whether Medicare will move... Read more
Mergers & Acquisitions:
Big Chains Make Big Acquisitions
Market consolidation continues, especially for the hospice sector. Amedisys Inc. will bee... Read more
Industry Note:
Don't Miss Medicare's Free OASIS-D Training
Are you ready for new OASIS sections in the New Year? Now's the time to get serious about... Read more
Industry Note:
RAP Relief Included In Hurricane Michael Response
Home care and hospice providers hit hard by Hurricane Michael are getting some regulatory ... Read more
Industry Note:
Late Files Lead To This Claim Suspension
You shouldn't have to wait long for a resolution if your claims are hung up by Reason Code... Read more
Industry Note:
Premiums, Deductibles To Creep Up Next Year
Medicare premiums and deductibles will rise on Jan. 1. The standard monthly premium for Me... Read more
Industry Note:
Regional Health Systems Split Up Joint HHA
What three regional health systems joined together, they are now putting asunder. Penn Me... Read more
Industry Note:
Another Hospice Owner Pleads Guilty To Fraud
A Mississippi hospice owner has pleaded guilty to Medicare fraud in a $13 million scheme. ... Read more
Industry Note:
Issuance Of New Medicare Cards Almost Complete
Medicare has started mailing new Medicare cards to beneficiaries who live in Wave 7 states... Read more
Review Choice Demonstration:
Burden For RCD Revised Downward
Stay tuned for operational guide, education. Gear up now for the Review Choice Demonstrat... Read more
Hospice:
Medicare To Reduce Hospice Aide, Drug, Training Burdens
How much difference will these changes really make? Hospices may be in for a treat if Med... Read more
Survey & Certification:
Some Med-Related Duties Might Come Off Hospices' Plates
Proposed change would save hospices $80 million annually, CMS claims. The biggest-dollar ... Read more
HIPAA:
Are You Prepared For The Steep Cost Of A HIPAA Breach?
Hacking is on the rise, according to latest data. Recent data indicates Covered Entities ... Read more
Compliance:
Add An Incident Response Plan To Your HIPAA Toolkit
HIPAA breaches may be inevitable, so you need to be ready. Unless you feel prepared to in... Read more
Industry Note:
Home Care Grapples With Another Disaster
HHS declares public health emergency in Florida. Home care providers once more are puttin... Read more
Industry Note:
Don't Jump The Gun On Filing Your Medicare Claim Appeal, Or You May Slow Your Cash Flow Even Further
Don't jump the gun on filing your Medicare claim appeal, or you may slow your cash flow ev... Read more
Industry Note:
Give Your Patients This Advice If They Accidentally Throw Away Their New MBI-Based Medicare Cards
Your patients receive so much junk mail, it's hard to blame them for accidentally tossing ... Read more
Review Choice Demonstration:
Get Ready For RCD To Roll Out Dec. 10
Agencies welcome some clarifications, although heavy burden remains. Home health agencies... Read more
Medical Review:
Here's How The RCD Advanced Options Will Work
Know your choices. Unless you underwent Pre-Claim Review in Illinois, you'll have to unde... Read more
Reimbursement:
Monitor RAP Cancel Rate Or Risk Losing Advance Payments
Here's the benchmark you should be aiming for. In Medicare's latest proposed payment rule... Read more
Billing:
Learn The Road To RAP Suppression
Warning: Unresolved RAP issues can land you in a fraud contractor's crosshairs. If you're... Read more
Fraud & Abuse:
Reckoning Comes For These Fraudster Physicians
Kickbacks are the focus of many recent cases. Recent enforcement developments in home hea... Read more
Industry Note:
Industry Fights Against PDGM As Final Rule Date Nears
Legislation aims to eliminate adjustments. Witches and ghosts aren't the only scary thing... Read more
Industry Note:
Overlap Payment Glitch Menaces Hospice Claims
Watch out for a new hospice payment glitch. “Some claims are incorrectly rejecting for r... Read more
Industry Note:
Find Out Changes Medicare Made To MCReF System Based On User Feedback
Learn how to use the new Medicare Cost Report e-Filing (MCReF) system in an Oct. 15 webina... Read more
Industry Note:
Medicare Funds Palliative Care Quality Measure Work
The American Academy of Hospice and Palliative Medicine, in partnership with the National ... Read more
Industry Note:
New Transmittal Aims To Get Medicare Contractors On The Same Page For Stat Sampling
Medicare has issued new statistical sampling instructions to its contractors. “To e... Read more
Industry Note:
8-State Hospice Chain Makes 2 Acquisitions
Bristol Hospice, a portfolio company of Webster Capital, has bought the Colorado operation... Read more
Survey & Certification:
Proposed Regulatory Relief Won't Go Very Far For HHAs
Patients over Paperwork initiative results in some small — very small — proposed chang... Read more
Compliance:
No More Patient Rights Verbal Notice, If Rule Finalized
Change would save HHAs $55 million per year, CMS estimates. A new Home Health Condition o... Read more
Conditions of Participation:
Aide CoP Change Is Likely Not The One You're Looking For
CMS acknowledges reality in one area. Medicare will loosen up its testing requirements wh... Read more
Reimbursement:
It's On: MACs Are Watching Your RAPs
Don't be surprised when problems come to light. If you thought it would take a while for ... Read more
Billing:
Take These 4 Steps To Avoid RAP Punishment
If you like receiving money on the front end of an episode, make sure your RAP stats are g... Read more
Emergency Preparedness:
HHAs, Hospices Grapple With Hurricane Impact
For now, surveys are suspended in the Carolinas. Home care providers pray that they will ... Read more
Emergency Preparedness:
Know When Disaster Relief Could Apply To You
Though the term “disaster” is sometimes thrown around lightly, the feds have very stri... Read more
Survey & Certification:
Sidestep This Stealth Survey Trap Involving HIPAA
Business Associates matter to surveyors. It's not just the HHS Office for Civil Rights th... Read more
Industry Note:
Learn About Star Rating Change
Are you ready for the oral med management measure to be included? Want to find out what e... Read more
Industry Note:
Medicare Expects To Mail All MBI Replacement Cards To Beneficiaries By April
Medicare is getting closer to the end of its initiative to replace beneficiaries' Medicare... Read more
Survey & Certification:
Beware Aide Competency Testing Under Final IGs
Medicare tweaked testing IGs — but not enough. The final Interpretive Guidelines for th... Read more
Compliance:
Look To These 2 Bright Spots In Final IGs
Aides' med administration, verbal order clarifications welcome. While there is a lot to ... Read more
Regulations:
Unchanged IG Sections Pose Major Compliance Risks
Agencies' have their work cut out for them in avoiding survey deficiencies. Some Interpre... Read more
Hospice:
CMS Changes The Channel For Future Hospice Compare Additions
Medicare will no longer run new public display of measures through rulemaking. When it co... Read more
Payment:
Post Acute PPS Isn't Going Away
How do readmission payment penalties for HHAs sound? The Medicare Payment Advisory Commis... Read more
Industry Note:
Note This Payment Reduction Appeal Change
Get ready for no more paper reconsideration requests. If you think you're going to be doc... Read more
Industry Note:
Revised OT, PT LCDs Contain This Significant Change
If you're used to using certain codes for myalgia and post-op infection to justify your th... Read more
Industry Note:
Make This Oct. 5 Deadline
Now's your chance to look at your performance on the new Hospice and Palliative Care Compo... Read more
Industry Note:
MAC To School Docs On Home Health Duties
If you're trying to get your referring physicians to toe the line for face-to-face documen... Read more
Industry Note:
Get Your HQRP Bearings With New Education From CMS
You can learn more about the Hospice Quality Reporting Program by using newly posted mater... Read more
Industry Note:
Bay Area HHA Owner, Marketer Indicted On Kickback Charges — Plus Physician
A California home health agency marketer and referring physician have been indicted on Med... Read more
Industry Note:
Medicare Indicates Enthusiasm For Next-Gen ACOs And Their Cost Savings
Don't be surprised to see Medicare move more strongly toward Accountable Care Organization... Read more
Industry Note:
Guard Your PECOS Data Like You Would Your PHI
HIPAA requires that providers safeguard their patients' protected health information (PHI)... Read more
Survey & Certification:
Expect Survey Dial To Turn Up To 11
Warning: Learning curve likely steep. Although it may not always feel like it, many state... Read more
Compliance:
Language Discrimination Could Top Survey Hit List Under IGs
Tip: Translate your Patient's Rights notice into top 15 languages, expert advises. Home h... Read more
Regulations:
Watch Out For These 2 Survey Hot Spots On Heels Of Final IGs
SOC, reprisal IGs could give agencies trouble. Home health agencies have a lot to worry a... Read more
Survey & Certification:
Make Sure Your Staff Know What 'Abuse' Means In CoPs
Final Interpretive Guidelines may not jibe with your state laws. Some definition changes ... Read more
Targeted Probe & Educate:
It's Getting Worse: 91% Bomb TPE So Far
One MAC releases new stats about the medical review program. As Targeted Probe & Educ... Read more
Medical Review:
Try These 5 Tips To TPE Success
Do you know the difference between your charge error rate and your claim error rate? Whet... Read more
Targeted Probe & Educate:
Peruse Latest TPE Top Denial Reasons
Skilled nursing necessity reason slips off top 5 list. There's one new denial reason in t... Read more
Industry Note:
Start Countdown To 2019 HH PPS Final Rule
Do HHAs stand a chance against PDGM? The home health industry has bombarded Medicare with... Read more
Industry Note:
See How You Stack Up To Your Peers With Updated Data
If you're wondering how you compare to your peers, Medicare is offering an updated data re... Read more
Industry Note:
Know What HETS Is Telling You About Hospice Dates
Wondering exactly what you're looking at in the HIPAA Eligibility Transaction System (... Read more
Industry Note:
Learn The Latest Medicare Card Info
If you want to get the skinny on new Medicare cards, you can call into Medicare's next Ope... Read more
Industry Note:
Keep An Eye Peeled For Your Cap Overpayment Notice
The arrival of September may also mean the arrival of your hospice cap repayment notice. S... Read more
Industry Note:
Get The Latest Info On HEART Assessment Tool
Medicare is moving forward with its hospice patient assessment tool, even if that progress... Read more
Compliance:
Prepare For MACs To Monitor Your RAP Stats
Will you stick out like a sore thumb? You'd better rein in any sloppy RAP practices you'v... Read more
Audits:
Know Your Facts: Audit Contractors
TPE net reportedly catches lots of home care providers. Scrutiny of home health and hospi... Read more
Fraud & Abuse:
Recent Home Health Fraud Cases Focus On Kickbacks
Whistleblower rakes in $2.3 million. Be sure to toe the line in your relationships with i... Read more
HIPAA:
Keep Your BA Agreements In The Clear With These Facts
If you haven't correctly identified all your associates, you could be at risk. Ignorance ... Read more
Billing:
Know The Billing Ins And Outs For New Medicare Cards
What do you do when an MBI changes? Is it your patients' turn to wade into the new Medica... Read more
Industry Note:
Medicare Revamps Moratoria Waiver Process
Any exceptions may be only on a county-by-county basis. Home care providers that would li... Read more
Industry Note:
Not So Fast: Medicare Rolls Back Revocation Date Change
Don't try to take advantage of Medicare's new method for removing a hospice revocation dat... Read more
Industry Note:
Keep This Deadline Loophole In Your Back Pocket
If you run behind on submitting your documentation for a claim under medical review, you m... Read more
Industry Note:
Hospice Quality Reporting Program Info At A Glance
If you don't know HIS from QIES from QRP, you can check out Medicare's newest Hospice Qual... Read more
Industry Note:
Some Big States Are Lagging On PEPPER Downloads
If you haven't looked at your latest PEPPER benchmarking report, you may be lagging behind... Read more
Industry Note:
Give CMS Your Ideas On Reducing Burden
Do you wish you were seeing more benefit from Medicare's Patients Over Paperwork initiativ... Read more
Industry Note:
Don't Let Device Disposal Break Your HIPAA Compliance
How careful are you when it comes to disposing of your agency's electronic devices? If you... Read more
Industry Note:
County Sells HHA For $2 Million
Nash County, North Carolina will sell its home health agency to HealthView Capital Partner... Read more
OASIS:
Heed New Q&A, OASIS-D Manual Guidance On ROC Timing
CMS explains what the new HH CoPs require — and what they don't. Home health agencies h... Read more
Referrals:
Referral-Limiting Transfer Policy Hits Hospices This Fall
Plus: OIG examines HH transfer policy. Activity is up around Medicare's proration policy ... Read more
Fraud & Abuse:
Intermediate Sanctions, Tougher Medical Review, And More May Be Ahead
Prepare for these actions focused on GIP, nursing facility patients, and more. The OIG ha... Read more
Hospice:
Know Your Options When It Comes To Drug Reporting
CMS: Stick with one reporting method. The 2019 hospice payment final rule offers provider... Read more
Regulations:
Hospice PA Change Set To Take Effect Oct. 1
PA provision should improve hospice access. It may not go as far as some hospices want, b... Read more
Industry News:
Another Strike Force City Comes Online
Strike Force areas now number 10. The feds' Medicare Strike Force model has proven so suc... Read more
Industry News:
Heads Up, Agencies With Home Offices
Chain home health agencies and hospices should pay attention to a new cost reporting requi... Read more
Industry News:
Scammers Prey On Your Patients
Spread the word to help your patients receiving new Medicare cards: “Medicare will never... Read more
Industry News:
HHAs Pack New OASIS-D Training Sessions
If you haven't signed up for two upcoming OASIS-D training webinars offered by the Centers... Read more
Industry News:
NOE-Related Glitches Abound
Beware multiple hospice Notice of Election-related claims system glitches. Glitch #1: “... Read more
Industry News:
Mass. Crackdown On HH Fraud Yields Conviction, Sentence
A Boston home health agency owner has been sentenced to up to three years in prison after ... Read more
Industry News:
Court Awards $3M Judgment In NC Fraud Case
A North Carolina federal court has awarded a nearly $3 million judgement against Compassio... Read more
Industry News:
LTC & Rehab Hospital Chain Partners With Texas HHA
Enola, Pennsylvania-based Post Acute Medical, which provides post-acute healthcare service... Read more
Industry News:
Equity Firm Buys AZ Hospice With Eye Toward Growth
H.I.G. Growth Partners has acquired Sage Hospice in Phoenix, Arizona, the private equity f... Read more
Fraud & Abuse:
OIG Pushes HHA Surety Bond Requirement — Again
Watchdog agency isn't letting this recommendation go. A major home health agency burden n... Read more
Hospice:
1.8% Payment Bump For Hospices Stands In Final Rule
Medicare holds fast to its volatile wage index methodology. If you made budget plans base... Read more
Finance:
Make Cost Report Changes Before It Impacts Your Pay Rates
Are you in the nearly 40% of hospices not reporting volunteer services coordination? Medi... Read more
Quality:
6 Hospice Compare Revisions Are Now Final
Making CAHPS measures a year more recent would cut 20% of agencies off public display. Th... Read more
Industry Note:
Stay Tuned For Review Choice Demonstration Outcome
Pre-Claim Review closed doors in first round, trade group maintains. Hopefully, Medicare ... Read more
Industry Note:
CMS Head Showcases Managed Care Home Care Changes
Home health agencies are getting a boost from CMS Administrator Seema Verma when it comes ... Read more
Industry Note:
HHA Moratoria In 4 States Has Resulted In More Than 1,200 Medicare Enrollment Application Denials, CMS Reveals
The moratoria on new home health agencies continues in all counties in Florida, Illinois, ... Read more
Industry Note:
Take 45 Minutes To Learn More About Medicare's Updated Free Benchmarking Reports
Want to find out more about how to use your free, updated PEPPER benchmarking report from ... Read more
Industry Note:
Massive Catholic Health System Consolidates Home Care Businesses In 7 States
The largest Catholic health system in the world, Ascension Health, has fully integrated it... Read more
Industry Note:
North Carolina County Sells Agency To LHC-Health System Joint Venture
By the end of the month, Wilson County in North Carolina will sell its nearly 50-year-old ... Read more
OASIS:
Focus On New Fall Item In OASIS-D
Crucial: Know how to assess an intercepted fall. If you don't learn the ins and outs of o... Read more
Training:
Begin OASIS-D Training Immediately, Experts Urge
Check out these high-priority items on the training list. It may be the end of summer, bu... Read more
Fraud & Abuse:
Whistleblowers Rake In Millions In Fraud Cases
Qui tam law firms reach out to employees. You'd better make sure you're running a tight s... Read more
Compliance:
Pending Lawsuit Could Shorten Your Cert Signature Timeframe Even Further
Keep a close eye on this threatening case. If you think securing physician certification ... Read more
Assessment:
Make Sure You're Following The OASIS Rules For Unexpected Discharges
Tip: Avoid a CoP violation with CMS's latest advice. A newly released OASIS question-and-... Read more
HIPAA:
When Do You Have To Report A HIPAA Breach?
Follow this expert's decision tree. Deciding when to take the reputation-threatening step... Read more
Industry Note:
Use New Clarifications About Registries And Overtime Laws
Warning: Don't expose yourself to financial risk. The distinction between an employer tha... Read more
Industry Note:
New Medicaid Reassignment Proposal Affects Union Dues
A recently proposed Medicare rule aims to remove states' ability to “make payments to th... Read more
Industry Note:
Dive Into HHA Survey Deficiency Data
Want to get a detailed look at home health agency survey deficiencies dating back to 2011?... Read more
Industry Note:
Get Up To Speed On Star Rating Methodology Changes
If you're interested in the proposed changes to Medicare's star rating process, but missed... Read more
Industry Note:
Home Health, Hospice M&A Continues In High Gear
The home health and hospice M&A market has shown no sign of declining — although tha... Read more
Industry Note:
Show-Me State Hospital, HHA Partner
Mercy Hospital and Integrity Home Care + Hospice in Springfield, Missouri are partnering. ... Read more
Industry Note:
Home Health Marketer Pleads Guilty After Doc Husband
Former home health marketer Lisa McLaren Janick has pleaded guilty to falsifying documents... Read more
OASIS:
New Set Of OASIS Q&As Address Manual Change
For M2102f, official diagnosis not necessary. Medicare has followed up on its promise to ... Read more
Patient-Driven Groupings Model:
CMS Suggests Swapping RAPs For Notices Of Admission
Watch out for NOE-like disaster, expert warns. One payment reform change Medicare is cons... Read more
Hospice:
Know Your New Hospice Billing Ins And Outs
System changes ease NOE corrections. It's essential to stay up to date on Medicare billin... Read more
Regulations:
HEART Testing Pushed Back Following Pilot
HQRP training, Hospice Compare refresh also discussed in forum. It looks to be a while be... Read more
Appeals:
Court Grants Potential Overpay Breathing Room
A 43-claim audit led to $7.9 million overpayment demand. A federal court decision issued ... Read more
Industry Note:
GAO Highlights Home Health As Fraud Risk Priority
CMS lacks risk assessment, report says. Medicare officials have a way to go in enhancing ... Read more
Industry Note:
Aug. 7 Deadline Looms
Look in your mail or your QIES CASPER folder to see whether CMS is going to cut your payme... Read more
Industry Note:
Download Your New HH PEPPER Report
Home health agencies can download their updated PEPPER benchmarking reports now. The Q4CY1... Read more
Industry Note:
Find Out How Testing Of IMPACT Act Data Is Going
Receive IMPACT Act information and give CMS your two cents on the matter in a July 25 Spec... Read more
Industry Note:
Claim System Snafu Suspends Claims In Error
Heads up for this claims system glitch: Part A claims including those for home health “a... Read more
Industry Note:
Humana Completes Monster Hospice Merger
Humana Inc. and its private equity firm partners have completed their high-profile acquisi... Read more
Industry Note:
Great Lakes-NHHC-Jordan Merger Renamed Elara
The newly formed company that combines Great Lakes Caring, National Home Health Care, and ... Read more
Industry Note:
Phishing Scams Hook 2 Hospice Employees
Tighten up your employee training on HIPAA, or face potential embarrassment over even mino... Read more
Quality:
Say Farewell To 7 Quality Measures Under Proposed Rule
Dropped measures will come with OASIS changes. Medicare continues to focus on fine-tuning... Read more
Regulations:
Revised, Additional Factors To Determine Which Quality Measures Get Dropped
CMS aims to reduce provider burden with new criterion. Medicare officials have made a lot... Read more
Prospective Payment System:
Proposed Rule Addresses Remote Monitoring, Home Infusion, VBP, And More
Change could lead to more accurate profit margin figures. Payment reform and rate increas... Read more
OASIS:
Start Your Next OASIS-D Phase With New Manual
CMS plans OASIS-D educational sessions. The wait is over — mostly. Medicare has release... Read more
Patient Driven Groupings Model:
Beware: Pay Reform Impact File Missing Major Adjustment
Plus: See how much Medicare's behavioural adjustments are stripping from base rate. If yo... Read more
Industry Note:
Note These OASIS Changes In The PPS Proposed Rule
CMS wants to double Medicare spending per beneficiary timeframe. Don't miss smaller but s... Read more
Industry Note:
HHAs Don't Qualify For Home Infusion Transitional Payments, CMS Clarifies
If you're a little confused about the new home infusion benefit that CMS has proposed in t... Read more
Industry Note:
Influential Newspaper Puts Humana Hospice Deals Under The Microscope
Attention from the New York Times is rarely good for Medicare providers. Now the Times has... Read more
Industry Note:
CMS Issues Latest F2F Template Versions
Check out the latest versions of Medicare's “clinical templates or suggested clinical da... Read more
Industry Note:
Note This PEPPER Training Time Change
Review the most recent home health agency PEPPER benchmarking report in a newly reschedule... Read more
Industry Note:
Pre-Claim Review Urgently Needs Your Attention, Before It's Too Late
Don't get so distracted by the payment reform proposal and other 2019 HH PPS proposed rule... Read more
Reimbursement:
2.1% Pay Hike To Bring $400M More To HHAs Next Year
For once, HHAs have no rebasing or case mix creep cuts to contend with. For the first tim... Read more
Prospective Payment System:
Medicare's New Pay Reform Proposal Looks Awfully Familiar
New PDGM is HHGM with a few tweaks. If you didn't like Medicare's ideas on home health pa... Read more
OASIS:
These 8 OASIS Items Will Determine Your Functional Scores Under PGDM
M1800: Grooming M1810: Current Ability to Dress Upper Body M1820: Current Ability to Dress... Read more
Diagnosis Coding:
Check Out The Secondary Dx Groups That Will Boost PDGM Pay
CMS listened to HHGM commenters and revised the case mix category methodology. The newly ... Read more
Billing:
Medicare Wants To Scrap RAPs Under Payment Reform
LUPAs thresholds to vary under PDGM. The home care industry may hate the idea, but CMS is... Read more
Fraud & Abuse:
Proposed Rule Cites Abuses In Pushing For RAP Elimination
Will out-and-out fraudsters wreck your cash flow? If you're wondering why Medicare wants ... Read more
Regulations:
Medicare Provides More Info On Pay Reform This Time Around
Data helps pinpoint winners, losers under new payment system. Aside from budget neutralit... Read more
Documentation:
Proposed Rule Snuffs Out Any Hope For Documentation Reform Based On BBA 18
HHAs can't celebrate their independence from this hassle. While not exactly what home car... Read more
Certification:
HHAs To See Some Relief With Physician Recert Estimates
F2F reform is what's really needed, expert urges. After years of punishing claims denials... Read more
Industry Note:
Massive Fraud Takedown Includes Home Care Providers
Cases tick the usual fraud hot spot boxes. More proof of the feds' increased fraud fighti... Read more
Industry Note:
MBI Card Wave 3 Starts
If you're in a “Wave 3 state” for the new Medicare cards, your patients should be star... Read more
Industry Note:
Stark Law Changes Under Medicare Consideration
Are Stark Law prohibitions making your life difficult — especially when it comes to pati... Read more
Fraud & Abuse:
OIG Targets LUPA Gaming In Newest Work Plan Item
Feds will examine cases where one visit translates to additional thousands of dollars. Ju... Read more
Compliance:
Take These 4 Steps To Head Off LUPA Troubles
Your PEPPER report could come in handy. With attention on low-visit episodes heating up, ... Read more
Review Choice Demonstration:
Will Your State Be Next On Pre-Claim Review List?
Medicare to spend nearly $400 million on RCD project, it says. While recently released do... Read more
Medical Review:
Illinois HHAs Hope For Generous Exemptions To RCD
Even agencies that qualify for exemption will be subject to 5% ‘spot check.' One of the... Read more
Enforcement:
OIG Racks Up Big Numbers In Latest Period
Nearly $1.5 billion in recoveries keeps the OIG on task. If you're waiting for federal fr... Read more
Hospice:
Hospice Fraud Settlement Leads To Execs' Salaries Splashed Across The Newspaper
Hospice nursing supervisor admits to hastening patients' death with overmedication. Two h... Read more
Industry Note:
MAC Calls Off UPIC Scare
Stay alert to claims hitting S B6001, though. HHH Medicare Administrative Contractor Palm... Read more
Industry Note:
OIG Targets Inappropriate Managed Care Denials
In addition to looking at home health episodes that barely exceed the LUPA threshold, the ... Read more
Industry Note:
Hospice Access A Problem For Kidney Dialysis Patients
Medicare patients on chronic kidney dialysis have “woefully poor access to hospice care,... Read more
Industry Note:
Senior Fraud Patrol Recovers Millions For Medicare
The Senior Medicare Patrol program continues to go strong, with the HHS Office of Inspecto... Read more
Industry Note:
Medicare To Ease Hospice Billing Next Month
Get ready for changes to your hospice billing July 2. Change #1: “A new hospice electio... Read more
Industry Note:
Ohio Nonprofit Affiliate Group Grows
Ohio nonprofit Loving Care Hospice, based in London and Marysville, plans to join Ohio's H... Read more
Reader Question:
VA Patient Successfully Sues For Home Care Continuation
The U.S. Department of Veterans Affairs has agreed to continue to provide home care for an... Read more
Review Choice Demonstration:
This State To Go First In Revived Pre-Claim Review Demo
GAO wants Pre-Claim Review to resume. Medicare is revealing more details about its resurr... Read more
Medical Review:
Industry Mobilizes For Pre-Claim Review Opposition
Learn from original PCR run, trade group tells Medicare officials. Unlike with the origin... Read more
Know Your Facts:
Live Discharge Rate Dropped Again In 2017
LOS ticks upward. You have only a matter of days left to give Medicare your two cents on ... Read more
Hospice:
Prior Auth For Common Drugs May Be On Hospice Horizon
You should be paying for insulin, beta blockers, and more, CMS instructs. Data revealed i... Read more
Utilization:
Hospice Payment Reform Fails To Move The Needle On Skilled Visits At End Of Life
Only slight improvement shown by claims data. Medicare's hoped-for solution for boosting ... Read more
Fraud & Abuse:
OIG Shines Spotlight On Home Care Fraud
Watchdog agency profiles Texas, Florida cases. The feds continue to paint home care with ... Read more
Industry Note:
Say Goodbye To Drug Education Measure, Hello To Oral Meds Improvement Measure
Learn the details of star rating changes in upcoming call. Now that the flu measure has f... Read more
Industry Note:
High-Profile Hospice Cases Showcased In OIG Report To Congress
Don't let a first-level appeal time out due to missing technicalities. If certain informa... Read more
Industry Note:
The HHS Office of Inspector General took the opportunity
The HHS Office of Inspector General took the opportunity to once again trumpet its largest... Read more
Industry Note:
What's Ahead Under IMPACT Act? Find Out Here
Get the latest info on the IMPACT Act in a Frequently Asked Questions call. Register for t... Read more
Industry Note:
You Have Until The End Of The Month To Review Your Latest Compare Data Reports
Don't miss your chance to review your Hospice Compare data for the next refresh. “Hospi... Read more
Reader Question:
Medicare Mails Out Next Batch Of MBI Cards To Benes
If you operate in a “Wave 2” state, your patients should start receiving their new Med... Read more
Pre-Claim Review:
It's Baaaack — CMS Re-Proposes Home Health Pre-Claim Review
Know these 3 crucial differences between the old and new PCR program. Just when you thoug... Read more
Reimbursement:
Face-To-Face Problems Drive PCR Troubles
Postpayment review limits your documentation improvement options. Don't expect the change... Read more
Targeted Probe & Educate:
Nearly 1/3 Of Claims Fail Palmetto TPE Review So Far
Plan of Care denials top Palmetto GBA's list. Another HHH MAC has released preliminary Ta... Read more
Compliance:
Use These 7 Tips To Protect Your Claims Against TPE Denials
Ignoring ADRs pretty much guarantees more review, expert warns. The consequences for not ... Read more
Medical Review:
Revise Your Thinking On TPE Rounds
Round timing is provider-specific under new initiative. Getting a clear picture of the Ta... Read more
Industry Note:
Damaging Hospice Prosecution Grabs Headlines Again
Hospice director of operations turns star witness. Mainstream news stories outlining Medi... Read more
Industry Note:
MedPAC Lacks A Home Care Representative Yet Again
The newest crop of MedPAC commissioners is heavy on physicians and light - extremely - on ... Read more
Industry Note:
Walk Through The TPE Basics With New Video
With the latest Targeted Probe & Educate review results not looking good (see story, p... Read more
Industry Note:
Tell Staff To Beware New Mileage Deduction Limitations
If you don't pay the full Internal Revenue Service mileage rate to your employees for trav... Read more
Industry Note:
OIG Schools Providers On Integrity Agreements
Find out more about Corporate Integrity Agreements in a new less-than-three-minute video f... Read more
Industry Note:
Home Care Fraud Trial Ends In Guilty Verdict For Doc
After a four-day trial, a federal jury has convicted Michigan physician Millicent Traylor ... Read more
Industry Note:
Qui Tam Suit Costs Hospice $2.5 Million
A whistleblower lawsuit filed by hospice physicians has cost one nonprofit Florida hospice... 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
Targeted Probe & Educate:
Whopping 80% Of Reviewed HHAs Flunk TPE
Denial rates over 25% will keep you on TPE review at this MAC. The results from the firs... Read more
Compliance:
F2F Tops Targeted Probe & Educate Denial Reasons
Therapy visit medical necessity comes in second. Know what denials your claims may be mos... Read more
Medical Review:
Criteria To Get Off TPE A Bit Easier Than Probe & Educate
Expert: Crucial data missing from TPE report. One HHH Medicare Administrative Contractor'... Read more
HIPAA:
Closing Your Agency's Doors Won't Close Out Your HIPAA Responsibilities
Warning: Proper disposal of Protected Health Information is an OCR hot spot. Ensuring the... Read more
Human Resources:
Phrase Your Employee Feedback Constructively
Watch out for this common supervisory mistake when furnishing staff criticism. Your emplo... Read more
Industry Note:
Beat OASIS Matching Edit With These Tips
Resubmitting the same claim without changing anything won't help. Autocorrection of the M... Read more
Industry Note:
Hospice TPE Results Held Up
Home health agencies might be getting some vital Targeted Probe & Educate info from HH... Read more
Industry Note:
Medicare Focuses On Rural DME
On the heels of Medicare's Rural Health Strategy announcement (see Eli's HCW, Vol. XXVII, ... Read more
Industry Note:
Check This Hospice List
In light of increasing medical review from an array of sources, hospices may want to tight... Read more
Industry Note:
MBIs From MAC Portal Lookup OK To Use
Don't worry about getting your patients' new Medicare numbers before they do using the new... Read more
Industry Note:
ESRD Patients Underserved By Hospice
Patients with End-Stage Renal Disease aren't receiving as much hospice care as they should... Read more
Industry Note:
Shorter HH Visits Increase Hospital Readmissions
Looking for a way to achieve the holy grail of reducing your patients' hospital readmissio... Read more
Industry Note:
Health System Partners With Private Duty Co
Another approach to reducing hospitalizations can be seen in a new private pay partnership... Read more
Industry Note:
Compare Data Updated
Take a look at your data on Hospice Compare, if you haven't done so since May 16. Medicare... Read more
Industry Note:
MI HHA Owner Guilty
Detroit-area home health agency owner Zahir Shah had pled guilty to Medicare fraud charges... Read more
Survey & Certification:
PoC Deficiency Tops Citation List Under New CoPs
Just keep waiting on those CoP Interpretive Guidelines. Home health agency survey citatio... Read more
Regulations:
Medicare Will Keep The OASIS Guidance Coming
Plus: Rural add-on, QRP education, more. Perhaps due in part to the appearance of OASIS-D... Read more
Hospice:
Switching To Monthly Drug, DME Reporting Is Optional
PA changes disappoint. Medicare's new instructions for drug and DME claims reporting may ... Read more
HIPAA:
Boost Compliance By Reviewing Top 10 Cybersecurity Terms
What you don't know may hurt you. Failing to keep up to date on important cybersecurity i... Read more
Industry Note:
Beware Claims Processing Snafus Related To New MBIs
You may not want to pull the trigger quite yet. Now that your patients are getting their ... Read more
Industry Note:
Hospice Provider Breaks Record With $3 Million Integrity Agreement Penalty
If you need a reminder of why you should walk the line and avoid having to enter into Inte... Read more
Industry Note:
Tap These New Resources To Learn About Cost Report Electronic Filing
You can learn more about the new Medicare Cost Report e-Filing (MCReF) system by listening... Read more
Industry Note:
Hospice Compare Data For Next Quarter Refresh Are Set
Any Hospice Item Set data you submitted after May 15 will not go into the August refresh o... Read more
Industry Note:
Pay Slowdowns Hit Claims Thanks To This Glitch
Expect extra time until you get your reimbursement if your claim is erroneously rejected w... Read more
Reader Question:
Protect Your Claims From Recert Estimate Mistakes
Warning: Vague statements about length of service won't cut it. Question: How can we make... Read more
Conditions of Participation:
Don't Let Simple Address Mistakes Torpedo Your Survey
Learn from one agency's citation under the new CoPs. The new Home Health Conditions of Pa... Read more
Quality:
Quality Takes Center Stage In Proposed Hospice Rule
Check out new time frames for Hospice Item Set data review. You'd better pay close attent... Read more
Health Information:
Medicare Gears Up For EHealth Info Exchange Requirements
IT CoPs for post-acute providers on agenda. Before you find yourself slapped with a set o... Read more
Hospice:
Don't Let Physician Assistant Hospice Change Confuse You
CMS is clear on PAs' dos and don'ts under the new regs. You'll still need to get a physic... Read more
HIPAA:
Cover These HIPAA Basics Or Risk Hefty Penalties
Learn a valuable lesson from this $2.3 million HIPAA settlement. If you skimp on risk man... Read more
Industry Note:
CMS Aims To Keep Payment Model Experiments Voluntary
Return on investment matters when it comes to pay reform models, CMMI indicates. Curious ... Read more
Industry Note:
CMS Launches Rural Health Strategy Initiative
Rural providers that feel like Medicare isn't doing enough to help cope with difficulties ... Read more
Industry Note:
New Way To See RHC Days On Claims Coming Soon
Medicare plans to give hospices a helping hand when it comes to identifying "high" or "low... Read more
Industry Note:
Learn About New Cost Report Filing System
Get more details about the new Medicare Cost Report E-Filing (MCReF) system, which will ac... Read more
Industry Note:
Accrediting Body Focuses On Fighting Workplace Violence
If you don't do your best to prevent workplace violence for your employees, you may pay at... Read more
Industry Note:
Home Health Fraudster To Pay 2.2 Million
An Ohio HHA owner has pleaded guilty to Medicaid and tax fraud charges. Cheryl McGrath, ow... Read more
Industry Note:
Qui Tam Suit Against Texas Provider Fails
Not every whistleblower suit costs providers. Afederal judge has dismissed a whistleblower... Read more
OASIS:
New OASIS Q&A Sheds Light On ROC Date Change Under CoPs
Switch: You aren't limited by the 2-day time frame, CMS clarifies. A new set of quarterly... Read more
Reimbursement:
Hospice Pay Rates To Rise 1.8% Next Year
Watch out: Reducing RHC rates with rebalancing is still on CMS's future agenda. Starting ... Read more
Hospice:
Cost Report Changes To Hit Hospices Hard, Rule Indicates
Sixty-six percent of hospice cost reports in 2016 would fail new edits. The recently anno... Read more
2016 Hospice Cost Report Missing Information
Line 3 Employee Benefits - missing from 13.80% of reports in 2016 (385 reports) Line 4 Adm... Read more
Quality:
Prepare For Hospice Compare Changes
Revisions will take public reporting to 'a whole new level,' expert says. Medicare's focu... Read more
Quality:
These 7 Measures Will Go Low-Profile In 2019
Pain assessment measure trips up hospices. When the composite quality measure "Hospice an... Read more
Billing:
Medicare Grants Hospices Billing Relief For Drugs
But CMS can't budge on sequential billing. The Trump Administration is putting itsmoney w... Read more
Industry Note:
Find Out More About This Appeal Option
Will you find this new appeal route appealing? One of the two new appeal options availabl... Read more
Industry Note:
Facilitate Your Patients' New Medicare Cards With Quick Address Checks
You being ready for the new Medicare cards is only part of the job. "Your Medicare patient... Read more
Industry Note:
Publicly Traded Chain, Nevada Health System Announce Partnership
LHC Group Inc. and Saint Mary's Health Network have announced finalization of an equity pa... Read more
Conditions of Participation:
CoP Changes To Competency Evals For Aides Put HHAs At Survey Risk
Are your patients willing to be bathing guinea pigs? More than four months into implement... Read more
Compliance:
Know Your Aide Competency Requirements
Observation is required for these subject areas. Under §484.80 Condition of participatio... Read more
Hospice:
Prepare To Get More Detailed In Your Hospice Cost Report
Note this big change to reporting drug costs. Newly released hospice cost report revision... Read more
Finance:
Report Costs For These Lines, Or Else
New Level 1 edits make these cost report lines mandatory. Without costs recorded on these... Read more
Regulations:
Medicare Rolls Out Electronic Signatures For Cost Reports
New option applies to all providers' reports. To take advantage of Medicare's new electro... Read more
Industry Note:
Weigh Your M1060 Options Carefully
Using previous measurement as last resort. For the first time since April 2016, Medicare ... Read more
Industry Note:
West Virginia Leads In Hospice PEPPER Downloads, While Utah Trails Last. Where Does Your State Stand?
If you aren't sure how to best use your newly updated hospice PEPPER report and missed Med... Read more
Industry Note:
Medicare Home Health Spending To Climb 78% In Next Decade, CBO Predicts
Position yourself to benefit from growth in Medicare home health spending. The Congression... Read more
Industry Note:
Kindred Buyers Announce Major Hospice Acquisition
The same group of purchasers making the massive Kindred at Home acquisition are planning a... Read more
Industry Note:
3 Providers Will Merge To Form 15-State Chain
Great Lakes Caring, National Home Health Care, and Jordan Health Services plan to merge, t... Read more
Industry Note:
Learn The Ropes To ID Claims Suspensions
Are suspended claims confusing you and holding up your reimbursement? You can get a clue a... Read more
OASIS:
Use These 9 Steps To Gain Mastery Over OASIS-D
Tip: Make real-life scenarios part of your staff training. Come January, your reimburseme... Read more
Education:
Tip: Stress The Importance Of Avoiding Dashes
Now's the time for clinicians to polish their general OASIS coding skills. With the OASIS... Read more
Assessment:
Take A Closer Look At New GG0170 Items
Do your staff understand the difference between 'Partial/moderate' and 'Substantial/maxima... Read more
Appeals:
Weigh New Appeal Options Carefully
Your ALJ success rate should factor into your decision, legal experts advise. Don't forge... Read more
Industry Note:
Check Out Hospice Cost Report Updates
Tune in to electronic signature webinar for all provider types May 1. Get ready to make s... Read more
Industry Note:
School Docs On Certs
Are you having a tough time securing required certification documentation from referring p... Read more
Industry Note:
Assess Your Labor Law Risk Exposure
Kindred Healthcare Inc. has agreed to pay $12 million to settle a class action lawsuit all... Read more
Industry Note:
Updated Data On Utilization, Payment & More Available
You can now access Medicare payment data for home health from 2015. The Centers for Medica... Read more
Industry Note:
HH Market Saturation Thins While Hospice Thickens
Just how crowded is your market? You can get the official stats from Medicare's market sat... Read more
Industry Note:
Ohio Agency Pays Thousands Due To Excluded Employee
Be diligent with your employee background checks, or you may find yourself in the position... Read more
Industry Note:
Utah HHA Coughs Up $78K After Self-Disclosing To OIG
Another home care provider has taken advantage of the HHS Office of Inspector General's se... Read more
Industry Note:
Houston HHA Fraudster On OIG's Fugitive List
A home health industry fraudster has the dubious honor of becoming the OIG's most recently... Read more
Industry Note:
North Carolina County Plans Agency Closure
Another county home health and hospice provider looks set to close. Person County Commissi... Read more
Industry Note:
Here's How To Fix Your Reason Code 32113 Problem
Watch out for junk data in a Medicare claim field making your claims bounce back. Problem... Read more
OASIS:
Watch Out For These OASIS-D Trouble Spots
New GG items should top your priority list. If you think the changes coming to OASIS in J... Read more
Regulations:
Say Hello To These New OASIS-D Items
IMPACT Act-sparked additions are headed your way soon. Focus your attention on the OASIS ... Read more
OASIS:
Medicare To Drop These 28 Items In OASIS-D
Two items will also be deleted only at certain time points. Last year, the Centers for Me... Read more
Assessment:
Get Ready For OASIS-D To Shake Up Your World
From medical review to star ratings to surveys, expect the revised assessment tool to have... Read more
Fraud & Abuse:
OIG Highlights Home Health Fraud In Latest Report
The industry is still living down the Dr. Jacques Roy case. Don't expect fraud and abuse ... Read more
Industry Note:
Medicaid F2F May Continue To See Wiggle Room
CMS to use enforcement discretion. Home health agencies may get a little leeway on certai... Read more
Industry Note:
Boehler Named CMMI Head
Home care providers will see a CMS executive with home-based business experience, for once... Read more
Industry Note:
Appeal Option Extended
If you missed the Low Volume Appeals filing deadline, you can still take advantage of the ... Read more
Industry Note:
MAC Helps You With New Medicare Card Ropes
Do you need a quick way to determine whether your patient's Medicare number is the old HIC... Read more
Industry Note:
Follow These NOE Exception Guidelines Or Lose Pay
Be ready to back up your request for a Notice of Election timely filing exception if anoth... Read more
Industry Note:
Study Shows One Way To Reduce Hospital Readmissions
Looking to reduce hospital readmissions for your patients? Consider the findings of a new ... Read more
Industry Note:
OIG Fraud Program Report Highlights Hospice Cases
The HHS Office of Inspector General spends plenty of time on hospice fraud as well in its ... Read more
Industry Note:
School CMS On Reducing Regulatory Burden
Medicare is asking you to share a piece of your mind on how to reduce regulatory burden. ... Read more
Industry Note:
New HART Version Out
The Hospice Abstraction Reporting Tool v1.4.0 is now available for download at www.cms.gov... Read more
Industry Note:
Nursing Director Sentenced
The assistant director of nursing at a Detroit home health agency has received a three yea... Read more
Industry Note:
Equity Firm Buys Chain
NexPhase Capital has acquired private duty franchisor SYNERGY HomeCare for an undisclosed ... Read more
OASIS:
Submit Your OASIS-D Suggestions Before It's Too Late
Comment early and often. If you think Medicare needs to change some things about the newl... Read more
Managed Care:
Watch For Business Opportunities As Medicare Allows MA Plans To Cover Aide Services
Key: Help show that aide services will 'reduce avoidable emergency and healthcare utilizat... Read more
Regulations:
Stark Law Fate Uncertain, CMS Administrator Indicates
Will a decades-long prohibition on physician referrals and ownership get the ax? Home car... Read more
Medical Review:
Pay Attention To Midstream TPE Education
Improving your billing rate in the middle of a Targeted Probe & Educate round could sa... Read more
Diagnosis Coding:
Stop Using ICD-9 As A Coding Crutch
Remember, you won't get any more GEMs. Question: I often find myself coding ICD-9 in my h... Read more
Industry Note:
MACs Get Marching Orders To Reprocess Rural Add-On Claims
Remember: This is the last year of a full add on under BBA 18. As promised, Medicare has ... Read more
Industry Note:
Share These Recert Estimate Tips With Your Docs
Are you risking denials with records that include an insufficient physician recertificatio... Read more
Industry Note:
Half Of Docs Spend Less Than A Minute Reviewing 485
A new study by Johns Hopkins University researchers underscores what many home care provid... Read more
Industry Note:
View HIS Coding, HQRP Training At Your Leisure
Help for hospices is now available from Medicare in a number of new educational offerings.... Read more
Industry Note:
New Quality Measure Aims To ID Problem Discharges
Now's your chance to comment on a new quality measure Medicare is readying to address inap... Read more
Make The Most Of Your Eli's Home Care Week Subscription
You have 15 years' worth of information on a multitude of home health topics at your finge... Read more
Industry Note:
Double-Check Who Is Signing Your Cost Reports
Some newly announced changes for home health agency cost reports may alter how you submit ... Read more
Industry Note:
Massive Merger Of LHC, Almost Family Complete
Two publicly traded chains, LHC Group Inc. and Almost Family Inc., have completed their me... Read more
Industry Note:
Private Duty Chain Addus Makes Major Acquisition
Private duty chain Addus HomeCare Corp. has purchased the assets of Arcadia Home Care &... Read more
Industry Note:
Updated Hospice PEPPER Reports Out Soon
Get ready for an update to the free benchmarks Medicare provides you through the PEPPER pr... Read more
Reimbursement:
MedPAC Report Urges Congress To Cut Home Health Pay By 5%
Expect 14.4 percent profit margin for 2018. Home health agencies would see cuts on top of... Read more
Know Your Facts:
Number Of HHAs, Episodes Fell In 2016
Drop in agencies occurred in fraud-prone areas, MedPAC says. Law- and policymakers are ba... Read more
Payment:
MedPAC Continues To Push Unified Post-Acute PPS
Under PAC PPS, home health stays would see downward adjustment. While home care providers... Read more
Hospice:
Rebounding Hospice Stats Underlie Rate Freeze Rec
Number of providers climbed 4%. Although spring is here, hospices are still feeling the c... Read more
Utilization:
RN Visits Tick Up Under Payment Reform
Social worker visits remain virtually unchanged under SIA policy. The jury is still out o... Read more
Lawsuits:
Patient Steering Suit Ruling May Open Door To More Legal Action
Hospital-based agencies should review their processes, attorneys advise. A patient steeri... Read more
Fraud & Abuse:
Beware Bumped Up Penalties In Budget Law
The Bipartisan Budget Act did more than change Medicare reimbursement. Get to know the su... Read more
Industry Note:
Get Your First Look At OASIS-D
CMS has released new document. The first step to preparing for your new OASIS tool is to ... Read more
Industry Note:
MAC Survey Underway
Take the opportunity to grade your HHH Medicare Administrative Contractor. "The 2018 MAC S... Read more
Industry Note:
Don't Miss Preview Reports
You can check out your latest Hospice Compare preview reports now in your CASPER folder. B... Read more
Industry Note:
2 New Quality Measures Out
You have a little over a month to comment on two new quality measures regarding medication... Read more
Industry Note:
IMPACT Act Call Scheduled
Tune in to a Medicare Special Open Door Forum on the IMPACT Act and improving care coordin... Read more
Industry Note:
OH Hospice Buy Planned
Columbus, Ohio-based Stonehenge Partners Inc. has acquired Queen City Hospice and Capital ... Read more
Industry Note:
Chain Acquires In South
Encompass Health Corp. has agreed to acquire Birmingham, Alabama-based Camellia Healthcare... Read more
Industry Note:
Hospice Settles For $1.2M
A for-profit hospice chain and its CEO have agreed to pay $1.2 million to settle Medicare ... Read more
Industry Note:
HHA Owner Draws 20 Years
A Miami home health agency owner has been sentenced to 20 years in prison, the Department ... Read more
Industry Note:
Therapy Fraud Unsealed
The fraud crackdown in Miami continues. Co-owners of home health agency Florida Patient Ca... Read more
OASIS:
Prepare For OASIS-D To Hit In January
Setting your implementation schedule is still a bit tricky. Just when you were feeling co... Read more
Regulations:
Say Goodbye To These 33 OASIS Items Come January
On top of making IMPACT Act-related additions, the forthcoming OASIS-D form will cut these... Read more
Medical Review:
Use These 8 Pointers To Defend Your Claims Against F2F & Cert Denials
Will new F2F clinical template help you? Scrutiny of your claims is heavier than ever, a... Read more
Documentation:
Tap These Resources To Help Make Your Claims Bulletproof
Share tips and tools with your referring docs. You can boost your compliance - and reimbu... Read more
Industry Note:
OIG Blasts HHA Surveys
Cheating by providers too easy under current protocol, report concludes. Expect increased... Read more
Industry Note:
Publication of CoP Interpretive Guidelines Still A Few Months Away
Nevermind Groundhog Day last month - home health agencies just found out they'll be gettin... Read more
Industry Note:
Check Out HQRP Report Change
Don't get spooked by new wording in Medicare's Hospice Quality Reporting Program Hospice I... Read more
Industry Note:
HHS Secretary Outlines Path Ahead
Expect more Value-Based Care reimbursement models in your future. During the Federation o... Read more
Industry Note:
Access New Appeals Info Here
Providers that missed the Centers for Medicare & Medicaid Services' recent call about ... Read more
Industry Note:
New Medicare Cards May Mean New Processes
If you use a common trick to get your patients' correct HICN for billing, that option is g... Read more
Industry Note:
Find Out About HIS Coding And More In CMS Webinar
Learn more about Hospice Item Set coding and other Hospice Quality Reporting Program issue... Read more
Industry Note:
Kindred Faces Shareholder Suit To Stop Sale
A hedge fund investor in Kindred Healthcare Inc. has filed a lawsuit to stop the comp... Read more
Industry Note:
Chicago HHA Owner Draws Prison Time For Kickbacks
The 81-year-old owner of a home health agency in the Chicago suburbs has been sentenced&nb... Read more
Industry Note:
Heartland Hospice Dodges Bullet In Whistleblower Cases
The feds have declined to intervene in four newly unsealed whistleblower lawsuits aga... Read more
Industry Note:
Federal Agents Raid Chain's OKC Offices
An FBI raid is never a good sign. "Multiple agencies" including the FBI are investiga... Read more
Documentation:
Cert, F2F Documentation Troubles Plague HHAs
Recent documentation change in budget law amounts to no change, experts say. With Targete... Read more
Legislation:
Go To The Source For Documentation Language
Key point: 'May' versus 'shall.' Here's the Bipartisan Budget Act language specifying the... Read more
Regulations:
Prepare To Bombard CMS With Comments About Documentation Change
There's still a chance to persuade CMS to make change mandatory. Home health agencies wou... Read more
Certification:
Target These Mistakes Your Referring Physicians Make
Diagnosis alone doesn't cut it. The Medicare requirement basing home health agency paymen... Read more
Compliance:
Are Your Docs Hitting These 5 Cert Points?
Forget the ides of March: Beware missing encounter date. According to Medicare regs, a ph... Read more
Industry Note:
Keep Eye Out For Aseracare Verdict
Forthcoming decision could determine fate of many whistleblower cases. A U.S. Appeals Cou... Read more
Industry Note:
Get Quick Notification of Targeted Probe & Educate Developments Online
Home health agencies served by HHH Medicare Administrative Contractor CGS have good news a... Read more
Industry Note:
CMS Launches MyHealthEData
Get ready for potential new patient datarelated responsibilities under a recently unveiled... Read more
Industry Note:
Heed HIPAA Rules For CAHPS Surveys
If you haven't done so yet, expect to have a conversation with your CAHPS vendor about HIP... Read more
Industry Note:
Therapy Caps Depart, But KX Modifier Remains
Don't think Medicare therapy cap amounts for Part B therapy services are going away entire... Read more
Industry Note:
State Needs Surety Bonds For Home Care, Auditor Urges
Home health agencies may not be subject to surety bonds under Medicare - much to the OIG's... Read more
Industry Note:
VA To Piggyback On Medicare Fraud-Fighting
Expect even more enforcement activity under a new relationship between the Department of V... Read more
Industry Note:
Private Duty Chain Makes NM Buy, Including Hospice
Addus HomeCare Corp. has agreed to purchase Ambercare Corporation Inc., a provider of pers... Read more
Industry Note:
Canadian Firm Buys In NE
Nova Leap Health Corp., based in Halifax, Nova Scotia, has acquired private duty company F... Read more
Industry Note:
SNF HHAs Change Hands
Nursing home chain HCR ManorCare is filing Chapter 11 bankruptcy and handing over ownershi... Read more
Industry Note:
Hospitals Close HHAs
More hospitals are closing their home care units. In Nebraska: Methodist Hospital in Omah... Read more
Regulations:
Rural Add-On Rate Kicks Back In April 2
Retroactive add-on adjustments likely will take a while longer. The Bipartisan Budget Act... Read more
Hospice:
NOE Problem Fixed, CMS Says
Plus: Fix HIS data before the preview stage. The EDI glitch that was preventing Notices o... Read more
Outcomes:
8 CAHPS-Based Measures On Hospice Compare
How do your stats stack up to the national averages that debuted Feb. 20? Communication w... Read more
Finance:
Publicly Traded Companies Grapple With Challenges
Almost Family-LHC merger nears completion. Smaller providers aren't the only ones struggl... Read more
Industry Note:
OIG Targets 4 Geographic 'Hot Spots' For Enforcement
But it wants to put 8 more areas in the enforcement crosshairs. Fraud and abuse scrutiny ... Read more
Industry Note:
Bundling Of Oxygen Wound Treatment Looms
Every year, home health agencies must adjust to some new codes being added and deleted fro... Read more
Industry Note:
New Medicare Cards Set To Mail Next Month
Medicare has been talking about switching beneficiaries to the new Social Security Number-... Read more
Industry Note:
Get To Know A New Cost Report Acronym — MCReF
Starting this month, "you will have the option to submit Medicare cost reports through a n... Read more
Industry Note:
Learn About Hospice And Disabilities In Webinar
The intersection of hospice and patients with disabilities can be tricky to navigate. Lear... Read more
Industry Note:
OIG To Examine Statistical Sampling
A Medicare contractor audit that uses statistical sampling can strike fear into providers'... Read more
Industry Note:
Accrediting Body Makes CoP-Related Updates
The Joint Commission is now surveying deemed status home health agencies under new standar... Read more
Reader Question:
Medicare Addresses TPE Denial Rate Benchmark
Your peers' stats matter in determining the cutoff for review. Question: What is the benc... Read more
Budget:
Home Health Payment Reform Mandated By Budget Deal
Stay on CMS's case every step of the way. If you thought your biggest priorities this yea... Read more
Documentation:
HHAs' Documentation Remains Optional For Audits
While not everything agencies want, at least change is a step in the right direction. The... Read more
Reimbursement:
New Budget Law Kills 'Super-MedPAC' Board
Lawmakers on both sides of the aisle agree. While the Independent Payment Advisory Board ... Read more
Legislation:
Home Health Rate Cut Included In Budget Deal
Therapy caps, Medicare Advantage changes also impact home care. The newly enacted require... Read more
Hospice:
Budget Law Contains Win, Losses For Hospices
Good news is accompanied by bad news in the budget deal. One part of the Bipartisan Budge... Read more
Budget:
Look To Trump Administration Proposal For Budget Threats
PAC PPS would cut tens of billions. A requirement that home health payment reform be budg... Read more
Industry Notes:
Don't Count Out Copays
Beneficiaries need an incentive to decline care, GAO says. The perennial money-rais... Read more
Industry Note:
Get Up To Speed On 2020 HQRP Requirements Here
Check out new Hospice Quality Report- ing Program resources at www.cms.gov/Medicare/Qualit... Read more
Industry Note:
HHS Offers Tools For Opioid Addiction Situations
The Department of Health & Human Services is offering a helping hand for providers dea... Read more
Industry Note:
Don't Forget Cap Impact When You're Hit With Takebacks
If you're a hospice provider that's been hit with an overpayment request from a Recovery A... Read more
Industry Note:
Nevada Nonprofit Hospice Acquires Kindred Location
Nathan Adelson Hospice, the largest non-profit hospice in Nevada, is acquiring Kindred Hos... Read more
Industry Note:
Hospice Provider Makes In-State Acquisition
Pennsylvania Hospice Holdings has acquired Taylor Hospice in Ridley Park, Pennsyl- vania f... Read more
Audits:
RACs Get 8% Of Every Denial They Make
Bounty hunter contract tempered with some protections. If you're wondering just how much ... Read more
Medical Review:
Here's How RAC Reimbursement Works — And Affects You
Some successful appeals don't count against Performant. Look to Performant's contract wit... Read more
Documentation:
Put QA On Your Short List Of Duties To Tackle
Invest resources on the front end of RAC review, so the back end doesn't close your doors.... Read more
Budget:
Watch For Payment Reform In Budget Legislation
What the FECCA? Home care industry experts have expected Medicare to come back with a pay... Read more
Hospice:
Hospital Early Discharge Provision Pops Up In Budget Legislation
Penalty for discharging early to hospice would limit hospice access. The new bill passed ... Read more
Medical Review:
MAC Releases Probe & Educate Round 2 Stats
Did you land in the minority? Close to half of home health agencies that Palmetto GBA rev... Read more
Industry Note:
Get Ready To Change Billing Procedure For Transfer Patients
Medicare to straighten out start date/admission data snarl. This summer, Medicare plans t... Read more
Industry Note:
Home Health Moratoria Heads Into 5th Year
As expected, the Centers for Medicare & Medicaid Services has extended for another six... Read more
Industry Note:
OIG Wants Your Ideas
Don't miss your chance to pitch a new safe harbor to the OIG. You have until Feb. 27 to s... Read more
Industry Note:
Beware This Review & Correct Report Glitch
If you'd like to learn more about Review and Correct Reports for Home Health Agencies, tun... Read more
Industry Note:
Medicare To Allow Non-Skilled Home Care In MA Plans
A change to Medicare Advantage plan structure may benefit home care providers as well as p... Read more
Industry Note:
HQRP Manual Updated
Make sure you're using the most up-todate version of Medicare's Hospice Quality Reporting ... Read more
Industry Note:
State Bill Would Require Hospices To Destroy Pain Meds
Hospice providers in Kentucky may have a new duty added to their already full plates. Hosp... Read more
Industry Note:
Hospice Fraud Settlement Pays Whistleblower $900K
Haven Hospice, the hospice provider that recently announced the closing of affiliate VNA a... Read more
Industry Note:
Hospice Nonprofits Merge
Nonprofits West Texas Rehabilitation Center and Hospice of San Angelo will merge March 1, ... Read more
Audits:
New RAC Topic Could Bring Punishing Recoveries
New audit contractor may be ready to pounce after lull. While you're keeping one eye on T... Read more
Strategy:
Fend Off RAC Audits, Denials With These 13 Pointers From The Experts
Zero in on your worst documentation offenders. If you get mired down in Recovery Audit Co... Read more
Appeals:
Gear Up For RAC Determination Appeals
Don't forget the Discussion Period option. If you receive a denial from the Recovery Audi... Read more
Medical Review:
Probe & Educate Round 2 Denied Two-Thirds Of Claims Reviewed
F2F continues to lead denial reasons. Can you afford to get paid for only one out of ever... Read more
Face-to-Face:
Are You Guilty Of These F2F Mistakes?
Tip: The physician must document the date. As in round 1 of Medicare's Probe & Educat... Read more
Industry Note:
Preventable Hospitalization Measure In The Works
Expert panel assembling now. Don't miss this opportunity to influence the Medicare requir... Read more
Industry Note:
Court Reverses Convictions For HHA Owner, Physician
A federal judge has overturned a fraud conviction in a case that was high-profile enough t... Read more
Industry Note:
Note New Cap Reporting Policy For Terminating Hospices
Hospices exiting the Medicare market have a new procedure to follow for self-reporting the... Read more
Industry Note:
Industry Hopes For Rural Add-On Rescue
Don't count out your rural add-on yet. "We predict that the rural add-on will be extended,... Read more
Industry Note:
Therapy Cap Claims Under 'Rolling Hold'
Claims for outpatient therapy provided in the home under Part B are starting to process wi... Read more
Industry Note:
Florida Provider Widens Service Area
Trilogy Home Healthcare is expanding its service area, the West Palm Beach, Florida-based ... Read more
Regulations:
Prepare For Flu Measure Drop's Impact On Your Star Rating
Conditions of Participation, CAHPS also discussed in Open Door Forum. A Home Health Compa... Read more
Conditions of Participation:
Know The Ins And Outs Of Furnishing Records Under New CoPs
CMS sheds light on this sometimes confusing requirement. Under the new CoPs, you'll have ... Read more
Hospice:
All Clear On Payment Reform Billing Problems May Have Been Premature
MCCM, NOE submissions, and more also discussed in forum. If you thought your under- and o... Read more
HIPAA:
Stay Off The OCR's HIPAA Wall Of Shame
Learn from the biggest breaches of 2017. From new Conditions of Participation to billing ... Read more
Human Resources:
Use These 5 Pointers To Succeed As A New Supervisor
Beware this common new supervisor pitfall. You were a great employee, and now management ... Read more
Industry Note:
RAC Sets Its Sights On Home Health Medical Necessity
Brace for more medical review. Home health agencies can expect medical review heat to get... Read more
Industry Note:
CMS Holds Off On Imposing Therapy Caps — For Now
If you furnish outpatient therapy in the home under Part B, Medicare is giving you a bit o... Read more
Industry Note:
Home Care Saves Money, Another Study Shows
Home health agencies have more ammunition showing how valuable their services are. A stud... Read more
Industry Note:
Ward Off PECOS Edit Denials With MAC Tool's Help
If you're seeing claims denied because the ordering physician isn't in the PECOS system, y... Read more
Industry Note:
Hurricane Results In VNA, Hospice Closure
Hurricane Irma's effects are still being felt months later. The latest toll on the home ca... Read more
Industry Note:
Multi-State Chain Unites Under One Name
All Metro Health Care, a home care provider serving patients in five states, has changed i... Read more
Industry Note:
Senate Confirms New HHS Secretary
The Department of Health & Human Services once again has a leader. The Senate confirme... Read more
Medical Review:
Good News: Home Health Error Rate Takes Another Big Dive
Bad news: HHA error rate is still much higher than average. Don't expect Medicare to ease... Read more
Survey & Certification:
Keep Up On These CoP Developments
New surveyor training materials may help you head off citations. Home health agencies hav... Read more
Budget:
MedPAC Wants To Strip $10 Billion From Medicare Home Health Spending
Hospice would get whacked with a $5 billion budget chop. As expected, Medicare Payment Ad... Read more
Fraud & Abuse:
Medical Director Mayor Faces Fraud Charges In South Texas
Surprise! The person paying kickbacks may be working for the FBI. Anew fraud case allegin... Read more
Mergers & Acquisitions:
Nonprofits See M&A Activity
Hospital closures of home health, hospice units continue. It wasn't just the holidays kee... Read more
Human Resources:
Follow These 9 Steps To Protect Your Staff — And Your Agency — From Sexual Harassment
Giving employees multiple reporting options is crucial. As sexual harassment allegations ... Read more
Industry Note:
Use This New Method To Correct Your Hospice Compare Data
Contact your MAC, not ASPEN coordinator.re The Hospice Compare site launched last fall ha... Read more
Industry Note:
Government Watchdog Urges Medicaid To Root Out Conflicts Of Interest In HCBS Programs
Conflicts of interest continue to plague Medicaid home care programs, possibly leading to ... Read more
Industry Note:
Correct NOE, NOTR Dates With This MAC's Tips
The Centers for Medicare & Medicaid Services and its contractors are still working out... Read more
Industry Note:
Consult Job Aid To Clear Up NPWT Billing Confusion
Medicare's new reimbursement rules for disposable Negative Pressure Wound Therapy devices ... Read more
Industry Note:
Dial Into CMS Special Open Door Forum For Info On New Medicare Cards
Wondering how Medicare's new beneficiary card initiative will affect your Medicaid clients... Read more
Medical Review:
MACs Ramp Up Targeted Probe & Educate In New Year
Take these 5 steps to head off TPE disaster. Be sure you're ready as the MACs get their T... Read more
Hospice:
Hospices Are On The TPE Hot Seat For These Topics
A second MAC reveals some of its TPE targets. While providers are still figuring out the ... Read more
Conditions of Participation:
Forge Ahead With CoPs Despite Lack Of Final Interpretive Guidelines
Final IGs won't differ much from draft anyway, CMS source maintains. If you thought you'd... Read more
Compliance:
Keep Your Texting In Compliance With Recently Clarified Medicare Guidance
Texting physician orders is never OK, CMS stresses. Unsecured texting may be one of the m... Read more
Reimbursement:
Electronic NOE Submission Problems Dog Hospices
One MAC is using a workaround to let NOEs process via EDI - but the others aren't. Hospic... Read more
Industry Note:
Goodbye Cardiac & Hip Bundling Models, Hello BCPI Advanced
How will new bundling models affect you? To many providers' relief, the Centers for Medic... Read more
Industry Note:
Fate Of Rural Add-On May Be Decided By Congress In Coming Days
Keep an eye on Congress to see whether the rural add-on remains eliminated. "We believe it... Read more
Industry Note:
Medicare Launches Next Phase Of Its 'Patients Over Paperwork' Initiative
Do you think the Centers for Medicare & Medicaid Services is living up to the ideals o... Read more
Industry Note:
Don't Dally In Compiling Your Data If You Think You Exceeded The Hospice Cap Last Year
One HHH Medicare Administrative Contractor is still sending hospices their PS&R data f... Read more
Industry Note:
New Year, New (Higher) Mileage Rate
Don't forget to adjust your travel reimbursement amount, if you tie it to the Internal Rev... Read more
Industry Note:
HHS Extends Health Emergency Periods In These Areas
Recovery from Hurricane Maria has prompted the Department of Health and Human Services to ... Read more
Medical Review:
Unravel TPE Mysteries With MACs' Help
Getting ADRs without a TPE letter? Better check on it. Although the Targeted Probe & ... Read more
Reimbursement:
MAC Hits These Hot Spots For TPE
Make sure you're prepared to defend claims for long-stay hypertension patients. The data ... Read more
Budget:
MedPAC Readies Cut Recommendations
Advisory commission pulls no punches with proposed 5 percent cut for home health agencies.... Read more
Therapy:
Get Therapy Out Of The HH PPS Calculation, MedPAC To Urge
Copays also eyed once again. While most home health agencies cheered when CMS pulled back... Read more
Prospective Payment System:
Post-Acute Payment PPS Still On MedPAC's Mind
Commission looks for ways to decrease payments to for-profits, freestandings. It may not ... Read more
Hospice:
Creeping Hospice Stats Lend To Rate Freeze Argument
Profit margin is back up. The weather won't be the only thing freezing, if an influential... Read more
HIPAA:
Claims Audits Aren't The Only Ones That Matter
Don't overlook IT audits. You're familiar with Medicare audits and maybe even HIPAA audit... Read more
Industry Note:
Hospice Pay Reform Correction Headache Continues
Check your 'adjusted' claims. If you submitted adjustments to your Routine Home Care hosp... Read more
Industry Note:
Medicare Enrollment Application Fee Rises This Year
The fee for submitting your Medicare enrollment application, including for revalidations, ... Read more
Industry Note:
Dial In To Find Out More About Medicare's New Low Volume Appeals Option
If you have fewer than 500 Medicare appeals pending, you may want to listen in on an educa... Read more
Industry Note:
Shareholder Protests Proposed Deal For Humana To Acquire Kindred At Home
Kindred Healthcare has agreed for its Kindred at Home division to be acquired by Humana an... Read more
Industry Note:
Ohio Health System, Home Care Provider Form Joint Venture
Summa Health system in Ohio is forming a joint venture with its Summa Health at Home and S... Read more
Labor Law:
Stay Tuned For News On How Much You Must Pay Employees
Big salary threshold jump for white-collar exemption in flux. The legal and regulatory ba... Read more
Regulations:
Revisit White-Collar Exemption Basics
These requirements show why salary is important. Need a quick brush-up on this labor law ... Read more
HIPAA:
Take A Cue From OCR On Handling Opioid Addiction Info-Sharing For Patients
'Crisis situations' can preclude HIPAA violations, HHS suggests. Not sure what your agenc... Read more
Human Resources:
Work On Yourself To Work Toward Employee Success
Tip: Your staff are watching you for an example Great bosses grow their employees by mode... Read more
Fraud & Abuse:
Major Metro Area Home Health Industry Skewered By Newspaper Exposé
State plans to tighten background checks. Members of the home health industry know there ... Read more
Industry Note:
Check Out Your Updated Hospice Compare Data
Hospice-finding tech still glitching. Hospices waiting for the first refresh of their qua... Read more
Industry Note:
OIG Points Finger At Hospice In Semiannual Report
Home health agencies aren't the only ones on the hook for low overpayment collection rates... Read more
Industry Note:
Keep Your 855 Submissions Straight With MAC's Help
One HHH Medicare Administrative Contractor is trying to clear up confusion for home health... Read more
Industry Note:
See Reporting Exceptions For Wildfire Areas Here
The Centers for Medicare & Medicaid Services is granting exceptions to certain Home He... Read more
Industry Note:
Keep This Quality Resolution In The New Year
With quality data becoming more important than ever for home health agencies and hospices,... Read more
Industry Note:
Kindred Acquisition Expected By Insurer
Post-acute care behemoth Kindred Healthcare may get even bigger. Insurer Humana is in seri... Read more
Industry Note:
Get Up To Speed On Medicare Card Changes Before April
One of the many issues you'll have to tackle in 2018 is the switch in beneficiaries' Medi-... Read more
Reader Question:
Patient's Death Doesn't Mean Your HIPAA Duties Expire Too
The decedent's rights may surprise you. Question: How long do I need to maintain a patien... Read more