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Home Health & Hospice Week

Legislation:
BUDGET AX FALLS ON HHAS' NECKS
Congress approves 2006 rate freeze, but glimmer of hope remains.The week before Christmas ... Read more
Inherent Reasonableness:
IR RULE THREATENS DME PROFITS
Inherent reasonableness, competitive bidding may put a double whammy on suppliers.Forgive ... Read more
Prospective Payment System:
BILL CBSA CODES OR RISK CLAIMS DELAYS
Heads up, HHAs:  Don't let the Jan. 1 billing change catch you by surprise.If you are... Read more
Billing:
ENSURE SMOOTH TRANSITION TO CBSAs WITH THESE 6 STEPS
Four-digit codes are out, five-digit codes are in.Here's one New Year's resolution you'll ... Read more
Regulations:
EXPECT DME COMPETITIVE BIDDING RULE 'SOON,' CMS SAYS
Latest Open Door Forum also highlights quality standards, drug formularies.Don't try to pi... Read more
OASIS:
UPDATE YOUR COMPUTER OR RISK OBQI ACCESS
CMS is working on hospice claims processing problems, official promises in Open Door Forum... Read more
Industry Notes:
BEWARE V57.X AS SECONDARY DIAGNOSIS
Rehab code acceptable only as primary diagnosis, new guidelines say.If you're still report... Read more
Referrals:
HOSPITAL TRANSFER POLICY SLASHES HOME CARE REFERRALS
List of prorated DRGs jumped from 30 to 182 on Oct. 1.Your local hospital may reduce your ... Read more
Hospitals:
KNOW YOUR FACTS--HOSPITAL POST-ACUTE TRANSFER POLICY
Learning the ins and outs of hospitals' post-acute care transfer policy may help you save ... Read more
Inherent Reasonableness:
IR MAY THREATEN DME PAYMENTS SOON
Final rule published for mechanism to cut payment rates.Durable medical equipment supplier... Read more
Prospective Payment System:
MEDPAC FINDINGS HIGHLIGHT PPS FLAWS
CMS considering numerous changes to payment system.If you have a higher case mix, are larg... Read more
Fraud & Abuse:
COMMIT DME FRAUD, GO TO JAIL
Feds rack up convictions for wheelchair funny business.Recent jury convictions underscore ... Read more
Hospice:
NEW ADMISSION REQUIREMENT RILES HOSPICES
Survey woes may lie ahead, experts warn.New hospice requirements related to medical direct... Read more
Industry Notes:
LAWMAKERS SHARPEN BUDGET KNIVES AS MEDPAC URGES HHA RATE FREEZE
Budget negotiations may be entering the eleventh hour.Senate and House leaders are negotia... Read more
Kickbacks:
TREAD CAREFULLY WITH REFERRAL SOURCE RELATIONSHIPS
OIG highlights $300,000 home health kickback settlement.If you're trying to strengthen you... Read more
Fraud & Abuse:
AVOID FRAUD CHARGES WITH BULLETPROOF DOCUMENTATION
HHA pays millions in OIG settlement focusing on record-keeping.In the world of the home he... Read more
Quality:
WHEELCHAIR SUPPLIERS EMBRACE PROPOSED QUALITY STANDARDS
Changes shut out unscrupulous suppliers.The Centers for Medicare & Medicaid Services s... Read more
Referrals:
HOSPITAL REFERRAL DATA TO REMAIN A SECRET
CMS drops regulation requiring public disclosure of hospitals' HHA referral stats.The bitt... Read more
Hospice:
HOSPICES WELCOME DISCHARGE FOR CAUSE REGULATION
Now you can legally discharge disruptive, abusive or uncooperative patients.Hospices that ... Read more
Regulations:
PREPARE FOR DISCHARGE PLANNING REQUIREMENTS
Know what's required and what's not under the new hospice mandate.Hospices need to get rea... Read more
Industry Notes:
IRS TAKES MILEAGE RATE DOWN A NOTCH
Lower gas prices lead to lower reimbursement level in 2006.Now that record-setting gas pri... Read more
OASIS:
HHAs WIN BREATHING ROOM ON M0175 TAKEBACKS
Appeals questions stave off recoveries related to patients' prior inpatient staysHome heal... Read more
DID YOU KNOW?
M0175 overpayments come about when home health agencies fail to mark all the correct respo... Read more
Appeals:
TECHNOLOGY SIMPLIFIES MEDICARE APPEALS
Hearings can now take place via video and telephone--but providers aren't happy.It may be ... Read more
Compliance:
OIG TARGETS THERAPY FOR FURTHER SCRUTINY
2006 Work Plan also focuses on Home Health Compare.If you think the heat has been on home ... Read more
Compliance:
OIG SETS SIGHTS ON DME TROUBLE SPOTS
Work plan emphasizes medical necessity documentation.Durable medical equipment providers s... Read more
Reimbursement:
BEWARE--COUNT AUDIT EXPENSES WHEN THEY OCCUR
Requirements trump consistency in latest PRRB decision.Even if your intermediary has OK'd ... Read more
Kickbacks:
7 TIPS KEEP YOUR GIFT-GIVING NICE, NOT NAUGHTY
Say no to gift certificates, yes to food for holiday gifts, legal experts advise.'Tis the ... Read more
Audits:
CMS PONDERS INCENTIVES FOR RACs TO FIND UNDERPAYMENTS
Providers blast project's one-sided approach to claims accuracy.Recovery audit contractors... Read more
Industry Notes:
HOUSE PASSES BUDGET RECONCILIATION BILL
Congress one step closer to finalizing Medicare budget for 2006.As the House and Senate pr... Read more
Legislation:
LAWMAKERS SHUN HOME CARE CUTS--FOR THE MOMENT
Danger lurks in Senate-House conference, lobbyists warn.Home care providers are holding th... Read more
Lawsuits:
BEWARE OF KICKBACKS MORPHING INTO FALSE CLAIMS
A recent decision in a DME case serves as a warning for providers.Should your durable medi... Read more
Reimbursement:
HHAs READY TO HEAD TO COURT OVER THERAPIST PAY
Victory is a sure thing, experts say.Home health agencies are planning to fight a Centers ... Read more
Medical Review:
MEDICARE HALVES PAYMENT ERROR RATE IN 2005
DMERCs have highest error rate of all Medicare contractors.Health care providers' increase... Read more
Strategy:
DIVERSIFY TO THRIVE IN NEW HOME CARE WORLD
You can be a hero to patients by increasing your business.If you're focusing only on your ... Read more
Case Study:
VNA BUSINESS SKYROCKETS UNDER PRIVATE PAY MODEL
Learn valuable lessons from one agency's business diversification journey.What would you d... Read more
Industry Notes:
WAGE INDEX BILLING CONFUSION HOUNDS HOSPICES
Hospices continue to have trouble billing claims correctly after the switch to Core-Based ... Read more
Prospective Payment System:
PPS UPDATE LAGS BEHIND FUEL COSTS
Are the published 2006 rates here to stay?Don't get too comfortable with the recently issu... Read more
Drug:
CMS SLASHES INHALATION DRUG THERAPY FEE
Care management activities not part of Medicare benefit, agency says.In a move that left r... Read more
OASIS:
GAUGE YOUR LIABILITY WITH THESE 3 STEPS
Adjustments for OASIS item on prior inpatient stays befuddle HHAs.If you're scratching you... Read more
Legislation:
WHITE HOUSE VETO THREAT BODES ILL FOR HOME CARE
House budget bill on track to pass with no Medicare cuts.Home health agencies are anxiousl... Read more
Referrals:
BOOST PHYSICIAN REFERRALS WITH THESE 5 TIPS
Making docs' lives easier can make your patient load grow.Home health agencies searching f... Read more
Coding:
SADMERC PANEL WILL TACKLE POWER CHAIR CODES
Medical director makes announcement at Medtrade.The statistical analysis durable medical e... Read more
Associations:
NEW INDEPENDENT ASSOCIATION OF STATES LAUNCHED FOR HOME CARE
State coalition seeks equal footing with all national trade groups.Home health agencies ha... Read more
Legislation:
SENATE LETS EXTENDED RENTALS ROLL ON FOR POWER CHAIRS
Approved amendments also restores first-month purchase options.The U.S. Senate has approve... Read more
Industry Notes:
HOME CARE PROVIDERS BLAST CMS' HURRICANE RESPONSE
Complaints pile up about the agency's regulatory relief in the face of natural disasters.P... Read more
Prospective Payment System:
HHAs WIN ONE-YEAR TRANSITION TO NEW WAGE INDEX AREAS
CMS announces final 2006 payment levels.Home health agencies will see a 2.8 percent increa... Read more
Legislation:
SENATE PUTS DME MAINTENANCE PAYMENTS ON THE CHOPPING BLOCK
Proposal would also axe beneficiaries' extended rental option.Durable medical equipment pr... Read more
Legislation:
SO FAR SO GOOD IN MEDICARE BUDGET NEGOTIATIONS
But HHAs are far from safe from spending cuts, experts warn.Home health agencies may have ... Read more
Coverage:
SENATE BLOCKS FUNDING FOR POWER MOBILITY RULE
Regulatory rescue comes as one lawsuit fails, another announced.Following the failure of a... Read more
Conferences:
HHAs EYE PRIVATE PAY AT NAHC ANNUAL MEETING
Outcomes, referrals also catch industry's interest in Seattle.The home care industry conti... Read more
Reimbursement:
PREPARE POST HASTE FOR PAY FOR PERFORMANCE
The new reimbursement mechanism will be here sooner than you think.If you're ignoring the ... Read more
Outcome:
BOOST YOUR OUTCOMES FOR P4P WITH THESE TIPS
Don't let a slow start on QI cost you later.You'd better get moving now to show improvemen... Read more
Industry Notes:
CHECK OUT YOUR M0175 ADJUSTMENTS
Intermediaries put adjusted claims from the first year of PPS on display.Now is the time t... Read more
Legislation:
LAWMAKERS DROP HOME CARE CUTS-FOR NOW
Is a reprieve from an inflation update freeze only temporary?Home health agencies appear t... Read more
Coding:
MOBILITY SUPPLIERS WIN REPRIEVE ON NEW CODES
Industry lawsuit targets impending rollout of interim final rule.The Centers for Medicare ... Read more
Medical Review:
HAVE NO FEAR, MEDICAL REVIEW TO LAST JUST A YEAR
3 tips for getting off medical review as fast as possible.Your Medicare contractor can sti... Read more
Compliance:
DME SUPPLIERS SHOULD BRACE FOR TOUGHER NSC OVERSIGHT
GAO criticizes standards compliance.Suppliers can expect to undergo more thorough inspecti... Read more
Diagnosis Coding:
AVOID THIS PITFALL WHEN USING NEW DIAGNOSIS CODES
Do you know when you still should use the old 2005 codes?The new 2006 diagnosis codes have... Read more
Reimbursement:
CORRECT CLAIMS NOW BEFORE IT'S TOO LATE
Can you afford to throw away tens of thousands of dollars by ignoring the corrections dead... Read more
Survey & Certification:
HOSPICE CHAIN SEES TWO OFFICES DECERTIFIED
For-profit vows to fight CMS ruling.VistaCare Inc. is undergoing every home care provider'... Read more
Industry Notes:
CONSOLIDATED BILLING LIST EXPANDS
Here are 5 new supply codes you're financially responsible for.Home health agencies will s... Read more
Therapy:
OIG HITS THERAPY HOT BUTTON IN NEWEST AUDIT
Medical reviewers deny therapy visits on new grounds.A new federal report on home health a... Read more
Medical Review:
HOLD ONTO YOUR THERAPY DOLLARS WITH THESE 6 STEPS
A pre-billing audit is key to accurate therapy claims.In the wake of the feds' intense scr... Read more
Legislation:
BUDGET AX HANGS OVER HOME CARE PROVIDERS' NECKS
Freeze on inflation update threatened.Members of Congress searching for budget cuts in the... Read more
Finance:
APRIA LOWERS EARNINGS PROJECTIONS
Fuel costs, hurricane expenses and ASP declines contribute to woes.A variety of factors ar... Read more
Reimbursement:
DEFERRED COMP DECISION COSTS HHA $17K
Neither a borrower nor a lender be, PRRB decision suggests.Even if the feds give a stamp o... Read more
Compliance:
STOP DME WHISTLEBLOWERS BEFORE THEY STOP YOU
With qui tam suits breaking out all over, now is the time for a compliance checkup.The num... Read more
Industry Notes:
INTERMEDIARY CRACKS DOWN ON DRESSINGS DIAGNOSIS CODE
Will your V58.3 claims measure up?Get ready for increased scrutiny for claims with V58.3 a... Read more
OASIS:
MILLIONS IN M0175 ADJUSTMENTS TO HIT NEXT MONTH
View the recoupments, based on patients' prior inpatient stays, starting Oct. 24.You may h... Read more
DID YOU KNOW?
M0175 overpayments come about when home health agencies fail to mark all the correct respo... Read more
Reimbursement:
WARD OFF INCORRECT M0175 TAKEBACKS WITH THESE 4 STEPS
A little claims investigation can go a long way.You can minimize the coming M0175 mayhem w... Read more
Drugs:
OIG CASTS DOUBT ON INHALATION DRUG DISPENSING FEE
Suppliers warn of service loss if dispensing fee gets slashed.Inhalation drug suppliers co... Read more
Hospice:
CODE CONFUSION CONFOUNDS HOSPICE CLAIMS
HHAs get a preview of wage index transition woes.If the switch from MSAs to CBSAs for the ... Read more
Competitive Bidding:
PAOC HEARS PLEAS FOR COMPETITIVE BIDDING CARVE-OUTS
Stakeholder presentations dominate meeting.With competitive bidding looming on the horizon... Read more
Coverage:
APPLY BRAKES TO WHEELCHAIR RULE ROLLOUT, SENATORS SAY
Lawmakers raise concerns about policy's subjectivity, consistency.Three politically powerf... Read more
Industry Notes:
COUNT YOUR HOSPICE CONTINUOUS CARE HOURS CORRECTLY
Rounding up could get you into trouble.Hospices that round up their hours to meet the cont... Read more
Fraud & Abuse:
HHA REFERRAL KICKBACK SCHEME BITES BACK
Detroit-area HHAs paid for referrals, DOJ complaint alleges.If you've ever thought about p... Read more
Referrals:
SAFEGUARD YOURSELF AGAINST KICKBACKS WITH THESE 5 TIPS
Educating your marketers is key to compliance, legal experts says.Home care providers that... Read more
Regulations:
INSPECT DME QUALITY STANDARDS WITH A FINE-TOOTH COMB
CMS urges suppliers to submit detailed comments on controversial standards.Suppliers hopin... Read more
Disasters:
MORE KATRINA RELIEF ON THE WAY
CMS eases up on RAP recoupments, coming M0175 takebacks.The 91 home health agencies CMS es... Read more
Reimbursement:
AVOID DME PAYMENT BLUES WITH BLUE CROSS NUMBER
Don't let the lengthy application form scare you off.A durable medical equipment company n... Read more
Compensation:
HHAs PREPARE FOR COURT CASES TO DEFEND PT PAY
PRRB gives thumbs up to agencies' therapist compensation.Two home health agencies recently... Read more
Industry Notes:
CLOCK TICKS ON NPI APPLICATIONS
Be prepared to use both old and new numbers during transition.The national provider identi... Read more
Medicaid:
OIG ACCUSES HHAs OF $1.8 MILLION IN DUPLICATE PAYMENTS
Overlapping Medicare, Medicaid claims suspect, says report targeting dual eligibles.Home h... Read more
Coverage:
POWER MOBILITY GETS ANOTHER PIECE OF THE COVERAGE PUZZLE
Draft LCD answers some questions, raises others.Solving a complex jigsaw puzzle is hard en... Read more
Diagnosis Coding:
MAKE THESE CHANGES WHEN NEW DIAGNOSIS CODES HIT OCT.1
Providers get no grace period for update.It's that time of year again already--time to lea... Read more
Coding:
LAST-MINUTE CHANGES DEEPEN POWER MOBILITY CHAOS
Companies decipher latest CMS edict while engineers head back to the lab.The power mobilit... Read more
Disasters:
KATRINA MAY THREATEN MEDICARE RATES
You can donate to home care employees.Hurricane Katrina may take its toll on home care pro... Read more
Regulations:
DON'T MAKE UNNECESSARY VISITS FOR EXPEDITED REVIEW NOTICES
Remember these delivery rule exceptionsNearly three months into the expedited review notic... Read more
Industry Notes:
OIG PUSHES INCREASED PHYSICIAN INVOLVEMENT FOR HHAs, SUPPLIERS
Hospice-SNF relationships also targeted.Home care providers could work even more closely w... Read more
Recruitment & Retention:
IRS Hikes Mileage Rate 20% In Face Of Gas Prices
Providers struggle with whether to increase mileage reimbursement. Welcome news about trav... Read more
Strategy:
Combat High Gas Prices With These Alternatives
But beware labor law pitfalls of some popular strategies. Desperate times call for despera... Read more
Power Mobility:
Suppliers Poke Holes In Wheelchair Rule
CMS gets an earful from industry in special Open Door Forum. The power mobility industry m... Read more
Regulations:
7 Elements Of A Power Mobility Prescription
Though much remains murky about the interim final rule for power mobility, suppliers now h... Read more
OASIS:
OASIS Rules Loosened Further For Hurricane Victims
Door-to-door marketing restriction lifted for affected DME suppliers. The Centers for Medi... Read more
Disasters:
Home Care Providers Scramble To Find Employees, Patients
Industry's good Samaritans pitch in on disaster relief. Three weeks after Hurricane Katrin... Read more
Industry Notes:
Correct Your Corrections Procedures For Claims
FISS update changes the way you enter RTP corrections. If you're having problems fixing yo... Read more
Regulations:
EXPEDITED REVIEW NOTICES AT ADMISSION A NO-NO
CMS pulls about-face in prohibiting common HHA practice.If you're one of the many home hea... Read more
Appeals:
DOC CERT WINDOW FOR EXPEDITED REVIEW TOO WIDE
New leeway could increase HHAs' burden.While you have less than a day to respond to an exp... Read more
Disasters:
INDUSTRY STEPS UP IN RESPONSE TO HURRICANE KATRINA
OASIS suspended for directly impacted.Home care providers have been smack dab in the middl... Read more
Charity:
CHARITY SEEKS CPAP DONATIONS FOR KATRINA SURVIVORS
Many Gulf Coast apneics are in need.Brother, can you spare a continuous positive airway pr... Read more
Contractors:
GET READY FOR MEDICARE CONTRACTING REFORM CHAOS
CMS proceeds despite GAO concerns.Durable medical equipment suppliers should prepare for a... Read more
Reimbursement:
PROVIDERS GET A BREAK FROM NAME/ID EDITS
Patient nicknames won't be the bane of your billing anymore.Pressure from thousands of pro... Read more
Industry Notes:
DON'T FORGET TO APPLY FOR YOUR NPI
But you may not want to rush the application, experts warn.You have a year to apply for a ... Read more
Survey & Certification:
Avoid Survey Woes With Careful Discharge Policy
CMS updates State Operations Manual If your policies state that you must secure a physicia... Read more
Assessments:
Know Who To Assess - And Who Not To
Comprehensive assessments aren't always required, CMS explains in revised SOM. You could b... Read more
Coverage:
Don't Expect New PME Rule To Cure Documentation Woes
CMS lets the chaos continue, industry groups charge. Power mobility equipment suppliers sh... Read more
Mobility Assistive Equipment :
Say Goodbye To CMNs For Power Mobility
New rule also details face-to-face exam. Suppliers will no longer have to submit certifica... Read more
Regulations:
M0175 Takebacks Finally To Hit In November
 CMS forum also reveals details on expedited review, outcomes and hospital referrals.... Read more
Hospice:
Hospices Dodge 2005 Cap Cut
CMS backtracks on cap drop released earlier. Hospices whose reimbursement is limited under... Read more
Industry Notes:
Home Care Providers Grapple With Hurricane Katrina
Thousands of HHA employees displaced. Many home care providers' and patients' worst fears ... Read more
Prospective Payment System:
YOU'RE OFF THE HOOK FOR SOME BUNDLED ITEMS
CMS' new explanation of HHA consolidated billing could help your bottom line.When rehab pr... Read more
Oxygen:
O2 SUPPLIERS COULD BREATHE EASIER WITH EXPANDED COVERAGE
CMS asks for evidence to support proposed policy change.Home oxygen suppliers may soo... Read more
Reimbursement:
PATIENTS MAY BE LIABLE FOR BUNDLED SERVICES
Add educating hospital discharge planners to your to-do list.If you don't pay for bundled ... Read more
Hospice:
HOSPICE REIMBURSEMENT CAP DROPS FOR 2005
CMS could retroactive lower cap for 2004, triggering overpayments.Hospices whose reimburse... Read more
Competitive Bidding:
BILL WOULD EASE COMPETITIVE BIDDING BURDEN
Congress considers bill to exempt rural areas, make other changes.Suppliers may get a repr... Read more
Regulations:
EARLY BIRD GETS THE EXPEDITED REVIEW SUCCESS
Use these 5 tips to deliver your mandatory notices before it's too late.If you fail to del... Read more
Industry Notes:
QIO EFFECTIVENESS UNDER SCRUTINY
Powerful senator wants extensive information about your QIO.Your Medicare Quality Improvem... Read more
Lawsuits:
STOP PATIENT POACHING WITH POWERFUL NON-COMPETES
Heed the latest court decision that shoots down one HHA's non-compete agreements.Your non-... Read more
Human Resources:
CRAFT SUCCESSFUL NON-COMPETES WITH THESE 5 TIPS
What do you have that's worth protecting?If you're relying on your employees' consciences ... Read more
Accreditation:
ACHC TEST DRIVES NEW ACCREDITATION MODEL
Initiative integrates ISO standards with the existing process.Home medical equipment and h... Read more
DID YOU KNOW?
The International Organization for Standardization or ISO is a network of the national sta... Read more
Referrals:
OIG SCRUTINIZES DOC CERT BILLING UNDER CPO REVIEW
Feds could make billing for home health certs and recerts harder that it should be.If you ... Read more
Marketing:
HELP YOURSELF BY HELPING DOCS BILL FOR CERTS & RECERTS
Assist physicians in learning the cert/recert billing ropes with these 5 steps.Your physic... Read more
Oxygen:
DON'T GET BURNED BY A COMMON OXYGEN MYTH
It's a fire hazard, but it's not flammable.The general public is prone to mistakenly think... Read more
Industry Notes:
LAWMAKERS DEMAND CLEAR MOBILITY EQUIPMENT GUIDELINES
Documentation requirements are inconsistent, senators blast.Two U.S. senators want mobilit... Read more
Therapy:
OIG HAMMERS THERAPY IN NEWEST AUDIT
Major therapy denials and downcodes could spell trouble for industry.Home health agencies ... Read more
Medical Review:
WARD OFF THERAPY DENIALS WITH THESE 10 TIPS
Are you waving a red flag at medical reviewers?If you can't prove the therapy visits you'r... Read more
Respiratory Therapy:
PROPOSED DRUG DISPENSING CUT LEAVES SUPPLIERS GASPING
CMS seeks comments on appropriate fee amount.Respiratory providers should gird for battle ... Read more
Coverage:
MEDICARE'S MDI COVERAGE MAY HIT NEBULIZER SUPPLIERS
More data needed to determine appropriate device, experts say.Companies that supply nebuli... Read more
Hospice:
HOSPICES TO SEE 1-YEAR PHASE-IN OF NEW WAGE AREAS
...but transition will sacrifice some providers' wage increases.The final rule on hospice ... Read more
HIPAA:
GET HIPAA-COMPLIANT OR STOP GETTING PAID
Oct. 1 looms as drop-dead date for electronic claims compliance.If you've been putting off... Read more
Industry Notes:
ALJ TRANSFER TO HHS COULD LIMIT ACCESS, GAO WARNS
Video hearings not necessarily an adequate substitute for in-person hearings, report says.... Read more
Referrals:
OIG TARGETS PHYSICIAN CPO IN LATEST REPORT
Massive denials could scare docs away from billing underutilized service - and referring t... Read more
Marketing:
HELP DOCS BILL CPO WITH THESE 12 RULES
Know what counts and what doesn't for the 30-minute requirement.You can strengthen your re... Read more
Case Study:
EDUCATE YOUR DOCS ON CPO-BEFORE THE OIG DOES
One HHA is making referral sources' lives easier - and more profitable.Don't let the HHS O... Read more
Oxygen:
DME SUPPLIERS CLEARED TO DELIVER HOME OXIMETRY TESTS
CMS relaxes limits on self-testing.Durable medical equipment suppliers will soon be able t... Read more
Regulations:
2-SHEET EXPEDITED REVIEW NOTICE OK, CMS SAYS
But exception applies only under certain circumstances.New information about the expedited... Read more
Medicaid:
LOUISIANA AIMS TO CUT CUSTOM WHEELCHAIR ORDERS
Medicaid changes how nursing homes pay for equipment.If you're a durable medical equipment... Read more
Industry Notes:
FEDS PUSH PRIVATE FINANCING OF LONG-TERM CARE
Is it time to branch into private pay?The time may be right to rethink your business lines... Read more
ELI Research is proud to present a subscriber-only service -Eli's home health coding and oasis discussion group
Eli's Home Health Coding and OASIS Discussion Group will allow you to have your questions ... Read more
Demonstration:
CMS REVEALS BARRIERS TO PARTICIPATION IN DAY CARE DEMO
HHAs must pay for entire day of adult day care, plus transportation, under test project.De... Read more
Day Care:
KNOW YOUR FACTS-ADULT DAY CARE DEMONSTRATION
The ball is rolling on Medicare's medical adult day care demonstration project. Here are t... Read more
Oxygen:
SUPPLIERS CAN PITCH POCs TO GLOBETROTTING CUSTOMERS
Feds OK O2 concentrators for air travel.The Federal Aviation Administration is making life... Read more
Regulations:
CMS BACKS DOWN ON DOC CERT FOR EXPEDITED REVIEW
QIO can't furnish beneficiary risk certification required for review.The number of work-in... Read more
Survey & Certification:
COURT SHOOTS DOWN BID FOR OUTSIDE REVIEW OF SURVEYS
You're stuck with your survey report.An Indiana home health agency's attempt to secure an ... Read more
Medicaid:
MISSOURI MEDICAID CHANGES PINCH DME
NCART protests coverage restrictions at governors' meeting.The durable medical equipment i... Read more
Industry Notes:
HOME CARE COULD PLAY ROLE IN HIGH COST DEMO
Goal: Reduced ER visits & hospital stays.Although none of the six organizations chosen... Read more
Prospective Payment System:
WAGE INDEX REVAMP COULD BRING MAJOR PAY CHANGES
Medicare PPS rates to increase 2.5 percent in 2006.Your payment rates could look drastical... Read more
Coverage:
DMERCs GREASE THE WHEELS FOR SCOOTER SCRIPS
Beneficiaries no longer need a medical specialist's OK.It may be bad news for physiatrists... Read more
Regulations:
8 TIPS FOR TOP TRAINING ON EXPEDITED REVIEW NOTICES
Nailing down who's responsible for what is crucial to compliance.Many home health agencies... Read more
Accreditation:
SMALL FIRM OFFERS ACCREDITATION ALTERNATIVE FOR DME
The 'big three' accreditors aren't the only game in town for suppliers.With mandatory accr... Read more
Billing:
NEW CLAIM FORM SCHEDULED TO HIT SOONER THAN YOU MIGHT THINK
Will UB ready to say good-bye to the UB-92?The date has been set: The new UB-04 officially... Read more
Industry Notes:
P4P BILL GAINS STEAM UNDER AARP BACKING
Information technology another topic likely to see legislative action.The powerful America... Read more
Regulations:
HHAs GRAPPLE WITH EXPEDITED REVIEW NOTICES
Late notice, overwhelmed staff head up HHAs' challenges in implementing new rule.The new e... Read more
Compliance:
GET TO KNOW YOUR EXPEDITED REVIEW NOTICE EXCEPTIONS
Misunderstanding this area could cost you unnecessary time and money.Do you know just when... Read more
Reimbursement:
USE THESE TIPS TROUBLE-FREE DIABETIC TEST CLAIMS
When doctors up testing, suppliers must provide more data to avoid rejection.Doctors occas... Read more
Legislation:
P4P MAY COME KNOCKING SOONER THAN YOU THINK
Leading lawmakers take action on paying health care providers for quality measures.You'd b... Read more
Therapy:
REHAB FACILITIES' 75 PERCENT RULE COULD BE BOON FOR HHAs
CMS charges ahead with major change for joint replacement patients' site of service.A majo... Read more
Audits:
WATCH OUT FOR QUESTIONABLE MAE CLAIMS AUDITS
Contractors are violating the law, power mobility industry charges.If you're a supplier of... Read more
Industry Notes:
ALJs MAKE SWITCH TO HHS
Providers' chances of getting a fair hearing may have just gotten slimmer.A video conferen... Read more
Regulations:
Issue Review Notices Starting July 1 Or Risk Noncompliance
But the expedited review notices aren't yet ready for prime time, experts protest. Get rea... Read more
Education:
Bone Up On Notice Rules
Here's where to find out the most you can about the new expedited review notice requiremen... Read more
Appeals:
Breathe A Little Easier On These Expedited Review Notice Topics
Hint: You can deliver the notice at the start of care if you want to. The expedited review... Read more
Patient Rights:
Don't Make This Crucial ABN Mistake
Hold the phone on ABNs and ignore the NEMB altogether. One of the biggest gray areas regar... Read more
Case Study:
Inhalation Drug Cuts Are Taking A Toll On Providers
One provider does the math - and comes up worried for the future. If the government's redu... Read more
OASIS:
Check Out These Vital New OASIS Q&As
Some clarifications may surprise you. Think your clinicians know how to answer OASIS quest... Read more
Industry Notes:
HHS Snatches Back Compensation
Regular payroll checks not so good for liquidating prior year's costs. A Louisiana home he... Read more
Fraud & Abuse:
OIG Shines Fraud Spotlight On HHAs In Report To Congress
Jail time and fines for kickbacks, cost report fraud featured in semiannual roundup. You'd... Read more
Coverage:
Suppliers Take Another Step Toward Ambulation Standard
Mind the gap between NCD's effective and implementation dates. The Centers for Medicare &a... Read more
Hospice:
Brace for Background Checks To Hit Your Hospice
Proposed COP changes may throw your hospice a curve ball. Get ready to put all your employ... Read more
Accreditation:
HME May Get Kinder Accreditation Option Thanks to VGM
Suppliers praise increased competition, but some question group's independence. Home medic... Read more
Reimbursement:
HHA's Cost Report Victory Likely Short-Lived
CMS expected to overturn favorable PRRB decision on therapist compensation. If you've file... Read more
Appeals:
New Appeals System Skimps On In-Person Hearings
 Rule changes could damage your chances of a successful appeal, experts fear. Under t... Read more
Industry Notes:
OIG Plans More Therapy Audits
 But audits won't hit every region, OIG says. Home health agencies should prepare to ... Read more
Therapy:
THERAPY MEDICAL REVIEW MAY INCREASE IN WAKE OF OIG REPORT
OIG audit denied nearly half of HHA's high-therapy claims.If your therapy documentation is... Read more
Medical Review:
PROTECT THERAPY REIMBURSEMENT WITH THESE 5 STEPS
Medical reviewers have strong incentives to deny your therapy visits.Expect medical review... Read more
Coverage:
EXERCISE PATIENCE TO WEATHER MAE MAYHEM
Now that the NCD is final, keep your eyes peeled for DMERCs' local coverage policies.The f... Read more
Reimbursement:
REPORT MAE CLAIMS TROUBLE TO CMS
Suppliers should direct NCD-related payment woes to regional offices.The Centers for Medic... Read more
Hospice:
HOSPICE COPs PROPOSE MAJOR DIFFERENCES IN ASSESSMENTS, QI
Host of changes will require hospices to make significant operational shifts.The long-awai... Read more
Regulations:
EXPECT JULY 1 IMPLEMENTATION FOR TERMINATION NOTICES
No compliance leeway despite short notice on new forms.You'd better be prepared to hit the... Read more
Industry Notes:
NEW JCAHO SAFETY GOALS FOCUS ON COMMUNICATION
Caregivers, patients and families targeted by new goals for 2006.Home care providers accre... Read more
Reimbursement:
New Medicare Accounting System to Delay RAP Payments
'HIGLAS' system in place at one RHHI, on deck for the rest. Get ready to take on more bill... Read more
Prospective Payment System:
HIGLAS Less Generous On Interest Rates, Experts Warn
Expect changes to check reissuances, third-party withholdings too. If Palmetto GBA is late... Read more
Accounting:
Expect Withholds by Tax ID Number, Not Provider Number
Confusion ahead for large organizations. Your tax identification number may become more im... Read more
Coverage:
Reach Out To Challenge Medicare's In-The-Home Restriction
Providers are invited to join lobby effort challenging policy. Want to strike down Medicar... Read more
Referrals:
Drastic Hospital Transfer Policy Expansion Could Choke Off Referrals
CMS proposes reducing hospitals' DRG payments when patients go to home care. Your job of s... Read more
Industry Notes:
Early Demo Findings Could Sour PolicyMakers On DM
Patients' adherence to medication, diet and exercise regimens same as control group. Patie... Read more
Competitive Bidding:
High-Tech DME Could Get Competitive Bidding Reprieve
Mystery lawmaker agrees to sponsor carve-out legislation. Certain durable medical equipmen... Read more
Prospective Payment System:
Major PPS Changes Scheduled To Hit In 2007
Don't expect the lucrative therapy threshold to remain the same. Hold onto your hats - the... Read more
Inhalation Drugs:
Answer OIG Inhalation Drug Survey Carefully - Your Fees May Depend On It
 Ask for deadline extension, trade group recommends. Attention, inhalation drug thera... Read more
Patient Rights:
Get To Know Your ABN Options Before The Deadline Hits
CMS offers up some differences between ABNs and termination notices. Buckle up for a bumpy... Read more
Compliance:
ABN Implementation May Lag Behind Termination Notices
Still get ready to tackle the new requirement this summer. The new advance beneficiary not... Read more
Reimbursement:
Brace For More DME Cost-Containment
DME benefits manager aims to help health plans trim spending. Durable medical equipment pr... Read more
Therapy:
Associations Team Up To Alleviate OT Headaches
If CMS makes OT a qualifying service, scheduling could get a whole lot easier. How many ti... Read more
Industry Notes:
Hospice COPs Could Be Out Any Day
But will the long-pending standards get pushed back once again? Hospices will be seeing th... Read more
Regulations:
GET SET TO TAKE ON HUGE NEW BURDEN IN TERMINATION NOTICES
Despite confusion, HHAs must comply with new notice requirement by July 1.A massive new pa... Read more
Education:
START TRAINING NOW ON NEW TERMINATION NOTICES
Putting new procedures in place for these confusing requirements may take a while.You can'... Read more
Lawsuits:
LEGISLATION, LITIGATION DICTATE CONFUSING NOTICES
The confusing and haphazard instructions for the new termination notices and home health a... Read more
Patient Rights:
NEW ABN INSTRUCTIONS THROW OUT DOC ORDER CRITERIA
Prediction: You'll issue a lot more ABNs under the new policy.Get ready to hand out home h... Read more
Fraud & Abuse:
SCOOTER LAWSUIT ROLLS ON-AND YOUR BOTTOM LINE MAY DEPEND ON IT
DMERCs accused of illegal post-pay review tactics.After getting slapped with a lawsuit fil... Read more
Industry Notes:
NEGLIGENCE VERDICT SLAPS HHA WITH $6 MILLION IN DAMAGES
Hiring worker with criminal record sealed the case.A Cuyahoga County, OH jury found MedLin... Read more
Coverage:
SUPPLIERS CELEBRATE FUNCTIONAL AMBULATION STANDARD
But final wheelchair NCD lets in-home restriction remain.There's good news and bad news in... Read more
Medical Review:
HHAs Off The RAC Hook - But Suppliers Not So Lucky
Three-state medical review demo excludes home health agency claims. The Recovery Audit Con... Read more
Audits:
Don't Expect RACs To Identify Underpayments
 New medical review contractors get paid only for collecting overpayments. The financ... Read more
Hospice:
Hospice Pay Levels Swing Thanks To Wage Index Revamp
 MSA shuffle is preview for coming home health agency changes. Some hospices will be ... Read more
Fraud & Abuse:
Don't Let Erroneous DMERC Education Letters Slide
Ignored warnings could come back to bite you later. If your durable medical equipment busi... Read more
Reimbursement:
Get Your HHA Started The Right Way - On Your Cost Report
PRRB shoots down arguments for start-up costs, accrued fees. Medicare home health agency s... Read more
Oxygen:
Help Breathe New Life Into HME Industry Appeals For Change
AAH launches major data collection effort. If you haven't already done so, get ready to ha... Read more
Industry Notes:
$10 Billion Medicaid Cut Pact Doesn't Rule Out Medicare Cuts
 House and Senate finally agree on budget blueprint. By a slim margin, the U.S. House... Read more
Appeals:
EVIDENCE SUBMISSION MISTAKES COULD TORPEDO YOUR APPEAL
Good cause for post-QIC submission of evidence may be trickier than CMS indicates.The new ... Read more
Reimbursement:
BEWARE DISPENSING FEE DENIALS FOR INHALATION DRUGS
CMS pledges to set DMERCs straight on G codes.If you've been experiencing inexplicable den... Read more
Kickbacks:
PROTECT YOURSELF AS CMS EYES MEDICAL DIRECTORS
Going overboard on number of directors raises a red flag.The newest compliance hotspot for... Read more
Coding:
HEADS UP ON SADMERC CODING DELAYS
Remember: You can't bill for supplies that haven't been coded.A backlog of manufacturer re... Read more
Medical Review:
DON'T LET THIS TOP DENIAL REASON DOOM YOUR REIMBURSEMENT
Physician orders are the cornerstone of a solid billing program.Four of the top ten denial... Read more
Compliance:
KEEP PHYSICIAN ORDER PROBLEMS AT BAY WITH THESE 6 TIPS
Log those orders to comply with deadlines.For home health agencies that often see denial c... Read more
Industry Notes:
JOINT REPLACEMENT PATIENTS FARE BETTER AT HOME, STUDY SAYS
Finding: Home care costs Medicare less for these patients.A new study commissioned by the ... Read more
Appeals:
FIND YOUR WAY AROUND EVIDENCE SUBMISSION LIMITS
CMS reveals details on revamped appeals process set to hit next month.The new rule limitin... Read more
Contractors:
CMS NAMES NEW APPEALS CONTRACTORS
If you're wondering who will be handling your home health agency and hospice claims appeal... Read more
Competitive Bidding:
NEW ANALYSIS CASTS DOUBT ON COMPETITIVE BIDDING SAVINGS
Economist raises concerns about anti-competitive aspects of CMS initiative.Durable medical... Read more
Fraud & Abuse:
OIG INVESTIGATES VITAS HOSPICE CHAIN
Are recent subpoenas a sign of an industry crackdown?The booming hospice sector is seeing ... Read more
Regulations:
SAY GOODBYE TO ENVIRONMENTALLY HARMFUL ALBUTEROL MDIs
FDA bans some inhalers containing ozone-depleting chemicals.Over the next three years, dur... Read more
Studies & Surveys:
RESEARCH BOOSTS ECONOMIC ROLE OF MOBILITY EQUIPMENT
New analysis finds they save Medicare more than initially thoughtMany power wheelchair and... Read more
Industry Notes:
HIPAA ENFORCEMETN MAY GET TOUGHER
HHS proposes civil monetary penalties for all HIPAA infractions.Get HIPAA-compliant or get... Read more
Medical Review:
RACs Could Drive Home Care Providers Out Of Business
Contractors have huge incentive to recoup. Recovery Audit Contractors could be more than j... Read more
Audits:
RAC Home Health Hit List Likely To Include Therapy
Pilot's medical review focus could spill over to other regions. The most confusing areas o... Read more
Reimbursement:
Brace Yourself for Lower Oxygen Rates
CMS plans to lower Medicare reimbursement as of April 8. Oxygen suppliers who were holding... Read more
Hospice:
Kick Hospice Consult Kickbacks To The Curb
CMS issues instructions on hospice pre-election evaluation and counseling services. If you... Read more
Compliance:
Avoid Medical Director Kickbacks With These 4 Tips
 Documenting your medical director's service is a must. Your hospice medical director... Read more
Lawsuits:
DME Suppliers Win Case For CMN Primacy
HHS loses suit but sets payback amount. A recent court case offers good news and bad news ... Read more
Industry Notes:
Senators Criticize Medicare Appeals Changes
ALJ changes could restrict access to appeals avenue, top lawmakers say. The plan to shift ... Read more
Prospective Payment System:
Rural HHAs Face Expiration Of Add-On
Cut could push rural providers out of business, reps predict.The financial picture is blea... Read more
Competitive Bidding:
Brace For A Nationwide Bid Area For Mail Order DME
Controversy could throw a wrench into suppliers' bidding plans.Heads up, durable medical e... Read more
Drugs:
New Drug Price List Offers Mixed Bag For Suppliers
Albuterol is up but ipratropium bromide is down, latest fee schedule indicates.The Centers... Read more
Regulations:
Your Medicare Contractor Could Change Soon
Contracting reform will mean intermediary shuffle for some agencies.Remember those Medicar... Read more
Oasis:
Prevent Oasis-Based Downcodes Before They Happen
And you can still appeal this common denial.Is your OASIS documentation costing you your r... Read more
Medical Review:
Contractors Gear Up To Find Fault With Your Claims
CMS names Recovery Audit Contractors.If you receive a medical review request from someone ... Read more
Reimbursement:
Oxygen Rates To Drop 12%
The HHS Office of Inspector General has finally completed its study on Medicare oxygen rat... Read more
Industry Notes:
Accreditation Required For Suppliers, Despite Bidding Status
DME contractor reform delayed a bit, CMS also says in forum.Durable medical equipment supp... Read more
Kickbacks:
Don't Let Marketing Compensation Sell You Out
TLC settles marketing kickback charges from government for $130,000.You'd better make sure... Read more
Marketing:
Side-Step Marketing Pay Land Mines With These 4 Tips
Hint: Start by scrutinizing your compensation arrangements.Not sure how to structure your ... Read more
Reimbursement:
Market DME Upgrades to Maximize Income
Medicare gives patients what they need, but you can give them what they want.Attention, du... Read more
Lawsuits:
Court- Snatching Back Approval of Cost Report Methodology OK
Don't count on that written approval from your intermediary.If you get a new intermediary,... Read more
Documentation:
6 Simple Tips To Spiff Up
Hint: Don't fudge records to justify codes.With law enforcement intensifying its efforts t... Read more
Clip 'N' Save:
Where Is Your Billing Falling Short?
Use denial codes to pinpoint your problem areas.If you want to save yourself major time an... Read more
Industry News:
Senate Nixes $14 Million Cut To Medicaid In Budget Resolution
House hangs on to $20 million cut.The U.S. House and Senate have approved their budget res... Read more
Prospective Payment System:
PPS Reform Could Slap You With Risk-Sharing
MedPAC also considering return to per-visit pay.The time has come for refinement of the ho... Read more
Utilization:
HHAs Cut Visits By 47% In Response To PPS
Industry faces suspicions of care skimping.The home care benefit has undergone a major tra... Read more
Reimbursement:
Read This Before Making Patients Sign Medicare Claims
A beneficiary's John Hancock is not always required.Good news, suppliers: There are situat... Read more
Lawsuits:
Court Upholds $1.8 Million Judgment Against HHA Owner
Former MedShares exec's cost report mistakes add up quickly under False Claims Act.If you'... Read more
Appeals:
Direct Your Attention To Appeals Reform Windfalls
Providers will receive time-saving direct appeals rights.The Centers for Medicare & Me... Read more
Pricing:
Reprieve From Gap Filling Madness May Be Near
Move comes as CMS prepares to set new wheelchair rates using the controversial method.Reli... Read more
Industry Notes:
Statistical Sampling Rules On Deck
MMA changes may have less effect that providers hoped.The Centers for Medicare & Medic... Read more
Appeals:
Know Your Facts: Medicare Claims Appeals Changes
ALJs' move to HHS tops lengthy list of Medicare appeals reforms taking place soon. Medicar... Read more
Regulations:
Stay On Top Of Major Appeals Revamp
Sweeping restructuring could make Medicare appeals faster but harder. By this fall, your c... Read more
Competitive Bidding:
DME Industry Reps Praise PAOC Process
Suppliers say CMS is listening to their concerns. The third time's the charm - at least wh... Read more
Competitive Bidding:
Look For DME Draft Quality Standards This Summer
Don't delay in seeking accreditation. Durable medical equipment suppliers won't have to wa... Read more
HIPAA:
HIPAA Security Rule Deadline Looms
Are you ready to face the HIPAA music next month? The April 20 deadline for compliance wit... Read more
Compliance:
6 Steps To Get Up To Speed On HIPAA Security
Follow this expert advice to ensure your compliance - before it's too late. The security r... Read more
Industry Notes:
HHA Mergers & Acquisitions Surge In 2004
HME volume remains steady while hospice deals fall. Home health agency mergers and acquisi... Read more
Budget:
HHAs Shiver Over Official Rate Freeze Recommendation
A battle royale may be brewing between home care and lawmakers eager to make cuts.Home hea... Read more
Quality:
MedPAC Wants Pay Based On Outcomes - Including Adverse Events
You'd better get used to the idea, because experts say pay-for-performance is inevitable.T... Read more
Coverage:
Wheelchair NCD Won't Bring Documentation Clarity
Medical necessity concerns are a separate issue, CMS says.If you're looking to the nationa... Read more
Regulations:
Wheelchair NCD Won't Apply Retroactively
The Centers for Medicare & Medicaid Services has a message for suppliers who hope the ... Read more
Reimbursement:
Claim Owners' Compensation The Right Way
Don't let liquidation confusion ruin your cost report.You've got to know when to hold 'em ... Read more
Contractors:
Get Ready For The Medicare Contracting Revolution
CMS already has reassigned some states to new DME carriers. What's next?Big changes are co... Read more
Industry Notes:
State Aims To Toughen Up Surveys
More frequent surveys, Web site on deck.Home health agencies in North Carolina may be in f... Read more
Budget:
Rate Freeze, Copay Proposed For HHAs
CBO offers Congress cost-cutting options. The odds appear to be stacking up against home h... Read more
Reimbursement:
Share Your Power Mobility Denial Pain With CMS
 Region B represents a particular problem, some suppliers say. Frustrated over inexpl... Read more
Prospective Payment System:
Rural Add-On Elimination May Decimate HHAs
It's no joke: Lower payment rates for rural agencies take effect April 1. You can expect t... Read more
Strategy:
10 Tips To Combat Rural Add-On Shortfall
Hint: Take a close look at travel organization, productivity. Rural home health agencies w... Read more
Regulations:
Don't Hold Your Breath For OASIS Changes
Home Health Compare revision goes ahead without underlying OASIS revamp. If you're waiting... Read more
Accreditation:
Follow These 5 Tips To Survive Accreditation
Hint: Pick the right organization, and think of the surveyor as your friend. If you're an ... Read more
Industry Notes:
New Billing Code To Fix Hospice Benefit Period Problem
Hospices will want to avoid new code indicating Medicare non-payment. The Centers for Medi... Read more
Quality:
CMS WHITTLES HOME HEALTH COMPARE MEASURES TO 10
Risk adjustment problems keep 5 NQF-endorsed standards on the sidelines.Good news: You won... Read more
Competitive Bidding:
PAOC to Tackle Quality Standards ... But Is CMS Listening?
Gathering will test group's muscle.Heads up, durable medical equipment suppliers: If you b... Read more
Referrals:
SECURE YOUR RIGHTFUL REFERRALS WITH THESE 4 STEPS
The HHS Office of Inspector General is now on your side when it comes to heading off hospi... Read more
Compliance:
Use OIG Guidance To Battle Patient Steering
Watchdog agency reminds hospitals to play by the rules with home care referrals.Home healt... Read more
Accreditation:
Florida Considers Mandatory Accreditation for HME
Legislation could inspire other states.Think you needn't bother with accreditation? You mi... Read more
Industry Notes:
Are Intermediary And Carrier Changes In Your Future?
CMS wants all-purpose MACs to take over claims processing.Your days of doing business with... Read more
Quality:
Brace For 8 New Home Health Compare Measures
Even more measures may be on the way.Get ready for your publicly reported patient outcomes... Read more
HOME HEALTH COMPARE MEASURES
Pending Home Health Compare Measures Measures Already In HHC1. Improvement in ambulation/l... Read more
Coverage:
Prepare To Juggle 49 New Wheelchair Codes
CMS unveils new criteria for power mobility equipment.The Centers for Medicare & Medic... Read more
Kickbacks:
Whistleblower Suit Could Cost Louisiana HHA Big
Government-backed lawsuit focuses on kickbacks to physicians.Are your physician compensati... Read more
Budget:
President's Budget Proposal Leaves Medicare Alone
Big Medicaid cuts on the horizon, but Administration pushes home care.President Bush's bud... Read more
Compliance:
7 Tips To Keep Physician Payment Arrangements On The Up-And-Up
Fair market value is key to staying on the feds' good side.If your physician compensation ... Read more
Industry Notes:
California Fraud Unit Goes After Home Care Providers
State, feds cooperate in fraud-busting venture.California home care providers will receive... Read more
Audits:
Know Your Facts: Recovery Audit Contractors
Get ready for an extra layer of medical review. Starting this May, you'll have another pai... Read more
Medical Review:
Critics- Recovery Contractors Glorified Bounty Hunters
Home care could be hit especially hard by the pilot program that rewards contractors for i... Read more
Reimbursement:
Lack Of Specialty Codes To Scuttle P&O Payments
Now would be a good time to get your paperwork in order. Prosthetics and orthotics supplie... Read more
Reimbursement:
Specialty Codes Affected By P&O Restriction
If you don't qualify for one of these specialty codes, you'll no longer be able to bill fo... Read more
Compensation:
Compensation Confusion Costs HHA $90,000
Misconceptions over 75-day rule lead to PRRB split decision. If you want to claim your exe... Read more
Oxygen:
Look Closely At What Simplified Oxygen CMN Really Means
Prediction: Change could mean more audits in the future. Home medical equipment suppliers ... Read more
Regulations:
Beware 5 Termination Notice, Expedited Review Pitfalls
Will you have to secure physician orders for discharged patients? Home health agencies had... Read more
Industry Notes:
DMERCs Compete Under New Reform Initiative
Will you get a new carrier? The Centers for Medicare & Medicaid Services has launched ... Read more
Managed Care:
Make The Most Of Managed Care Rise
 Medicare issues final regulations on 'Medicare Advantage' MCOs. To industry veterans... Read more
Strategy:
7 Tips To Secure MCO Business And Success
Show managed care partners you can save them money with quality care. A Medicare managed c... Read more
OASIS:
HHAs Granted Breathing Room On M0175 Takebacks
 April next target date for millions of dollars in retroactive recoupments. If you ha... Read more
Quality:
National Quality Forum Report Pushed Off
 March earliest publication date for controversial standard recommendations. Home hea... Read more
Reimbursement:
M0175 and SCICs A Bad Combination
CMS reveals faulty downcoding when patients had a prior hospital stay and a SCIC. You may ... Read more
Marketing:
Warn Your Docs About Possible Fraud Scam
Help referral sources and plug your organization all at once. Looking for a good reason to... Read more
Regulations:
Mandatory Background Checks Hit Pilot States
CMS may still add your state. Are you ready to conduct exhaustive background checks on all... Read more
Industry Notes:
More Claims Scrutiny On The Way
Three states see pilot program rewarding new audit contractors for recoupments. Yet anothe... Read more
Quality:
Batten Down The Hatches For Pay For Performance
 MedPAC recommends payment incentives for quality indicators. Heads up, HHAs: As earl... Read more
Prospective Payment System:
Industry Fights Back After MedPAC Freeze Recommendation
Rural HHAs have decreased service areas, research finds. The Medicare Payment Advisory Com... Read more
Oxygen:
Submit Oxygen Claims Quickly - While You Still Can
Medicare pays higher 2004 rates while mulling this year's cuts. Oxygen suppliers are going... Read more
Reimbursement:
Watch Out For Bad Advice From Consultants
Faulty accounting, competition cost HHA more than $100,000. It turns out bad advice from a... Read more
Appeals:
7 Tips To Prepare For Termination Notices, Expedited Review
Don't miss the boat in gearing up for this fast-approaching deadline. A massive paperwork ... Read more
Regulations:
Will Termination Notice Be ABN Lite?
Troubling questions bedevil termination notice, expedited review process. Home health agen... Read more
Industry Notes:
Wheelchair Suppliers Call For Immediate Guidance
Clear, consistent documentation requirements another must, trade group says. Industry and ... Read more
Prospective Payment System:
Brace For Lean Budget Times Ahead
 MedPAC recommends HHA payment rate freeze for 2006. If home health agencies get thro... Read more
Reimbursement:
Don't Forget To Cash Those Checks - Not Just Write Them
Recent PRRB decision costs Louisiana HHA $47,000. If you were a little rusty on your accou... Read more
Survey & Certification:
Don't Drop The Ball On Drop Sites
 Follow these 3 steps to insure yourself against survey citations. Now that the Cente... Read more
Marketing:
Tap Into Top 10 Marketing Techniques
Networking, direct sales top the list of most effective marketing practices. Are you spend... Read more
Compliance:
Faulty Advice From Consultants Could Cost You Thousands
 7 ways to protect yourself. Many health care providers enlist the help of consultant... Read more
Fraud & Abuse:
Avoid These 6 Red Flags
Warning: A well-known name doesn't ensure your safety. If you want to stay out of the dogh... Read more
Industry Notes:
Enteral Nutrition Sting Ropes In Another Guilty Plea
Supplier excluded from Medicare. A man has pleaded guilty to violating anti-kickback laws ... Read more
Kickbacks:
3 Steps To Keep Your Donations On The Up-And-Up
Hospice donation wins stamp of approval from OIG. If you accept or give charitable donatio... Read more
Fraud & Abuse:
Lawmaker, Feds Sling Mud At Wheelchair Industry
While the Government Accountability Office gives suppliers a small break in its report, as... Read more
Studies & Surveys:
Get Ready For Wheelchair Advertising Restrictions
Surprise site visits, revised CMN needed too, new report says. The Government Accountabili... Read more
Reimbursement:
Factoring Arrangement Costs HHA $330,000
Is your accounts receivable financing up to snuff? Don't get clumsy with your cost report ... Read more
Recruitment & Retention:
Specific Examples Should Make Or Break Your Hiring Decisions
Follow these tips for getting the most out of your interviews. The more you can get potent... Read more
Medical Review:
Medicare Can't Punish You For Self-Disclosing Problems - But There's A Catch
Don't go straight to your contractor if the problem looks serious. The Medicare Modernizat... Read more
Industry Notes:
Final Rates For Inhalation Drugs Set
Rates change from original projections. Respiratory drug suppliers received some mixed new... Read more
Available Years:  2005  2004  2003