Advanced Search

Home Health & Hospice Week

HHAs:
Surprise! Here's Your Unannounced Survey
Watch out: New ‘extended surveys’ will dig deep into your business. In ord... Read more
Compliance:
Get To Know Definitions For New Survey Terms
Four potential survey outcomes lay out the playing field. The 2013 Home Health Prospec... Read more
PPS 2013:
Get Ready: CMS Moves Forward With M1024 Changes
  PPS 2013 clarifies and changes resolved condition reporting. Come Jan. 1, the... Read more
Hospice Coding:
Bolster Hospice Claims With Thorough Coding
Could a hospice case mix adjustment system be in your future? Your hospice claims cont... Read more
HIPAA Compliance:
Take 7 Steps To Protect PHI 'In The Cloud'
Choose your vendor carefully -- or risk leaks. If you’re like many other he... Read more
Breaching The Cloud:
Crucial Action Points You Must Follow
What are your responsibilities versus your BA’s? You have a lot of issues to con... Read more
Hospices:
Live Discharge Rates: Are You Making This One Mistake
Learn occurrence code 42 lessons from PEPPER reports. If you were unclear on how ... Read more
Medications:
What Is A Clinically Significant Medication Issue?
Check this list and examples to steer in the right direction. The Centers for Medicare... Read more
Studies:
Check Out This Newly-Validated Fall Risk Assessment Tool
Look for a boost in your Home Health Compare scores. Have you been frustrated by ... Read more
Industry Note:
Why A Pending Settlement Could Expand Your Home Care Reimbursement
Court decision may impact how Medicare pays for patients who aren’t improving. Y... Read more
Industry Note:
NYC HHAs Must Pay Back Nearly $70 Million
NYC HHAs must pay back nearly $70 million in improper Medicaid claims reimbursed from 20... Read more
Industry Note:
Kickbacks Conspiracy Yields Guilty Verdicts
Florida court convicted four individuals of kickbacks conspiracy charges related to home... Read more
Industry Note:
Preventing Falls Tops Safety List For HHAs
Preventing falls is one of the measures stressed in this year’s National Patient S... Read more
Industry Note:
MAC Cracks Down On LUPA Threshold
Make sure your documentation for episodes that barely exceed the LUPA threshold will sta... Read more
Industry Note:
Concealing Medicaid Fraud Lands HHA Employee In Prison
A former HHA staffing manager is facing 10 months in prison for allegedly altering recor... Read more
Industry Note:
Walgreen Co. Plans To Target Hospice Providers
Walgreen Co. wants your pharmacy business, as the industry giant will launch a national ... Read more
Industry Note:
Physician Convicted Of Falsifying Plans Of Care For HHAs
Falsified plans of care got a Houston-area physician in trouble with the Department of J... Read more
Industry Note:
Missed ADR Deadlines Trigger Auto Denials
Make Additional Development Request deadlines or risk auto denials, as one Medicare Admi... Read more
Industry Note:
New Tools To Secure PHI On Mobile Devices
Get expert help with protecting patient data on mobile devices, courtesy of the U.S. Dep... Read more
Industry Note:
Cancer Patients Need Earlier Hospice Referrals, Study Finds
Researchers call for earlier referrals for cancer patients, but payment policies are cre... Read more
Audits:
Use These Tactics To Prepare For ZPIC Audits
Why you should focus on 7 specific problems. With the wide variety of compliance issue... Read more
Compliance:
How To Win A ZPIC Appeal
What evidence is most compelling to auditors. Wading through the appeals process for Z... Read more
Regulations:
What The New Informal Dispute Resolution Provision Means For You
Keep these factors in mind when pursuing this alternative sanction. Along with a myria... Read more
Coding Corner:
Keep Your Functional Status Codes & Modifiers At Arm's Reach
 Cozy up to G-codes and modifiers for tracking patient status, goals and severity l... Read more
Management Strategies:
Build A Winning Team That's Loyal For The Long Run
Unlock the secret that motivates your employees and unleash their productivity with this... Read more
Industry Note:
MedPAC Calls For Lower Payments To HHAs
Commission wants to repeal the Medicare SGR, too. You’ll have lower home health ... Read more
Industry Note:
CMS Announces Possible Future Hospice Data Collection
The Centers for Medicare & Medicaid Services wants more hospice data, responding to ... Read more
Industry Note:
WebEx Training Module for Hospice QRP Data Entry Now Available
You now have help with the Hospice Quality Reporting Program, in the form of a WebEx tra... Read more
Industry Note:
False Claims Act Nets Nearly $5 Billion in FY 2012
Federal watchdog agencies netted nearly $5 billion in False Claims Act collections ... Read more
Industry Note:
HHA Fraudsters Get Prison Time, Multi-Million-Dollar Restitution
Michigan HHA employees get prison sentences and millions in restitution for a $13.8 mill... Read more
Industry Note:
IRS Passes New Medical Device Tax
The new medical device tax may make your costs skyrocket, especially when the added cost... Read more
Industry Note:
OIG Wants Tougher Scrutiny of Hospice Claims
The OIG released its Compendium of Unimplemented Recommendations (December 2012 Edition)... Read more
Industry Note:
Fiscal Cliff Talks Focus on Medicare Cuts
Medicare cuts and changes come to the table as the "fiscal cliff" looms, with ... Read more
Industry Note:
Medicaid Audit Programs Hemorrhaging Money, GAO Says
Medicaid is paying twice for audit activities, according to a GAO report released on Dec... Read more
Industry Note:
Your Dual-Eligible Patients Have Varying Consumer Protections
Your dual-eligible patients have varying consumer protections depending on the particula... Read more
Regulations:
Don't Count An Extra Therapy Visit By Mistake Under New Rules
Final rule language leaves many agencies with wrong impression, expert warns. If you thou... Read more
Hospice:
Use Correct Patient Status Codes, CMS Urges Hospices
Also: You're still the one responsible for your quality data submission, not your vendor.... Read more
Compliance:
OIG OKs Free Program Offering Non-Skilled Services
3 factors keep proposed arrangement in the clear. The OIG has put its stamp of approval o... Read more
Kickbacks:
Beware Pitfalls In Furnishing Bridge Services
Follow these 5 steps to compliance. If you want to protect your free services program by ... Read more
Industry Note:
DME Suppliers Top GAO's List Of Fraudsters
But HHAs aren't doing too badly at all. The percentage of home health agencies that were ... Read more
Industry Note:
Study Points To Enrollment Policies As Factor In Hospice Underuse
Payment limitations may be more of a factor in hospice underuse than many providers think... Read more
Industry Note:
Check Claims For Patient Name/HIC Number CWF Mismatch
If you’re seeing more returned claims due to a patient name or HIC number mismatch... Read more
Industry Note:
Get SNF Hospice Patient And Enrollment Answers From Palmetto
A recent question-and-answer session with Palmetto GBA revealed helpful advice from a pa... Read more
Industry Note:
Register Now For Therapy Functional Reporting Call
Want to get up-to-speed on therapy functional reporting? CMS is holding a National Provi... Read more
Industry Note:
SEC Concludes Financial Compliance Investigation
Recently completed Securities and Exchange Commission investigations handed down a clean... Read more
Industry Note:
Prepare For Mileage Rate Increase
Get ready to pay more for mileage, as the IRS is increasing business travel mileage rate... Read more
Industry Note:
HHA Closes After Losing Medicare, Medicaid Payment
ABC Homecare LLC closed after losing its Medicare and Medicaid reimbursement, following ... Read more
Industry Note:
HHA Owner Sentenced For Home Care Fraud In St. Louis
HHA owner Rose Ray-Vasser is facing 30 months in prison and $398,000 in restitution for ... Read more
Survey & Certification:
Surveys More Crucial Than Ever Under Alternative Sanctions
At least CMS won't publish your survey indiscretions in your local newspaper. Get rea... Read more
Compliance:
Get To Know These New Alternative Sanctions
Payment suspension sanction gets a little less punishing. Starting next summer, surve... Read more
Reimbursement:
CMPs May Crush HHAs
Daily fines add up quickly. Home care providers hungry for details of how surveyors, ... Read more
Regulations:
New Sanctions Put You At Surveyors' Mercy
Experts skeptical of checks and balances. What may bother home health agencies even m... Read more
Education:
Bone Up On PPS Final Rule
You can receive vital information on the 2013 prospective payment system final rule from... Read more
Industry Note:
Whistleblower Suit Leads To $1.3 Million Settlement
Hospice owner personally liable for $200K. More evidence that the feds are cracking d... Read more
Industry Note:
OIG Highlights Home Care Fraud
The HHS Office of Inspector General's latest semiannual report is playing the agency's g... Read more
Industry Note:
Data Mining-Triggered Edits On Deck
If your billing patterns make you stick out like a sore thumb, you may see pre-payment c... Read more
Industry Note:
New Year Brings Double Duty For Hospice Quality Data Reporting
January will be a busy month for hospices, quality reporting-wise. The hospice quality r... Read more
Industry Note:
Beware LUPA Glitch For High Therapy Episodes
If you want to receive the roughly $95 you're owed for a LUPA add-on amount when high-th... Read more
Industry Note:
Benchmark Yourself Against MAC's LOS Data
Want to see where you stack up against your peers when it comes to non-cancer lengths of... Read more
Industry Note:
Use Post-Discharge Study To Sway Hospitals
Looking for a way to convince hospitals that they should partner with you to reduce read... Read more
Industry Note:
Access Palliative Care Tool
If you're seeking educational materials to introduce the concept of palliative care to y... Read more
Industry Note:
Nurse Sentenced For Home Care Fraud In Detroit
A home care nurse defendant has drawn a two-and-a-half-year prison term in the $13.8 mil... Read more
Hospice:
Data Reporting Burden Looms On Hospices' Horizon
Medicare may provide a little room on new dataset implementation, at least.Hospice provide... Read more
Quality:
Focus On These 2 Hospice Quality Measures For Next Few Years
Be sure you're collecting data now or lose money in 2014.Hospices' problems with one of th... Read more
Education:
Get Training On PPS Final Rule, Clinicians' Documentation
Plus: Learn how to protect yourself against common HIPAA pitfalls with employees' pe... Read more
Compliance:
OIG Fraud-Fighting Army Mobilizes For Investigations
Watchdog agency is intent on stopping fraud quickly with data analysis.The OIG has its eye... Read more
Diagnosis Coding:
Try This 6-Phase ICD-10 Transition Plan, Expert Urges
A working budget should encompass every aspect of planning, including productivity trainin... Read more
Industry Note:
Dodge Costly ADRs For Your Part B Therapy Services
Pay attention to preapproval requests under Medicare's new process.If you're submitting pr... Read more
Industry Note:
OASIS, Aide Waivers In Place For Hurricane Sandy
Waivers for certain Medicare regulations are effective Oct. 26 for New Jersey and Oct. 27 ... Read more
Industry Note:
Congress Budget Action Expected Soon
With the election over, providers' eyes are turning to Washington, D.C. to see how lawmake... Read more
Industry Note:
Improper Billing Of Test Strips Widespread, OIG Says
Your diabetic patients may have more difficulty obtaining their test strips following an O... Read more
Industry Note:
Caregiver Support Key To Hospital Readmissions
A new study confirms what many home care providers could readily tell you -- the leve... Read more
Industry Note:
MSW Salary Levels Rise In Home Care
Home health agency payment rates may be flat, but salary levels for their social workers a... Read more
Industry Note:
Cancer Patients Need Earlier Hospice Referrals, Study Says
Cancer patients could benefit more from hospice care if their physicians didn't wait so lo... Read more
Industry Note:
Medicare Audit Dogs California Hospice
Beware: You may have to fight a reputational problem as well as a financial one if you vio... Read more
Industry Note:
Catholic Health System Merges Home Care Units
The Michigan Health Ministries of Ascension Health, a Catholic healthcare system with six ... Read more
Prospective Payment System:
Medicare Rates Down Slightly Starting In January
CMS sticks to its case mix adjustment guns.A tweak to the inflation update means your epis... Read more
Therapy:
CMS Pulls Back Part-Way On 'Close To' Therapy Change
Other final rule changes seem good for therapy visit coverage.Home health agencies have re... Read more
Regulations:
Alternative Sanctions To Change Your Survey World
Penalties may close your doors faster than termination, observers warn.There's no dodging ... Read more
Industry Note:
Public Home Care Companies' Earnings Crunch Eases
Chain celebrates closure of SEC investigation.Medicare rate cuts continue to take their to... Read more
Industry Note:
Flooding, Blackouts, Fuel Shortages Plague Home Care Providers In Wake Of Superstorm
Home care providers have been undertaking valiant measures to help patients impacted by Hu... Read more
Industry Note:
HIPPS Validation Underway For Post Acute Providers
Get ready for another claims processing hurdle to block your way to Medicare payment.The C... Read more
Industry Note:
Celebrate National Home Care & Hospice Month With These Themes In Mind
Don't forget to celebrate your staff, patients, and referral sources during National Home ... Read more
Industry Note:
Access Free CMS Training On New Hospice Quality Data Reporting
You can get some help from CMS on hospice quality data reporting and submission, starting ... Read more
Industry Note:
Use Your Current ABN Form Even Though It Expired Last Month
Even though your Medicare-issued advance beneficiary notice (ABN) form has an expiration d... Read more
Industry Note:
Senior Living Co. Buys FL's Largest Home Care Provider
Senior living company Emeritus Corp. plans to purchase Florida-based Nurse on Call, it say... Read more
Industry Note:
Hospice CFO Sentenced For Embezzlement
A system of checks and balances in your finance department may help you avoid the fate exp... Read more
Hospice:
Consider Correcting Occurrence Code 42 Claims
More hospice target areas may emerge.If you were unclear on how to use a certain discharge... Read more
Billing:
Where Is My Hospice PEPPER Report?
Some hospices to receive corrected reports.Not all hospices received a PEPPER report, but ... Read more
Diagnosis Coding:
M1024 Change Could Cut $200 Per Episode
Agencies won't get proper credit for patients' conditions if CMS finalizes coding revision... Read more
Prospective Payment System:
Expect Major Case Mix Changes If These Diagnoses Get the Ax
Will case mix points for resolved conditions become a thing of the past?Home health provid... Read more
Industry Notes:
Superstorm Puts Providers' Emergency Plans To The Test
One hospice facility evacuates.An unusual late season hurricane mixed with winter storm we... Read more
Industry Notes:
Take These Steps Now To Address Clarification Of 'Im-provement' Coverage Criteria
You can implement changes now in re-action to a proposed class action lawsuit eliminating ... Read more
Industry Notes:
Resubmit Claims Now That PECOS Glitch Is Resolved
Medicare has cleared up a claims system glitch that was halting providers' cash flow. "A n... Read more
Industry Notes:
Keep These National Patient Safety Goals In Mind For Coming Year
Preventing falls is one of the measures stressed in this year's National Patient Safety Go... Read more
Industry Notes:
California VNA Buys Mountain Area Agency
VNA Hospice & Palliative Care of South-ern California has purchased Rim of the World H... Read more
Industry Notes:
Closure Of Non-Profit Home Health Agency Threatens Home Care Access
Patients in Nevada's rural areas may face home care access problems following the Oct. 31 ... Read more
Industry Notes:
National Chain Secures New Credit Agreement
Amedisys Inc. has entered into a new $225 million unsecured credit facility agreement and ... Read more
Industry Notes:
Physician, HHA Owner, Recruiter Convicted In Detroit Fraud Case
The feds are proving that they're no longer keeping their hands off docs when busting a ho... Read more
Hospice:
Quality Reporting Burdens May Sink Small Hospices
Hospice providers give CMS an earful on quality reporting proposals.Hospices are hoping to... Read more
Quality:
Hospices Protest 'Comfortable Dying' Details
Some patients should be excluded from this new quality reporting measure, providers tell C... Read more
Strategy:
Challenges Bring Opportunity For Home Care
Now's the time to advocate for your industry.For home care providers, it's an increasingly... Read more
Coverage:
Lawsuit Settlement May Swell Your Patient Rolls
Agreement in class action suit should torpedo improvement criteria.Get ready to do away wi... Read more
Industry Note:
Background Checks May Cut Aide Misdeeds Up To 20%
Many nursing home aides with findings of neglect, abuse, or theft have previous criminal h... Read more
Industry Note:
Hit ADR Deadlines Or Throw Away Cash
Don't be late in responding to additional development requests, or you could be very sorry... Read more
Industry Note:
MAC Targets Claims With 5-7 Visits
Make sure your documentation for episodes that barely exceed the LUPA threshold will stand... Read more
Industry Note:
Watch Out For New Claims Requirement
You'd better be sure your beneficiaries' names and HICN numbers match what's in the Com-mo... Read more
Industry Note:
Lawmakers Look For 'Doc Fix' Funds
Hold onto your wallets -- Congress expects to approve a potentially reimbursement-dra... Read more
Industry Note:
Home Care Aides Aging With Their Clients
You may worry about the aging of your aide workers, but that's just how your clients may l... Read more
Industry Note:
Hospital Sells Hospice Unit In Georgia
Hutcheson Medical Center in Fort Oglethorpe, Ga., will sell its hospice unit, Hutche-son H... Read more
Industry Note:
Home Care Fraudster Earns Decade Jail Term
A Miami HHA owner has received a 10-year prison sentence after pleading guilty to Medicare... Read more
Industry Note:
Man Pleads Guilty To Medicaid Fraud In MN
A Minneapolis-area man has pled guilty to half a million dollars in Medicaid fraud. Throug... Read more
Industry Note:
U.S. Attorney Drops Kickback Charge In TN
The U.S. Attorney's Office in Nashville has dropped its temporary restraining order agains... Read more
Fraud & Abuse:
More Providers' Payments Suspended For Fraud Charges
Will your billing pattern put you on the target list for suspension?Medicare home care fra... Read more
Enforcement:
Feds Indict Fraudsters In Hot Spots Nationwide
HHAs with patients from indicted doc see no suspensions -- yet.Legitimate home care p... Read more
Know Your Facts:
These Stats Keep You On Investigators' Radar
Number of HHA subjects investigated skyrocketed 125 percent in five years.Federal investig... Read more
HIPAA:
Even CMS Accidentally Breaches Patient Privacy Sometimes
OIG investigates CMS's ability -- or lack of -- to keep benes' PHI private.Maint... Read more
Patient Privacy:
Follow These 6 Tips To Sidestep HIPAA Notice Costs
Avoid spending thousands to clean up HIPAA compliance issues.How would your home care agen... Read more
Industry Note:
Here's Another Reminder To Check The OIG Exclusion List
Kansas provider pays up for employing excluded individual.You should have lots of good rea... Read more
Industry Note:
MAC Shoots Down Common F2F Documentation Phrase
Think your docs' face-to-face documentation can slide by with a simple statement, "taxing ... Read more
Industry Note:
Provider Pays $1.5M HIPAA Fine Over Laptop
Remember, criminals don't have to actually use your patients' private health information f... Read more
Industry Note:
CMS Ups Readmission Penalties For 1,420 Hospitals
Hospitals that refer patients to you now might have an even more compelling reason to use ... Read more
Industry Note:
Tap New OASIS Training
Check out new OASIS-C training modules at http://surveyortraining.cms.hhs.gov/pubs/Provide... Read more
Industry Note:
60-Day Notice For PECOS Edits Stands
Physician PECOS edits may be coming your way soon, but CMS still will give you a heads up ... Read more
Industry Note:
Don't Let Venipuncture Confusion Trip Up Coverage
You need to know your coverage ins and outs to figure out whether your patient's venipunct... Read more
Industry Note:
Stick To ADR Deadlines
If you dawdle on responding to ADRs, you're putting your own cash flow at risk. So warns H... Read more
Industry Note:
Chain Pares MCO Biz
Home care chain Amedisys Inc. has changed its service agreement with Humana Inc. The chang... Read more
Industry Note:
Pneumococcal Vaccine May Get More Effective For Elderly
Your patients may receive better protection against pneumonia in the future, depending on ... Read more
Regulations:
Surety Bonds May Soon Burden Home Health Agencies
OIG revives its call for this long-delayed unrealistic requirement.Add one more expense to... Read more
Know Your Facts:
Industry Growth Draws OIG's Interest
HHAs exceed pre-interim payment system levels.Why is the OIG so gung ho on home health age... Read more
Compliance:
OIG Targets Face-To-Face Compliance For Scrutiny
Will your F2F documentation pass muster?A federal watchdog's investigation of home health ... Read more
Therapy:
Improve Patients' Outcomes -- Heed Mental Impact Of Trauma
Fall-induced PTSD can hinder ADLs.Are you noticing patients who have experienced falls and... Read more
Strategy:
4 Steps To Improve Hip Fracture Therapy
Strategies to help patients "work through their fear of falling" include the following, sa... Read more
Industry Note:
SNF Relationships Feature On Feds' Hospice Compliance Radar
Plus: Medicare may prorate hospitals' payment for patients transferred to hospice.The HHS ... Read more
Industry Note:
5010-Related Software Changes Plague Home Care Providers' Claims
Having trouble getting your claims to go through since Oct. 1? You might want to make sure... Read more
Industry Note:
Obtain Free Quality Improvement Help Here
You can obtain more free help with your quality improvement efforts from the Home Health Q... Read more
Industry Note:
Focus For Some SNF Patients Should Be On Palliative Care
Payment for palliative care should be incorporated into Medicare's skilled nursing facilit... Read more
Industry Note:
CMS To Turn On PECOS Edits 'Soon,' Agency Says
You're in a race against the clock to make sure your referral sources are enrolled in PECO... Read more
Industry Note:
Access Hospice Billing Report Training Online
If you missed Medicare's training session on the new hospice PEPPER comparative bill-ing r... Read more
Industry Note:
Washington Post Buys Regional Home Care Chain
The Washington Post Co. has agreed to acquire a majority stake in Mars, Penn.-based home c... Read more
Industry Note:
W. Va HHA Owner Pleads Guilty To Medicaid Fraud
A West Virginia HHA owner has pled guilty to Medicaid fraud charges. Shida Jamie of Golden... Read more
Regulations:
HHAs Fed Up With Face-To-Face Requirement
F2F mandate reduces access to home care, drives up rehospitalizations, commenters say.CMS ... Read more
Face-To-Face:
Industry Calls For 5 Major Face-To-Face Changes
CMS could streamline the requirement without a legislative change.The F2F burden is crushi... Read more
Enforcement:
Fraud Hammer Pounds Home Care Providers
Authorities bust fraudsters nationwide.Bad actors bilking Medicare and Medicaid home care ... Read more
Hospice:
October Brings New Hospice Requirements
Don't forget to make this claims change. With a new fiscal year come more than new... Read more
Industry Note:
Managed Care Numbers Climb
MA enrollment increased nearly 30% in 2 years.Your Medicare managed care headaches probabl... Read more
Industry Note:
HIPAA Penalties In Play
If a new Department of Justice conviction and guilty plea are any indications of what the ... Read more
Industry Note:
Try These Staff Flu Vaccination Strategies
Trying to figure out how to protect your staff and your patients from the flu this year, w... Read more
Industry Note:
Tap This Education Tool For New Therapy Review
One HHH Medicare Administrative Contractor is lending a helping hand in figuring out the n... Read more
Industry Note:
ABN Delivery May Be Simpler Than You Think
A question-and-answer on ABN delivery might make your scheduling a bit easier. "Can a Phys... Read more
Industry Note:
State Blocks OIG Recovery
The HHS Office of Inspector General wants New Mexico to recover $11 million from a Medicai... Read more
Industry Note:
Hospice Chain Grows
Walker, La.-based Doctor's Hospice has merged with Livingston, Ala.-based Legacy Hos-pice ... Read more
Industry Note:
Idaho Provider Drops Medicare Service Line
The Medicare home care business is getting less attractive as payment rates stagnate and r... Read more
Industry Note:
Hospital HHA Expands
Forrest General Home Care and Hos-pice in Hattiesburg, Miss., has opened a new branch offi... Read more
Reader Question:
Make Sure Patients Attend Right Kind Of Day Care Or Risk Homebound Problems
One MAC answers pressing day care-related questions.Question: Can I provide services to a ... Read more
Therapy:
'Close To' Elimination Will Wreak Havoc On Home Health Therapy
Drop the proposal for specific visit ranges, commenters urge CMS.Scheduling for therapy re... Read more
Regulations:
Therapy Visit Coverage At Stake In Final Rule
What happens if therapists miss a reassessment time point? Home health agencies may no... Read more
Hospice:
Sidestep Hospice Cert Pitfalls With These 4 Tips
Pointer: Use your own docs to persuade colleagues to improve documentation.So often for ho... Read more
Medical Review:
Step Up Your Hospice Cert Education Efforts
Tip: Your physicians are a critical tool.Certification errors are topping the list for hos... Read more
Industry Note:
Revisit Your Record Retention Policy Or Risk Yanked Billing Privileges
Medicare ups the retention period to 7 years.The feds may have given you a motivating fact... Read more
Industry Note:
Medicare Issues Therapy Cap Letters To Home Health Patients
If you furnish therapy only under home health, you probably thought the Part B therapy cap... Read more
Industry Note:
Sequestration Pay Cut Looms
As the Jan. 1 deadline for sequestration cuts approaches, the health care industry's heavy... Read more
Industry Note:
Discipline Matching Not Necessary For F2F
Obtaining face-to-face documentation from referring physicians is hard enough -- don'... Read more
Industry Note:
Claims System Fix Solves Remittance Advice Problem
A Sept. 4 fix to the Medicare claims system has cleared up one problem encountered by HHAs... Read more
Industry Note:
Use Hospital Pay Change As Relationship-Builder
Now's the time to strengthen your relationships with hospitals, thanks to the payment chan... Read more
Industry Note:
Wait For Licenses Stretches In Commonwealth
Virginia may have ended its moratorium on new HHA licenses, but that doesn't mean new agen... Read more
Industry Note:
Beware Employees With Sticky Fingers
Reimbursement and compliance problems aren't the only threats to your cash. Keep a close e... Read more
Industry Note:
Doc, Owners, RN Indicted In Detroit Fraud Scheme
Home care-related indictments continue to come down in the Detroit area. This time, the fe... Read more
Reader Question:
Make Sure An MSW Is Supervising Social Work Assistants
Tip: Consult your state regs for exact documentation requirements.Question: "I thought onl... Read more
Prospective Payment System:
Home Care Providers Slam 2013 Cuts For Case Mix Creep
Rural areas see access problems, reps say.Home health agencies should see an increase in t... Read more
Finance:
Is Your Cost Report Data Good Enough To Base Your Rates On?
Providers want rebasing year moved to 2011.The feds are gearing up for PPS rebasing, but h... Read more
Reimbursement:
Commenters Plead With CMS To Fix Wage Index Problems
HHAs face uneven playing field against hospitals.Every year, providers protest the inequit... Read more
Billing:
Get Your Docs' NPIs On The Claim By January
PECOS edit deadline continues to hang over providers' heads.You'd better make sure you hav... Read more
Industry Note:
Post-Acute Bundling Looms On Home Care Horizon
Will hospitals control HHA payments some day?The results aren't yet in from demonstration ... Read more
Industry Note:
Check Your 2013 Hospice Medicaid Rates
Hospices waiting for official notice of Medicaid rates will find they look very familiar, ... Read more
Industry Note:
Shadow Your CAHPS Vendor
You -- not your vendor -- will be left holding the bag if your vendor fails to s... Read more
Industry Note:
MAC Sends Takebacks In Blue Envelopes
You may soon get to dislike the color blue, if HHH Medicare Administrative Contractor CGS ... Read more
Industry Note:
Decode Your Appeal Status In DDE With This Info
Once you've filed an appeal for a Medi-care claim, you can turn to the Direct Data Entry s... Read more
Industry Note:
National Chain Makes Buys On West, Gulf Coasts
National chain Gentiva Health Services Inc. has a few more feathers to put in its mergers ... Read more
Industry Note:
New York Times Profiles Hospice Patient Appeal Case
Hospices can expect to hear more about beneficiaries appealing their coverage of items and... Read more
Industry Note:
HHA Owner Gets 20 Months For OASIS Falsification
Illegally changing OASIS assessments has netted one Illinois woman a 20-month prison sente... Read more
Industry Note:
Hospital Acquisition Of County HHA Stalls In Georgia
The sale of Wayne County, Ga.'s home health department may stall thanks to management cont... Read more
Regulations:
Claims Become Source For Hospital, ER Measures
But the hospitalization change takes place only on your CASPER reports.Your hospitalizatio... Read more
Hospice:
Tap These New Resources For Quality Reporting Info
Hospices can turn to two new user guides and a training session.The specifics of Medicare'... Read more
Compliance:
Check Your Employees Carefully Against Exclusions List
Two home care providers face big repayments due to excluded employees.You could have to co... Read more
Therapy:
Know Your Part B Therapy Review Ropes Or Face Big Payment Delays
HHAs furnishing outpatient therapy should pursue advanced approval when pushing $3,700.CMS... Read more
Emergency Preparedness:
Gulf Coast Providers Kick Emergency Plans Into Gear In Face Of Hurricane Isaac
Disruptions won't be over right away.If you've let your emergency preparedness plan quietl... Read more
Industry Note:
ICD-10 Implementation Date Finalized For Fall 2014
One-year delay to new diagnosis coding set gives providers some breathing room.The pressur... Read more
Industry Note:
Revocation For Hospice Patients Entering Nursing Homes Raises Red Flags
Medicare contractors are putting hospices on notice that they are watching for shady deali... Read more
Industry Note:
Watch For This Claims System Fix In September
Home health agencies should have one less claims glitch to worry about soon.The problem: C... Read more
Industry Note:
Feds Join Whistleblower Suit Filed By Former Hospice VP
Add one more whistleblower action to the list of lawsuits the feds have joined. U.S. Distr... Read more
Industry Note:
HHH MAC Offers Replays Of Education Sessions
Have you missed out on helpful educational sessions from your Medicare contractor due to a... Read more
Industry Note:
Volunteer State HHAs Agree To $9 Million Settlement
Fees paid under cost-based reimbursement lie at the heart of a $9 million settlement agree... Read more
Industry Note:
Miami Nurses Handed Guilty Verdicts For Diabetes Scam
Two more RNs have been convicted in the Ideal Home Health fraud case in Miami.RNs Odalys F... Read more
Industry Note:
Hospice Co. Partners With Retirement Community
Phoenix-based Banner Health has entered into a partnership agreement with Sun Health's Gra... Read more
Compliance:
Review Your Employee Bonuses Carefully
New indictment casts doubt on furnishing employee incentives.What you call a good marketin... Read more
Prospective Payment System:
Brace For Case Mix Diagnosis Coding Changes In 2013
Will you take a hit on resolved diagnoses?Prepare to see a reduction in home health reimbu... Read more
Diagnosis Coding:
Grouper Calculation To Change Based On This Coding Shift
PPS methodology leaves agencies with questions.The Centers for Medicare & Medicaid Ser... Read more
Case Mix:
Use Only These V Codes In M1024
These codes were included in the Cen-ters for Medicare & Medicaid Services' Attach-men... Read more
Industry Note:
Home Care Companies Hit Acquisition Trail
Providers change hands nationwide.Home care providers have been busy in the mergers and ac... Read more
Industry Note:
OIG Wants Outlier Cap Lowered
HHAs serving a high number of outlier patients under the prospective payment system may se... Read more
Industry Note:
Hospice PEPPER Training Full
If you're trying to figure out how to use the new hospice comparative billing report Medi-... Read more
Industry Note:
New Round Of DME Bidding Launches
Registration is now open for Medicare's competitive bidding round 1 recompete for durable ... Read more
Industry Note:
Recovery Audit Contractor Prepayment Reviews Start This Month
Now that Recovery Audit Contractors have named home health agencies as specific targets (s... Read more
Industry Note:
Senior Population Continues To Grow As Challenges To Recruiting Aides Intensify
Your patient pool will continue to grow in coming years, confirms a new government report.... Read more
Industry Note:
Medicare Smoothes Some Of PECOS' Rough Edges
Registering with CMS's PECOS system has had its share of headaches, but CMS has made a few... Read more
Industry Note:
Miami HHA Owner Pleads Guilty In $60M Scheme
A Miami home health agency owner has entered the latest guilty plea in a $60 million Medic... Read more
Industry Note:
Download Newest Version Of PPS Pricer, Including A Fix For LUPA Add-On
You can download an updated version of the HH PPS PC Pricer at www.cms.gov/Medicare/... Read more
Fraud & Abuse:
OIG Slams HHAs For Inappropriate Billing
Is a moratorium in the industry's future?Home health agencies' lives could get even harder... Read more
Compliance:
Take These 4 Steps To Minimize Compliance Risk With OIG Stats
Where do you stand on these 6 risk factors?In an unprecedented move, the OIG has revealed ... Read more
Education:
Get Training On Coding Crucial To Your Reimbursement, Compliance Record
Plus: Learn how to negotiate the hospice-nursing home minefield and protect yourself aga... Read more
Tool:
Benchmark Yourself Against These 6 Factors
\"These six measures of questionable billing indicate potential fraud,\" the HHS Office of... Read more
Industry Note:
Profits Fall For Publicly Traded Home Care Chains
One company bucks the trend with increased income compared to last year.The 2.3 percent Me... Read more
Audits:
RAC Posts Painful HHA Audit Topic
Brace for complex medical review based on medical necessity and eligibility.Get ready to f... Read more
Industry Note:
Court Highlights Hospice Beneficiary Appeal Process
Hospices may have to cover more drugs and services they don't approve, thanks to a court c... Read more
Industry Note:
HHH MAC Denies Hospice Claims With Vague Diagnoses As Non-Terminal
Don't submit a claim with one of these diagnoses, unless your documentation thoroughly bac... Read more
Industry Note:
Use This New Interactive Map From CMS To Find Your Compliance Bearings
Do you find the alphabet soup of Medicare contractors who deal with your payment and compl... Read more
Industry Note:
Former Miami HHA Owner Pleads Guilty To Fraud
A former Miami home health agency owner has pled guilty to a $42 million Medicare fraud sc... Read more
Industry Note:
Hospice Medical Director Indicted In Philly
Hospice medical directors are not out of reach of the long arm of the law. Last fall, Matt... Read more
Industry Note:
Hospices Continue Trend Of Opening Facilities From Coast To Coast
The number of hospice facilities seems to be increasing as fast as the feds' scrutiny of h... Read more
OASIS:
Improve Your Case Mix By Sidestepping These 3 Pitfalls
Don't forget that your OASIS assessments drive your cash flow.Boosting your case mix accur... Read more
Training:
Hit These 3 Training Areas To Hone Case Mix Accuracy
Try this expert technique to improve OASIS data.Once you've studied your agency's case mix... Read more
Therapy:
Keep An Eye On Codes For Outpatient Therapy
Get some clues about home care's future in the proposed physician fee schedule for next ye... Read more
HIPAA:
Don't Let Your Business Partners Trip Up Your HIPAA Compliance
VNA notifies patients of stolen laptop.How far do you want to go in policing your business... Read more
Industry Note:
HHAs To See Outlier Relief At Last
Latest fix is successful, contractors report.Home health agencies suffering for taking on ... Read more
Human Resource:
Find Out How Well You Know Your Crew
Are your workers in the right positions for their personalities, goals, and skill sets? As... Read more
Industry Note:
Medicare Payment Pattern Program Focuses On Hospice Hot Spots
Watch closely for a FedEx delivery late this month that contains your hospice's statistics... Read more
Industry Note:
Feds, Insurance Carriers To Share Your Claims Data
You'll have more eyes looking over your claims for fraud, thanks to a new partnership betw... Read more
Industry Note:
Medicare Takes Care Of One 5010 Problem For You
Haven't found the time to convert your electronic remittance advices to 5010 format? That'... Read more
Industry Note:
Keep Unnecessary Frequencies Off HHABNs, MAC Advises
Don't provide too many details in a home health advance beneficiary notice, or you'll just... Read more
Industry Note:
Fix For Contractor Number Claims Glitch Fails Again
HHAs served by Palmetto GBA are still seeing problems with claims suspending to status loc... Read more
Industry Note:
National Chain Beefs Up Indiana Presence With Buy
Atlanta-based Gentiva Health Services Inc. has acquired Advocate Hospice in Danville, Ind.... Read more
Industry Note:
5-Location Chain Expands Hospice Service Area
Lutheran Home Care and Hospice has expanded its hospice program to York County, Penn., rep... Read more
Hospice:
Hospices Brace For Modest 0.9% Pay Increase
Wage index adjustment strips $100 million from hospice payments in 2013.Medicare payment r... Read more
ICD-9:
CMS Cracks Down On Diagnosis Coding For Hospice Patients
The codes you put on your claims will help shape hospice payment reform, CMS warns. &n... Read more
Diagnosis Coding:
Use These 3 Tips To Ramp Up On Hospice Coding
Pointer: You don't necessarily have to hire a credentialed coder.Hospices that haven't bee... Read more
Industry Note:
HHA Must Pay Nearly $200K In Age Discrimination Lawsuit
Don't underestimate the reputational costs of HR-related legal action.You're facing increa... Read more
Industry Note:
CMS Wants Bigger Wage-Adjusted Portion For Home Health PPS Rates
Your stake in the wage index lottery is going to get higher next year, if a proposal from ... Read more
Industry Note:
Beware Group NPIs On Your HHA Claims
If you're using the wrong physician NPI on your claims, expect some communication from you... Read more
Industry Note:
Some De-Identified CAHPS Data Banned
Home health agencies trying to figure out how patient satisfaction varies among different ... Read more
Industry Note:
Switch To 5010 RAs Before Aug. 1 Deadline
You'd better switch over to the 5010 version of electronic remittance advices (835s) by th... Read more
Industry Note:
ICD-11 Implementation Still A Long Way Off
Despite endorsement of a direct move to ICD-11 from the American Medical Association and o... Read more
Industry Note:
Know Which Supplies To Include On HH Claims
Confused over how to bill your supplies under home health PPS? HHH Medicare Admini-strativ... Read more
Industry Note:
Follow This Tip For Faster CERT Review Resolution
For faster resolution of your claims reviewed under the Comprehensive Error Rate Test-ing ... Read more
Industry Note:
Health System Sells Home Care Unit To VNA
VNA Care Network & Hospice of Worcester, Mass., plans to buy UMass Memorial Home Healt... Read more
Industry Note:
PTA Poser Pleads Guilty In Detroit Fraud Case
Another guilty plea has come out of the $13.8 million fraud case against Detroit-area HHAs... Read more
Survey & Certification:
Surveyors Gain New Arsenal Of Tools In Proposed Rule
CMS gives HHAS a survey wakeup call with alternative sanctions.Are you ready to pay $10,00... Read more
Enforcement:
Check Out 5 New Alternative Sanctions
How long would you survive under a payment suspension?As always, the Medicare program will... Read more
Regulations:
Surveyors To Use 6 Factors When Setting CMP Rates, Other Sanctions
Immediate jeopardy determination will make the biggest difference.How will a surveyor deci... Read more
Compliance:
Alternative Sanctions Come With A Silver Lining
Informal dispute resolution will give agencies a chance to point out surveyor mistakes.Med... Read more
Industry Note:
Whistleblower Lawsuit Leads To Hospice GIP Settlement
Atlanta hospice forks over half-million dollars to lay fraud charges to rest.You'd better ... Read more
Industry Note:
Your CAHPS Data Is Showing
Your Home Health CAHPS patient satisfaction data is now up on the Home Health Compare webs... Read more
Industry Note:
Outlier Payments Still Aren't Fixed
You'll have to wait a while longer for your outlier reimbursement. The Centers for Medi-ca... Read more
Industry Note:
CMS To Base ACH Rate On Claims Data -- Not OASIS
Don't be surprised to see your acute care hospitalization (ACH) outcome data change. CMS p... Read more
Industry Note:
Use This Free Hospice Quality Reporting Training
Trying to get up to speed on the new hospice quality reporting requirements that kick in t... Read more
Industry Note:
ACOs Continue To Expand
Still trying to figure out exactly what your role should be in Medicare's Accountable Care... Read more
Industry Note:
Docs Face 27% Pay Cut
Expect your referring physicians to be scrambling as their 27 percent Medicare pay cut loo... Read more
Industry Note:
CMS To Collect Data On Therapy Patient Function
Wondering how CMS may reconfigure the therapy portion of home health payment rates? Take a... Read more
Industry Note:
NYC Aides Win OT Suit
The battle over the federal "companionship exemption" to overtime laws continues, but that... Read more
Industry Note:
Detroit HHA Owners Face Kickback, Fraud Charges
Two more home health agency owners in Detroit are facing fraud charges. Usha and Dee-pak S... Read more
Prospective Payment System:
PPS Rates To Stay Flat Next Year
But watch out for legislative reimbursement cuts.For the first time in years, home health ... Read more
Therapy:
Proposed Therapy Visit Ranges Spell Trouble Ahead
CMS wants to eliminate the 'close to' standard for multi-discipline episodes.One therapy r... Read more
Regulations:
Get Ready For Intermediate Sanctions To Change Your Compliance World
2013 proposed rule also addresses hospice quality reporting.One of the biggest regulatory ... Read more
Hospice:
Will An OASIS For Hospice Come Your Way Soon?
Get a glimpse of the hospice quality measures on CMS's requirement short list.Expect to se... Read more
Certification:
Physicians' F2F Documentation Continues To Challenge HHAs
Proposed rule fails to address crucial face-to-face problems.A small change to face-to-fac... Read more
Hospice:
OIG Calls For Crackdown On Hospice-Related Drugs
Medicare paid Part D plans $34 million for medications that hospices should have covered, ... Read more
Human Resources:
Follow Up Promises With Action
Working on your trust-building skills will reap rewards for both you and your team.One of ... Read more
Industry Note:
Make Sure Teaching For Dementia Patients Includes This Documentation
Tip: Training caregivers counts toward this skilled need, new MAC article says.Worried abo... Read more
Industry Note:
Medicaid To Expand
Now that the U.S. Supreme Court has upheld the majority of the Affordable Care Act, you ca... Read more
Industry Note:
CMS Trains Docs On NPIs
If you're dealing with physicians who are stymieing your efforts to bill correctly, CMS is... Read more
Industry Note:
Submit Discharges Timely
To avoid hassles from durable medical equipment suppliers, you should get your discharge c... Read more
Industry Note:
Diabetes Incidence Grows
Don't be surprised to see an increasingly larger percentage of diabetic patients. Advances... Read more
Industry Note:
HHA Teaches Med Students
A Rhode Island home care provider will take an active role in making sure physicians under... Read more
Industry Note:
Chain Makes Texas Deals
LHC Group Inc. has entered into a home health joint venture with 25-hospital Texas Health ... Read more
Industry Note:
Feds Indict In Chicago
The crackdown on home health fraud continues, and it's not being tempered for physicians i... Read more
Coverage:
Reviewers Take Aim At Medical Necessity
CERT reviews turn up problems proving skilled need for home health patients.More reviewers... Read more
Medical Review:
Wage War On Medical Necessity Denials With These 5 Steps
Know the rules when it comes to coverage, or lose your hard-earned reimbursement.Follow th... Read more
Fraud & Abuse:
Hospice Settles Fraud Charges For $6 Million
Whistleblower lawsuit leads to $1.3 million reward for relator.Do you base any of your cli... Read more
Compliance:
Beware Of Board of Director Insider Deals
Non-profit hospice gets raked over the coals in the press for doing business with board me... Read more
Industry Note:
OIG Wants CMS To Strengthen Medicaid Home Care Oversight
GAO notes states' increase in home care options.The Affordable Care Act appears to be do-i... Read more
Industry Note:
Tap This Tool To Clear Up Your Billing Problems
Trying to troubleshoot your claims err-ors? One HHH Medicare Administrative Contractor is ... Read more
Industry Note:
HHH MAC Debuts New Resource To Help You Figure Out CERT Denials
Denials from the Comprehensive Error Rate Testing (CERT) project can confuse pro-viders, b... Read more
Industry Note:
Watchdog Agency Wants Your Feedback On Self-Disclosure Changes
Do you have thoughts on how to improve the OIG's self-disclosure protocol? The watchdog ag... Read more
Industry Note:
Minority Patients With Heart Failure Lag In Hospice Use, Study Says
Hospice advocates have long lamented that minority populations use hospice less than white... Read more
Industry Note:
Senior Medicare Patrol Steps Up Activity
The Senior Medicare Patrol Project is stepping up its activity. In 2011, the 54 Senior Med... Read more
Industry Note:
HHA Owner Draws 9-Year Prison Sentence
A Miami-area home health agency owner and employee have received stiff prison sentences af... Read more
Industry Note:
CDC Offers New Tools For Flu Prevention Education Aimed At Seniors
Add these new resources to your flu-prevention toolkit. The National Council on Aging has ... Read more
Reader Question:
Do You Really Want To Go Nuclear With Competitors' Kickbacks?
Weigh your options carefully when responding.Question: In this day and age of acute sensit... Read more
Medical Review:
Therapy Tops Home Health Claims Errors
Flesh out therapy documentation to fight denials and downcodes.You'd better dot your i's a... Read more
OASIS:
Expect Closer Scrutiny Of Your OASIS Assessments
HHAs see M2030 downcodes.Don't be surprised if medical reviewers are quicker to take your ... Read more
Hospice:
Follow These 7 Steps To Head Off Hospice GIP Denials
Make sure each GIP day can stand on its own.Your hospice General Inpatient claims may soon... Read more
Diagnosis Coding:
Should Providers Go Straight To ICD-11?
Heavy-hitting trade group will weigh in.Home care providers who aren't thrilled with the s... Read more
Budget:
MedPAC Revisits Home Health Copays In Report To Congress
Influential advisory body to Congress also focuses on home infusion.You'll have to deal wi... Read more
Industry Notes:
Home Care Wins Funding In Innovations Awards
Telehealth, staff training draw federal dollars.The Centers for Medicare & Medicaid Se... Read more
Industry Notes:
Hospice Saves Medicare Money
Besides all the good that hospice does for a patient and her family, the benefit also save... Read more
Industry Notes:
Follow This NPI Search Tip
You can now resume your regularly scheduled NPI checks. CMS has now resolved "the latency ... Read more
Industry Notes:
Know When To Ignore Claim Suspensions
Don't waste time and energy when your claims get suspended, advises HHH MAC CGS in its Jun... Read more
Industry Notes:
Home Health Chain Settles EEOC Disability Lawsuit
Medicare regulations aren't the only ones you have to worry about violating. Are you sure ... Read more
Industry Notes:
Doc To Pay Half Million For Accepting Kickbacks
Once again, the feds have gone after a physician who accepted kickbacks for referring pati... Read more
Industry Notes:
Former HHA Owner Gets 9-Year Jail Term
Another stiff prison sentence has been handed down in the case against Houston-based Famil... Read more
Industry Notes:
Regional Chain Gears Up For Acquisitions
Expect to see more acquisitions from seven-state chain Encompass Home Health Inc. The Dall... Read more
Industry Notes:
Tarheel State Adds Inpatient Hospice Facility
Growth of hospice inpatient facilities continues. The Lower Cape Fear Hospice & Life-C... Read more
Audits:
CMS Begins Cost Report Audits For PPS Rebasing
Sloppy cost reports will come back to haunt the home care industry.The feds' new effort to... Read more
Finance:
Standardize Financial Info With New Cost Reporting Guidelines
Industry strives to enhance uniformity of financial data.One of the home care industry's h... Read more
Hospice:
GIP Hospice Care Under Fire
MAC denies majority of claims with 7 or more general inpatient days.Scrutiny of hospice ge... Read more
Education:
Get Training On Confusing Therapy Assessment Concepts
Plus: Learn crucial tips on dealing with OASIS medication items. You can receive vital... Read more
Medical Review:
Review Lookback Period Booted
Your MAC could request files older than 1 year.When your HHH Medicare Administrative Contr... Read more
Industry Note:
GAO Praises HHA Payment Suspensions
But home care audits are relatively few.The Government Accountability Office continues to ... Read more
Industry Note:
RAC Focuses On RAPs Without Final Claims
Add one more HHA issue to the approved list of RAC audit topics. Recovery Audit Contractor... Read more
Industry Note:
5010 Deadline Cut Short By Calendar
You may have a few less days to make the switch to the 5010 claims format than you thought... Read more
Industry Note:
Seek Accelerated Payments For Outlier Shortfalls
If Medicare's underpayment of outliers is killing your bottom line, you should consider ap... Read more
Industry Note:
Avoid ADR Pitfalls With These MAC Tips
You can increase your chances of successfully defending your claims against additional dev... Read more
Industry Note:
HHS Funds Increased Availability Of Home Care
Demand for Medicaid home care services may increase under a program approved by the Afford... Read more
Industry Note:
LHC Rejects Plan For Sale After Strategic Review
It appears LHC Group Inc. won't go on the auction block after all. Earlier this year, the ... Read more
Industry Note:
Another HHA Owner Pleads Guilty In Detroit
The guilty pleas keep coming in the fraud case involving four Detroit-area home health age... Read more
Reimbursement:
Providers Wrestle With Common Working File Mistakes
CMS claims its hands are tied when it comes to inaccuracies in the Common Working File.Whe... Read more
Hospice:
Get A Glimpse Of Your Hospice Quality Reporting Future
You might want to work on your pain management strategies first.Required quality reporting... Read more
Regulations:
New HHCAHPS Data Wave Coming In July
Plus: Medicare's hospice cap catch-up should end by next spring.If your CAHPS data didn't ... Read more
Diagnosis Coding:
Get Your V Code Usage Straight
Warning: Don't confuse 'status' and 'attention to' V codes.Home health coders and V codes ... Read more
Industry Note:
Data Mining Leads To Hospice Fraud Settlement
Owners excluded from Medicare for 7 years.If your billing is outside the norm, you'd bette... Read more
Industry Note:
Small Businesses Eschew Tax Credit, GAO Finds
If you're not using the Small Employer Health Insurance Tax Credit, you're not alone. When... Read more
Industry Note:
Observe These New Rules For 5010 Claims
Don't let technical oversights lead to claims rejections when Medicare starts enforcing th... Read more
Industry Note:
Prior Authorization Demo Slated For This Summer
Providers with patients who need power mobility devices are still waiting to hear when a d... Read more
Industry Note:
Refile RAPs For Claims Booted In Error For PECOS
If you had claims that received reason code 32072 before the PECOS edit was turned off, yo... Read more
Industry Note:
Correct Hospice Election Errors The Right Way
Watch out for errors on your Notices of Election, or you'll have to jump through a lot of ... Read more
Industry Note:
CMS Gives Benchmark Data To Oxygen Billers
Providers who furnish home oxygen will get a chance to measure themselves against their pe... Read more
Industry Note:
Virginia HHA Owner Indicted For Bogus Claims
A Medicaid home care agency owner in Virginia has been indicted for submitting claims for ... Read more
Reader Question:
Keep Physician Communication Open To Avoid Getting Stuck With The Bill
Make sure the ordering doc is on board with your care plan early on, experts advise.Questi... Read more
Diagnosis Coding:
Is A Further ICD-10 Delay In The Cards?
AMA wants a longer postponement to 2015.Whether you submitted comments on the new proposed... Read more
OASIS:
Bust These SOC OASIS Myths
Not every visit made to complete the comprehensive assessment and OASIS is billable.Accura... Read more
Fraud & Abuse:
OASIS, Documentation Troubles Featured In OIG's Latest Report
Watchdog agency lists millions in fraud settlements from the last six months.The feds want... Read more
Human Resources:
Keep Employees Enthused And Committed To Change
Change is inevitable and so is resistance to it. Take these steps to help your team deal w... Read more
Industry Note:
Keep An Eye Out For Looming PECOS Edit Date
Make sure your physicians are enrolled well ahead of time.The upcoming Medicare claims edi... Read more
Industry Note:
PTAN vs. NPI
Medicare maintains so many acronyms that it can be a full-time job to keep track of them. ... Read more
Industry Note:
Observe 5010 Deadline Next Month
If you've been taking advantage of CMS's 5010 enforcement "discretion period," your time's... Read more
Industry Note:
Reschedule Your NPI Look-Up Tasks
Trying to look up your docs' NPIs? You may have to get creative about when to accomplish t... Read more
Industry Note:
MACs Are Back To Assessing Hospice Cap Overpayments
Hospices' vacation from cap-related overpayments is over. CMS has sent a directive to HHH ... Read more
Industry Note:
Compare Yourself To Peers With New NCLOS Stats
Wondering how your hospice patients' length of stay stacks up to your peers? Check out one... Read more
Industry Note:
'Hospital At Home' Programs Wave Of The Future
Instead of bludgeoning the home care industry for fraud and abuse or other perceived misde... Read more
Industry Note:
Download Newest HHPPS Pricer, CMS Says
You can download the newest version of the Home Health Prospective Payment System PC Price... Read more
Industry Note:
DON Lands 8-Year Jail Term In Texas Fraud Scheme
In Houston, a $5.2 million Medicare fraud scheme has landed a former director of nursing w... Read more
Regulations:
Ready, Set, Check! CMS Approves Checkboxes For F2F Documentation
Beware the fine print, however.Medicare has finally loosened up on some unnecessarily stri... Read more
Hospice:
MAC Cracks Down On Claims For Long-Stay Hospice Patients
One edit of long-stay patients sees 97% denials.Medicare is clamping down on payments for ... Read more
Certification:
How Much Help Can You Give Docs On F2F?
CMS weighs in on handing out sample documentation.Medicare officials insist that physician... Read more
Medical Review:
Cover These Documentation Bases For Alzheimer's
Train your clinicians on what reviewers will be looking for.How do you prove that your pat... Read more
Human Resources:
Help Your Employees Deal With Their Baggage
When one of your employees experiences a personal tragedy, it can affect the entire office... Read more
Industry Note:
Looming Hospital Pay Change Affects Home Care
Readmissions focus of Medicare's payment policy.Medicare wants to penalize hospitals with ... Read more
OASIS:
CMS Crackdown On OASIS Submission Starts This Fall
You must submit data for every episode, CMS says.Home health agencies that fail to submit ... Read more
Industry Note:
Director Fired For HIPAA Slip
If you're not paying too much attention to information security at your organization, prep... Read more
Industry Note:
Check This List To Avoid Revalidation Confusion
Providers who miss revalidating their Medicare enrollment will face CMS revoking their bil... Read more
Industry Note:
Billing Fix On Deck
Hospices that have had problems with incorrect suspensions of claims with reason code 3141... Read more
Industry Note:
Heed These ADR Tips
One HHH MAC wants to make the Additional Development Request (ADR) response process simple... Read more
Industry Note:
Consider Adjustments For Dementia Coding Update
If you use dementia codes 294.20, (Dementia, unspecified, without behavioral disturbance) ... Read more
Industry Note:
Tap These Billing Tools For Hospice
Need help with your hospice billing? HHH MAC NHIC has issued two new billing guides that m... Read more
Industry Note:
Enroll A Month Earlier
You can get a jump on enrollment paperwork, thanks to new 855 submission deadlines. "Provi... Read more
Industry Note:
Hospice Facility Building On The Rise
Following a trend seen across the country, one area of Virginia will see its hospice optio... Read more
Pay For Performance:
Medicare Chugs Closer To Home Health P4P System
Will you have to pay for your patients' high rehospitalization rates? The pay for perfor... Read more
Reimbursement:
Start Working On Your HH Compare Measures To Prep For P4P
Tip: Put some resources into quality improvement. The timeline for a home health pay for... Read more
Fraud & Abuse:
2 Home Care-Related Defendants Plead Guilty After Record-Breaking Fraud Bust
Industry must combat fraud rep. The feds just charged 107 individuals nationwide with Me... Read more
Finance:
Home Care Companies' Earnings Suffer In Latest Quarter
Reimbursement cuts, face-to-face write-offs mar chains' profits. The Medicare reimbursem... Read more
Industry Note:
Medicare Funds Projects That Use Home Care Strengths
Educating patients, implementing telehealth figure in Innovation awards. The Centers for... Read more
Industry Note:
Deadline For Comments On 1-Year ICD-10 Delay Is Nearly Here
Providers that have an opinion -- either positive or negative -- on the propose... Read more
Industry Note:
Get To Know This New Code
When a patient passes away, you have another code to put on your claim. CMS has introduce... Read more
Industry Note:
Home Care Earns Top Profits, Newspaper Highlights
The home care industry is having to fight another charge threatening its reputation. Once... Read more
Industry Note:
Therapy Edits Focus On High Utilization
If you furnish Part B outpatient therapy to patients in the home, you should pay attentio... Read more
Industry Note:
MAC Calls Providers On The Carpet For 5010
Think that your HHH Medicare Ad-ministrative Contractor hasn't noticed that you aren't su... Read more
Industry Note:
CMS Issues New Billing Instruction For Hospices
Starting Oct. 1, hospices need to note a billing wrinkle in the new 5010 format. In 5010... Read more
Industry Note:
Good News In Observation & Assessment Clarification
Wondering exactly what's required to justify billing observation and assessment code G016... Read more
Industry Note:
NC Agency Owner Faces Fraud Charges
A North Carolina home health agency owner has pled guilty to Medicaid fraud. Prose-cutors... Read more
Reader Question:
Don't Let Ignorance Cost You Therapy Cap Dollars
Use HIQA to find out where your non-homebound patients stand on their caps. Question: Wh... Read more
Medical Review:
MAC Denies Almost All Long-Stay HTN Claims
Medical necessity can be hard to prove for hypertension patients. If you're treating a p... Read more
Coverage:
Take These 8 Steps To Torpedo HTN Denials
Make patient, treatment changes the cornerstone of your documentation for hypertension pa... Read more
Hospice:
Hospices Off The Hook For Some Hospital Costs
CMS rep answers providers' hospice coverage questions in forum. Every hospice has been t... Read more
Billing:
CMS Clarifies Rules For Submitting MSP Claims
Hint: Record all beneficiary insurance cards, not just the Medicare one. Don't let Medic... Read more
Reimbursement:
Your Top 3 Secondary Payer Questions Answered
Understand coordination of benefits to receive your rightful reimbursement. Still have q... Read more
Industry Note:
Don't Pay Docs For Face-To-Face Documentation
Physicians must turn to Medicare for payment, Q&A says. If you cave in to physicians... Read more
Industry Note:
Facilities Pay For Late Data
Have you been wondering if Medicare would follow through on penalizing home health agenci... Read more
Industry Note:
Make Sure Your Docs Are Enrolled In PECOS Before It's Too Late
Indicators that PECOS edits may be right around the corner are increasing. Background: In... Read more
Industry Note:
New HHS Initiatives Boost Medicaid Home Care
The Department of Health and Human Services is sending mixed messages about the value of ... Read more
Industry Note:
OIG Blasts Use Of KX On DME Claims
You may need to get more careful about using KX modifiers on your DME claims. Background:... Read more
Industry Note:
Copay Proposals Dog Home Care Providers
The specter of copays continues to plague home care providers this budget season. After b... Read more
Industry Note:
Heed MAC Clarification On Hospice Revocation Billing
Billing can get tricky for patients who choose to revoke their hospice election. HHH MAC ... Read more
Industry Note:
Miami HHA Owner Draws 10-Year Prison Sentence
Three Miami HHA operators who pled guilty to Medicare fraud early this year have received... Read more
Industry Note:
Feds Make Another Record-Breaking Fraud Bust
Another nationwide coordinated fraud bust has taken place. Hundreds of federal agents fan... Read more
Fraud & Abuse:
Feds Train Fraud Spotlight On Home Care
Watch out for further fraud-fighting measures such as an HHA surety bond. The home care ... Read more
Reimbursement:
CMS Moves Full Steam Ahead On PECOS Edits
You can't use ABNs for docs lacking PECOS records, final rule says. The PECOS-related cl... Read more
Compliance:
Don't Hang Up The Phone On Fraud Complaints
Your report can contribute to CMS's 'heat map.' Home care providers often voice frustrat... Read more
OASIS:
Make Changes To Staff's OASIS Assessments The Right Way
Fraud case highlights important compliance aspect of OASIS. You could lose hundreds of d... Read more
Industry Note:
Double-Check Your CAHPS Data Submission Or Risk Payment
Don't forget, your data is now on public display. Medicare won't take any excuses when i... Read more
Industry Note:
HHH Medicare Administrative Contractor Deactivates PECOS Edit
Stay tuned about what to do with your claims erroneously denied by Palmetto GBA for lacki... Read more
Industry Note:
Training Webinars Will Be Available Online
Did you miss Medicare's April training sessions on the new hospice quality reporting requ... Read more
Industry Note:
Consider ABNs When Therapy Caps Apply
Home care providers that are furnishing Part B therapy services in the home should pay at... Read more
Industry Note:
HHAs Continue To Flub 855 Paperwork For CGS Revalidations
Home health agencies continue to have trouble with their revalidation applications for HH... Read more
Industry Note:
Revised PPS Fact Sheet Addresses F2F, Therapy
Looking for a resource to help educate patients, referral sources, your own employees, an... Read more
Industry Note:
Get Hospice Discharge Coding Correct Now, Before July 1 Changes Hit, CMS Urges
CMS is reorganizing its hospice discharge coding this July 1, but you also need to make s... Read more
Industry Note:
Hospice Partners With Michigan ACO
Wondering what your relationship with the new Accountable Care Organizations should look ... Read more
Industry Note:
Looming 30% Doc Pay Cut Translates To Big Budget Reductions Coming
Gear up for some ugly Medicare budget cutting at the end of the year. It may be an electi... Read more
Regulations:
HHCAHPS Data Debuts On Home Health Compare
Medicaid ABNs, observation & assessment billing, and therapy reassessment timing also... Read more
Compliance:
Don't Click That Link! Healthcare Providers Vulnerable To Online Security Threats
Take these steps to safeguard against medical identity theft. As a healthcare provider, ... Read more
Fraud & Abuse:
Reduce Your ID Theft Risk With 7 Steps
Surprise audits can serve as deterrents to theft. Consider these field-tested tips on clo... Read more
Industry Note:
Watch For New Medicare Wage Index System
Will unfair exceptions finally go away? CMS is recommending a new hospital wage index sy... Read more
Industry Note:
Slow-Declining' Diagnoses Top Hospice Denial List
You should cast a sharp eye on any hospice claims you submit with a primary diagnosis of ... Read more
Industry Note:
CMS Website Revamp Wipes Out Your Bookmarks
It seems to be a regular occurrence, but can still be a hassle. It's time to reset your b... Read more
Industry Note:
Zone 3 ZPIC Launches This Week
The newest ZPIC's start date has rolled around. Cahaba Safeguard Administrators, the Zone... Read more
Industry Note:
Hold Off On 56900 Claims Action
If you had ADR'd claims denied in error with reason code 56900 (not receiving medical rec... Read more
Industry Note:
Avoid Common 855 Pitfalls In Sections 5 And 6
Watch our for reenrollment form pitfalls when it's your turn to revalidate. "Many Medicar... Read more
Industry Note:
CMS Fraud Program Crunches Data At Big Brother Levels
The Medicare program may have a closer eye on you than you think. CMS "has implemented a ... Read more
Industry Note:
$1.5 Million HIPAA Lesson: Secure Your Hard Drives
Learn a lesson from one health plan's HIPAA disaster. Blue Cross Blue Shield of Tennesse... Read more
Industry Note:
New HHA Company Hits Acquisition Trail
A newly renamed investment company plans a Florida acquisition, and has a wider acquisiti... Read more
Industry Note:
Texas Home Care Chain Makes Dallas Buy
Mt. Vernon, Texas-based Jordan health Services has purchased Dallas-area HHA Tritrax Heal... Read more
Certification:
Beware F2F Documentation Signed By Residents
CMS answers about face-to-face requirements raise more questions. That face-to-face docu... Read more
Reader Question:
Outlier Payment Deficiencies Cripple Small Providers
Will the next claims system update fix the problem? Question: Is there anything we can d... Read more
Hospice:
Hospice Payment Reform Rolls Toward 2013 Date
Quality reporting, surveys, and more discussed by CMS reps at industry meeting. Congress... Read more
Quality:
Take A Look At Your Potential New Quality Measures For Hospice
Pain, dyspnea, and patient preferences figure in possible future quality measures. Want ... Read more
Medical Review:
Shore Up Your Terminal Illness Documentation, Coding
Expect scrutiny for claims with dementia as the primary diagnosis. Denials for terminal ... Read more
Therapy:
Expect More Medical Review Of Your High-Price Therapy
Heed therapy cap law's new provisions. Therapy cap exceptions now apply through Dec. 31,... Read more
Diagnosis Coding:
CMS Settles On One-Year Delay For ICD-10
Don't count on the delay quite yet, coding expert warns. Home care providers have been w... Read more
Industry Note:
Stay On Track For 5010 Usage
MAC frowns on using 4010 form. CMS may have delayed 5010 enforcement until July 1, but y... Read more
Industry Note:
Study Compares Post-Acute Costs
Home care is the cheapest care setting for post-acute care, and now the industry has the ... Read more
Industry Note:
Home Care Providers See High Nurse Vacancy Rates
Despite the sluggish economy, many home care providers continue to have problems finding ... Read more
Industry Note:
Medicare Contractors Look To RACs For Targets
Recovery Audit Contractors have announced their first home health topics (see Eli's HCW, ... Read more
Industry Note:
Obey Revalidation Date
If you got an extension on your Medicare enrollment revalidation deadline, don't assume i... Read more
Industry Note:
CMS Names More ACOs
The Accountable Care Organization payment model is growing, so you may not want to wait a... Read more
Industry Note:
Follow These Billing Tips For Hospice Room & Board
When submitting hospice room and board charges to secure a denial, make sure you're putti... Read more
Industry Note:
Federal Court Shoots Down Challenge To Extrapolation
Gentiva Health Services Inc.' challenge to an extrapolation case has been shot down in fe... Read more
Industry Note:
Multi-State Chain Makes Utah HHA Buy
Cornerstone Healthcare Inc. has bought Zion's Way Home Health and Hospice in St. George, ... Read more
Industry Note:
HHA Owners Plead Guilty
Two Miami HHA owners and two em-ployees have pled guilty to a $20 million Medicare fraud ... Read more
Referrals:
F2F Requirements Cut Into Home Care Referrals
CMS defends its face-to-face documentation requirements for physicians. Face-to-face doc... Read more
Regulations:
Homebound Problems Dominate Claims Denials
CMS also discusses new OASIS form, PPS rate cuts, and more at industry conference. Expec... Read more
Fraud & Abuse:
Hospices Feature In Fraud Cases
Whistleblower case leads to $700,000 settlement. It's not just owners of shady hospices ... Read more
Reimbursement:
Is Outdated Coding Delaying Your Reimbursement?
Watch out for these old codes. If you're receiving denied claims due to diagnosis coding... Read more
Diagnosis Coding:
Avoid These Invalid Codes
Additional codes that became invalid for 2012 include: 286.5 (Hemorrhagic disorder due ... Read more
Industry Note:
Keep An Eye On IPAB Legislation
Providers band together to protest Medicare payment board. The U.S. House of Representat... Read more
Industry Note:
Double-Check These Exceptions When You Miss The Timely Filing Deadline
Think you'll have to kiss some Medicare reimbursement good-bye because you missed the tim... Read more
Industry Note:
Steer Clear Of These Prohibited CAHPS Questions
You can add supplemental questions to your Home Health Consumer Assessment of Healthcare ... Read more
Industry Note:
Diabetes Prevention Saves Money And Boosts Outcomes
Your current and future patients may benefit from new research findings about preventing ... Read more
Industry Note:
Stick To Monthly Billing For Hospice, MAC Stresses
If you submit more than one claim per hospice patient per month, you're on Palmetto GBA's... Read more
Industry Note:
Download Newest PPS Pricer From CMS
You can download a new prospective payment system pricer for 2011. The PPS pricer, which ... Read more
Industry Note:
Bookkeeper Embezzled $171K From Hospice
Be sure you're monitoring your financial employees closely, or they may be taking money o... Read more
Industry Note:
SNF Class Action Settlement Benefits California Hospice
Poor behavior on the part of a nursing home chain has resulted in a boon for one hospice.... Read more
Fraud & Abuse:
6 Tips To Handle Patients From Troubled Referral Sources
CMS releases list of 78 HHAs suspended. It could be your worst nightmare: A referral sou... Read more
Budget:
Copay Pressure Increases, Thanks To MedPAC Report
The home care industry's high profit margins grab national attention. Home health agenci... Read more
Therapy:
Use OASIS To Turbocharge Your Therapy Documentation
These M0 items can help beef up clinical records in case of medical review. Your therapy... Read more
Utilization:
If You're Located In One Of The Places On This List, Expect Extra Scrutiny
Texas leads the pack with 11 of the 25 highest utilization counties. The Medicare Paymen... Read more
Industry Note:
Providers Get Another 3-Month 5010 Delay
Expect more technical assistance with the new claim format. Right after confirming that ... Read more
Industry Note:
CMS Sets April Dates For Hospice Quality Reporting Training
Mark your calendars for a free opportunity to find out about Medicare's hospice quality r... Read more
Industry Note:
23 Organizations Added To Community Transitions Project
CMS is putting more money where its mouth is when it comes to preventing unnecessary reho... Read more
Industry Note:
Appeals Results Bring Down CERT Error Rates, OIG Says In New Report
The Medicare program's payment error rate may not be quite as bad as it first appears. In... Read more
Industry Note:
Beware Form 1099 Problems At Tax Time
With the April 17 deadline for filing federal taxes coming up, it may be time to revisit ... Read more
Industry Note:
Neglect CAHPS Participation At Your Financial Peril
Unless you want to receive 2 percent less in Medicare payments in 2014, you'd better make... Read more
Industry Note:
Troubleshoot 31503 Claim Returns With This New Tool
You can tap a new tool from HHH MAC CGS to help with a common hospice claim error. Proble... Read more
Industry Note:
Hospital Launches Own Home Health Agency
You might want to improve your response time to referrals, or face increased competition.... Read more
Industry Note:
Tarheel State To See New Hospice Facility
The number of inpatient hospice facilities continues to grow. In Newport, N.C., the state... Read more
Industry Note:
Code Nonroutine Supplies Accurately Or Risk PPS Rates
Policymakers soon will begin the process of "rebasing" PPS rates. Will you get enough cre... Read more
Referrals:
Beware Reliance On One Referral Source
Beefed up enforcement is your new reality. You may be thrilled to have one physician or p... Read more
Compliance:
Take 10 Steps To Avoid Referral-Related Compliance Landmines
Tip: Make sure compliance training isn't just for staff orientation. The 78 home health ... Read more
Fraud & Abuse:
OIG Gives Home Health Coverage An 'A,' But Fraud Pilot Still On Deck
Only 2 percent of reviewed claims fail OIG's coverage test. A new federal report on home... Read more
Enforcement:
Lawmaker Calls For More Fraud Fighting In Home Health
CMS allows "rampant criminality" in Medicare, district attorney in Texas says. The reper... Read more
Industry Note:
Skip These Unnecessary Hospice ABNs
HHH MAC clarifies your notice requirements relating to missing face-to-face encounters. ... Read more
Industry Note:
Use New Claims Format Or Face Denials
It's no joke -- effective on April Fool's Day, your Medicare claims must be in the n... Read more
Industry Note:
Clear Up This Question About Allowing Additional Visits
If you're not sure how specific the physician's order needs to be to allow additional vis... Read more
Industry Note:
Docs' Full NPIs To Appear In PECOS Reports
You may now find it a bit easier to figure out if your referring physicians are enrolled ... Read more
Industry Note:
Revamped MSN Encourages Bene Fraud Reporting
Home care providers have long complained of Medicare's Medicare Summary Notices (MSNs) co... Read more
Industry Note:
NLRB Says You Must Post Union Information
Don't forget to comply with a new National Labor Relations Board rule requiring employers... Read more
Industry Note:
Medicare Scammers Target Diabetes Patients
You might want to give your diabetes patients a heads up that a new scam targeting them i... Read more
Industry Note:
Tout Your Programs That Reduce Hospitalization Costs
If you aren't building a program showing insurers that your services can save money throu... Read more
Industry Note:
HHA Owners, Docs, RNs Indicted In Chicago
Don't be surprised if it takes months -- or longer -- to see additional indictm... Read more
Fraud & Abuse:
HHAs Fight Reputational Damage In Wake Of Fraud Bust
Stay tuned to find out the identities of the 78 suspended HHAs. The entire home care ind... Read more
Referrals:
Take Your Anti-Fraud Message To Clients, Referral Sources
Sidestep reputational damage by hopping on the anti-fraud bandwagon. Smart home care pro... Read more
Compliance:
National News Sting Adds Fuel To The Fire
HHA denies wrongdoing in alleged fraud uncovered by grandma. You'd better make sure you'... Read more
Enforcement:
HHA Fraud Case Is In The Details
Recruiting patients at a homeless shelter tops list of indicted agencies' alleged misdeed... Read more
Human Resources:
Combat Your Coworkers' Chronic Negativity
Negative people can be downers, but you can help them channel their energy more positivel... Read more
Industry Note:
Look For HHA Intermediate Sanction Rule By Fall
OIG takes CMS to task for neglecting congressionally mandated enforcement tools. If it t... Read more
Industry Note:
CERT Program Racks Up OASIS Denials
You may want to review three vital OASIS items, or risk your Medicare payment in medical ... Read more
Industry Note:
Double-Check Your Revalidation Status
If you think you don't have to worry about revalidating your Medicare enrollment because ... Read more
Industry Note:
Medicare Enrollment Via PECOS Gets A Little Easier
Ever since CMS began asking providers to complete Medicare enrollments using the online P... Read more
Industry Note:
Smart Scheduling Eases Workers' Gas Price Woes
Gas prices have been on a steep rise since mid-December, and it's taking its toll on home... Read more
Industry Note:
HHH MAC Offers Answers To HHABN Questions
You should have until at least October before you have to worry about switching Home Heal... Read more
Industry Note:
Texas Health Marketer Pleads Guilty To Kickbacks
Once again, the feds aren't just targeting home care providers when busting Medicare frau... Read more
Industry Note:
Enroll In Inspector General's 'Compliance 101' Resource
With enforcement action getting more aggressive, now is a good time to review your compli... Read more
Industry Note:
Monitor Your Employees Or Risk Theft
Keep a close eye on your employees with purchasing power, or you may end up bilked of hun... Read more
Industry Note:
Restructured Debt Agreement Boosts National Chain
Gentiva Health Services Inc. has "obtained an amendment to its senior secured credit agre... Read more
OASIS:
Brace For An OASIS Crackdown
OIG trains its sights on HHAs' data collection and reporting. If you've been lax with yo... Read more
Quality:
Leadership Makes The Difference In Reducing Rehospitalizations, Study Says
Accountability is the key to success with this important outcome. You can kiss better re... Read more
Top 5 Strategies For Preventing Unplanned Hospitalizations
1. Fall prevention. 2. Agency awareness and support. 3. Front loading. 4. Medication manag... Read more
Fraud & Abuse:
78 HHAs Put On Suspension At Once As Part Of Fraud Bust
Be careful about which docs certify your patients for home care It's not just home care ... Read more
Human Resources:
Why Your Motivation Methods Aren't Working
There's no one size fits all. One of your employees doesn't seem as content with her job ... Read more
Industry Note:
Home Care Companies Earnings Drop In Latest Quarter
Amedisys inks managed care deal. The U.S. Senate's therapy inquiry, the face-to-face ass... Read more
Industry Note:
Reexamine Your Interpreter Responsibilities
If you've let interpreter services fall off your priority list, it may be time to change ... Read more
Industry Note:
Zone 3 ZPIC Start Date Set For April
Home care providers located in ZPIC Zone 3 can stop wondering who their Zone Program Inte... Read more
Industry Note:
CMS Puts Hospice Quality Reporting Training On Deck
Keep your schedule free next month for CMS training on hospice quality reporting. The vol... Read more
Industry Note:
Use New HHABN Form By April
Don't forget to start using the new home health advance beneficiary notice form by April ... Read more
Industry Note:
Exception Process For Therapy Caps Signed Into Law
An extension to therapy cap exceptions until Dec. 31 is now law. Part of the Middle Class... Read more
Industry Note:
Home Health Aide Is Most Sleep Deprived Job In U.S.
Not sure why your aide staff seem unmotivated? Perhaps it's a lack of sleep. According to... Read more
Reader Question:
Beware Claiming Therapy As Unrelated To Hospice
Reviewers are cracking down on what's considered unrelated to the terminal diagnosis. Qu... Read more
Hospice:
Check Your Hospice Hot Spots Before Reviewers Do
Expect the number of whistleblower suits aimed at hospices to rise. Recent action by the... Read more
Medical Review:
Fend Off Hospice Scrutiny With Data Details
Use these 7 tips to keep your rightful hospice reimbursement. Chances are a reviewer's g... Read more
Fraud & Abuse:
Gentiva Agrees To $25 Million Settlement Over Odyssey Continuous Care Fraud Charges
Five-year corporate integrity agreement requires education, audits. Another fraud settlem... Read more
Diagnosis Coding:
Move ICD-10 Conversion Down A Notch On Your Priority List
ICD-10 deadline will be postponed -- but for how long? Just three months ago, Cente... Read more
Reimbursement:
Use This ADR Tool To Hang Onto Reimbursement That's Yours
Providers pass on OIG's second chance to submit medical records. You have most likely he... Read more
Industry Note:
Home Care Ducks Budget Ax For Now
Doc fix gets funding from hospitals, SNFs. President Obama is expected shortly to sign t... Read more
Industry Note:
Tap Free OIG Exclusions Training
If you don't want to be on the hook for hundreds of thousands of dollars in Medicare repa... Read more
Industry Note:
Avoid These Revalidation Pitfalls
You might think you've submitted your revalidation to HHH MAC CGS and that that task is o... Read more
Industry Note:
CMS Troubleshoots PECOS System Problems,
You should find changes to the PECOS system that now make it easier to use, claims the Ce... Read more
Industry Note:
Avoid Trouble With Therapy Reassessment Scheduling Tool
Having trouble coordinating therapist visits for the reassessment requirements that went ... Read more
Industry Note:
Home Care LVNs Draw 5-Year Jail Sentences
Two home care LVNs in Houston have been sentenced to more than five years in prison for c... Read more
Industry Note:
Agency Owner Charged With Forging Aide Qualifications
Law enforcement authorities are not treating lightly fudging of personal care attendants'... Read more
Industry Note:
VNS In Seattle Set To Close Its Doors
Swedish Visiting Nurse Services in Seattle will close its doors by the end of April, repo... Read more
Industry Note:
SoCal VNA Begins Work On Hospice Facility
A new hospice inpatient facility is coming to Claremont, Calif. The Visiting Nurses Asso-... Read more
Audits:
RACs Drop Audit Bomb On HHAs
High therapy, multiple recerts top RAC's hit list. After a lengthy delay, Medicare's boun... Read more
Contractors:
Get To Know Your Recovery Audit Contractor
RACs' contingency fees range from 9 to 12.5 percent. You may get a costly audit letter fr... Read more
Reimbursement:
Take 6 Steps To Protect Against RAC Audits
Consider serious therapy changes. If you haven't received an audit request from your Reco... Read more
Budget:
President Obama Proposes Home Health Copay -- Again
Plus: HHAs breathe sigh of relief over doc fix. Will home health agencies have the juice ... Read more
Hospice:
Address This Major Unmet Need For Hospice Patients In SNFs
Don't fall short in managing shortness of breath in terminally ill patients. Hospices ser... Read more
Industry Note:
The HEAT Is On Home Care Fraudsters
Nine Medicare fraud strike force teams contribute to record-setting fraud recoveries. Fed... Read more
Industry Note:
Medicare Wants Overpayments Back Within 2 Months
You'll have 60 days to report and return self-identified Medicare overpayments, if a new ... Read more
Industry Note:
National Quality Forum Approves 14 End-Of Life, Palliative Care Quality Measures
You can get a sneak peek at hospice quality measures Medicare is likely to require in the... Read more
Industry Note:
Hold Vendors Accountable For 5010 Transition
The April 1 enforcement deadline for using 5010 claim standards is fast approaching. "To ... Read more
Industry Note:
National Chain Mulls Possible Sale
Don't be surprised to see publicly traded company LHC Group Inc. change hands. The nation... Read more
Industry Note:
Calif.-Based Regional Chain Makes Oregon Buy
A subsidiary of The Ensign Group Inc. has entered the Oregon market with its acquisition ... Read more
Industry Note:
LTC Co.'s Home Care Biz Grows Through Acquisitions
Acquisitions have helped grow the home health and hospice business of long-term care comp... Read more
Industry Note:
DEA, FBI Raid Penn. Hospice Physician's Office
It's not just hospices feeling the effects of a crackdown on the industry. The feds have ... Read more
Industry Note:
HHA Owner Gets 8 Years In Jail For Medicare Fraud
The co-owner of a Los Angeles home health agency and durable medical equipment company ha... Read more
Lawsuits:
Brace For More Whistleblower Suits In Home Care
The damage a qui tam lawsuit does to your reputation may be as bad as the financial penal... Read more
Compliance:
11 Tips To Ward Off Qui Tam Lawsuits
A robust reporting mechanism is your best defense against a whistleblower suit. Being th... Read more
Human Resources:
How To Create An Exceptional Team
Follow these 5 steps to make your team more cohesive and more productive. Before you bec... Read more
Budget:
Politicians Look For Doc Fix Funding
Home care could be on the chopping block by the end of the month. Congressional negotiat... Read more
Industry Note:
For-Profit Hospices Painted With Broad Fraud Brush
Press coverage of hospice closure 'distorted,' industry expert maintains. The hospice in... Read more
Industry Note:
Payment Across Post Acute Providers Doesn't Make Sense For Home Care
The findings of a Centers for Medicare & Medicaid Services demonstration project on b... Read more
Industry Note:
OIG Wants Revalidating HHAs Classified As 'High Risk'
Home care providers are a target in the HHS Office of Inspector General's top challenges ... Read more
Industry Note:
Use This MAC's Tips To Fill Out Revalidation 855
Confused about how to fill out the 855 form for your revalidation? A new set of frequentl... Read more
Industry Note:
Assault On Nurse Shows Need For Security Precautions
It may be time to review your security procedures in light of a tragic crime against a ho... Read more
Industry Note:
Watch For New ADR Delivery Style
Take note, providers served by Palmetto GBA: the HHH Medicare Administrative Contrac-tor ... Read more
Industry Note:
Vaccination Back Pay Coming To You Soon, MAC Says
Waiting on back payments for underpaid vaccinations from September? You should see those ... Read more
Industry Note:
Gentiva Sheds 53 Locations Under Financial Pressure
Hard times call for hard measures. Na-tional chain Gentiva Health Services Inc. closed or... Read more
Industry Note:
Hospice Owner Gets Jail Time For GIP Upcoding
The feds have their eye on hospice upcoding. The owner of a hospice in Muscle Shoals, Ala... Read more
Fraud & Abuse:
Follow OIG Compliance Plan Guidance Step By Step
Missing an element could set you up for a costly lawsuit, or worse. Don't get caught in t... Read more
Reimbursement:
Copay Threat Grows Stronger, Thanks To MedPAC
HHA profit margin hits 19.4 percent, but steep drop predicted. The home care industry su... Read more
Hospice:
Change Your Hospice Discharge Coding This Summer
Revise one discharge code and learn another. Law- and policy-makers are determined to ge... Read more
Know Your Facts:
HHA Stats Climb Higher Than 1990s Peaks
Medicare program had 11,600 agencies in latest data calculations. Record numbers of home ... Read more
Therapy:
Watch Out For Stealth Home Care Episodes When Furnishing Part B Outpatient Therapy
The shoe may be on the other foot when you're the one furnishing Part B therapy. Providi... Read more
Industry Note:
HHH MAC Ramps Up Medical Review
Medicare contractor may ask to look at 40 claims in initial probe. You're not alone if y... Read more
Industry Note:
New CMS Education Takes Aim At Docs Withholding Documentation
Having trouble getting your referring physicians to cough up medical documentation reques... Read more
Industry Note:
MAC Sets 5010 Deadline
If you've been stalling on 5010 compliance, now's the time to get going on the new HIPAA ... Read more
Industry Note:
CMS Puts CHOW Changes In PI Manual
Medicare's revisions to change in ownership (CHOW) rules have officially hit the books. "... Read more
Industry Note:
Medicare Instructs Docs To Obtain NPIs
Physicians who are balking at obtaining a National Provider Identifier number are getting... Read more
Industry Note:
Keep These Safety Goals In Mind In 2012
Preventing falls is one of the measures stressed in this year's National Patient Safety G... Read more
Industry Note:
Chain Pays Nearly $10M For 16 Nursefinders Locations
Moorestown, N.J.-based chain BAYADA Home Health Care has acquired 16 Nurse-finders Home C... Read more
Industry Note:
Hospice Company Expands To 3rd State With SC Buy
Knoxville, Tenn.-based Caris Health-care has purchased Solaris Hospice with eight locatio... Read more
Industry Note:
HHA Owner, Employee Plead Guilty To Kickback Charges
A Miami home health agency owner and employee charged with Medicare fraud last fall have ... Read more
Hospice:
Hospice Pay Cut Threatens 2013 Reimbursement
MedPAC commissioners take aim at long stays. You'll have a new hospice quality reporting... Read more
Fraud & Abuse:
For-Profit Hospices Draw MedPAC Commissioners' Ire
Too many too quickly, influential advisory body to Congress feels. For-profit hospices r... Read more
Prospective Payment System:
Welcome Dementia Code Points To 2012 Case Mix
Watch for these case mix additions and deletions that took effect Jan. 1. The loss of ca... Read more
Referrals:
Help Docs Gain Rightful Pay For CPO Services
Tip: Docs can use a 'cheat sheet' to make CPO documentation easier. Physicians may be mo... Read more
Education:
Get Training On These Coding Curveballs
Plus: Examine how the PPS rates that took effect Jan. 1 will impact your patient case lo... Read more
Industry Note:
Eliminating Companionship Exemption A No-Win Move
Comments on the proposal are due next month. The Department of Labor's proposal to elimi... Read more
Industry Note:
Correction For Claims Rejection Errors On The Way
You'll have to sit tight to wait for a fix for your claims rejecting with C7121, HHH Medi... Read more
Industry Note:
Use These Billing Pointers For TENS Units
Trying to figure out how to bill therapists' home TENS unit instruction for your outpatie... Read more
Industry Note:
Risk Decertification If You Overlook Revalidation Request
You have until Feb. 27 to respond to HHH Medicare Administrative Contractor CGS's request... Read more
Industry Note:
Turn To These Resources For OASIS Coding Info
Wondering how to correct your OASIS coding when necessary? The Interpretive Guide-lines a... Read more
Industry Note:
Outlier Payment Calculation Problems Persist
Don't count on your outlier payments being sorted out quite yet. A claims system fix to c... Read more
Industry Note:
OIG Offers Compliance Plan Pointers Online
The OIG is expected to soon make compliance plans required for high-risk providers -... Read more
Industry Note:
MI Physicians Indicted In Alleged HHA Fraud Scheme
A Michigan HHA owner and physician has been indicted in federal court on kickback charges... Read more
Industry Note:
Feds Tout 19th Guilty Plea In FL HHA Fraud Bust
The feds have racked up another guilty plea in the fraud bust of ABC Home Health Care Inc... Read more
Regulations:
Beware This Grouper Diagnosis Coding Change
Outlier adjustments, OASIS updates, and more discussed in latest Open Door Forum. You'll... Read more
Hospice:
Submit Your Hospice Quality Data This Month
OMB approves new reporting form. A sea change in how Medicare will pay for hospice begins... Read more
Fraud & Abuse:
Feds Crank Up Home Care Fraud Busting
Medicare Fraud Strike Force racks up guilty pleas in three cities. It's not just owners w... Read more
OASIS:
Make Sure You See 20/20 When Assessing M2020
Warning: Your OASIS oral medication management skills may need a tune-up. Improving medic... Read more
Industry Note:
Watch Out For This OIG Work Plan Item
Medicaid overpayments could get you in trouble this year. Are you hanging on to a Medicai... Read more
Industry Note:
Your Part B Patients Can Use Therapy Cap Exceptions A Little Longer
The 27 percent Medicare rate cut for physicians isn't the only thing that got put off unt... Read more
HIPAA:
Don't Miss This Important 5010 Deadline
The enforcement date isn't the only deadline you have to worry about. If you haven't test... Read more
Industry Note:
Remember Appeals For Incorrect F2F Doc-Related Denials
Don't forget to file for reopenings when your HHH MAC erroneously denied your claim for f... Read more
Industry Note:
Sidestep This Little Known HIPAA Claims Mistake
Be sure the "Total Charges" field on your claims is filled out, or you could be risking H... Read more
Industry Note:
Hit Handwashing Hygiene Education This Winter
Use the CDC's oldie but goodie on handwashing hygiene to help keep your staff -- and... Read more
Industry Note:
Do This When Adjusting Claims With Denied Lines
Don't risk further delays to your cash flow by mucking up your claims adjustments. "The p... Read more
Industry Note:
Check Out ICD-10 Updates, Including ICD-9 Duplications
You may not be familiar with the ICD-10 code set yet, but it continues to grow anyway. CM... Read more
Industry Note:
7-State Chain Makes Tarheel State Acquisition
Augusta, Ga.-based CareSouth Health System Inc. has purchased the home health agency of t... Read more
Industry Note:
Law Firms File Shareholder Lawsuits Against VITAS
Fresh on the heels of the unsealed whistleblower lawsuit against AseraCare Hospice, law f... Read more
Lawsuits:
Whistleblower Lawsuit Signals Hospice Enforcement Ramp-Up
Get ready to defend your hospice claims if you treat long-stay patients. If you had any ... Read more
Prospective Payment System:
New HTN Payment Rules May Not Mean New Coding
A big shift in coding could prove CMS right that agencies were gaming. Now that it's the... Read more
Diagnosis Coding:
Avoid This Upcoding Trap With HTN Codes
You can capture case mix points with HTN codes in these circumstances. While the 401.1 a... Read more
HIPAA:
Pull Your HIPAA Act Together With These Pointers
It's time to move HIPAA off the back burner. With new HIPAA audits on the horizon, you'd... Read more
Industry Note:
Clock Restarts On Doc Fix -- And Possible Home Care Cuts
Two-month delay to 27% physician cut hammered out. After political theatrics from both s... Read more
Fraud & Abuse:
CMS To Take Action On More Identified Fraud Vulnerabilities, OIG Report Indicates
HHA outliers one of the few fraud risks CMS did address from 2009. The Centers for Medic... Read more
Industry Note:
MAC Resolves 5010 Billing Glitc
The Centers for Medicare & Medicaid Services wants home health agencies and hospices ... Read more
Industry Note:
Prepay Demos For Mobility Devices, RACs Delayed
Sometimes common sense does seem to prevail at the policy-making level. CMS has agreed to... Read more
Industry Note:
Demo For Doc, NP Visits At Home Gets Green Light
Medicare beneficiaries will receive more care at home under a new demonstration, but the ... Read more
Industry Note:
Know Which Revalidation Letter To Disregard
If you're still working your way through a backlog of mail you received over the holidays... Read more
Industry Note:
HHA, Hospice Reps Named To CMS Innovations Initiative
CMS will receive input from home care providers for its Innovations Center initiatives, w... Read more
Industry Note:
Keep Patients' PHI Out Of E-Mails To MACs
Don't risk HIPAA violations when you're trying to get help with your Medicare claims. You... Read more
Industry Note:
3 HHA Operators Plead Guilty To Kickbacks, Fraud
Three Miami HHA operators charged with Medicare fraud last year have pled guilty. Roberto... Read more
Industry Note:
State Regs Burden Inpatient Hospice Facilities
In addition to handing over its patients to another HHA, the Visiting Nurse & Hospice... Read more
Labor Law:
Say Goodbye To Companionship Exemption Under Proposal
Watch out for related lawsuits, attorney warns. Get ready to shoulder a whole new admini... Read more
Compensation:
Companionship Rule Change A Bust For Everyone
Rule will cost employers with no real benefit for workers, experts say. The Obama Admini... Read more
Compliance:
Don't Jump The Gun On Companionship Exemption Planning
How much risk are you willing to take on? The Department of Labor's dramatic proposal to ... Read more
HIPAA:
Polish Your HIPAA Practices In Advance Of Audits
Do your HIPAA P&Ps reflect your practices from years long past? Establishing HIPAA p... Read more
Hospice:
Study: Hospice Use In SNFs Produces Many Benefits
Hospice helps SNFs better meet patients' needs. Authorities are casting a very jaundiced... Read more
Industry Note:
Your 5010 Extension May Be Shorter Than You Think
Deadline will depend on your testing status. Get ready to start submitting 5010 claims b... Read more
Industry Note:
No ABNs Necessary For Excluded Services
There is good news on the ABN front. Home health agencies are off the hook for furnishing... Read more
Industry Note:
Longstanding Hospice Claims Glitch Fixed
You can finally resume inputting the certifying hospice physician's NPI and name in the "... Read more
Industry Note:
RACs Can Request More Records
Keep a wary eye on what Medicare's Recovery Audit Contractors are doing now, because they... Read more
Industry Note:
Missed The Hospice F2F? Take This Billing Step
Look for the small silver lining regarding billing for a hospice patient for whom you did... Read more
Industry Note:
Beware Weight Loss' Effect On Muscle, Bone
Tread carefully when your elderly patients are prescribed weight-loss diets. You may cons... Read more
Industry Note:
Fix For Outlier Claims Problem On The Way
If you receive outlier payments, you're not alone in finding them incorrect. "Outlier pay... Read more
Industry Note:
New CMS Website Pushes HH Compare Awareness
Your publicly reported outcomes on Home Health Compare may soon get more attention from y... Read more
Industry Note:
Dallas HHA Owners, Recruiter Plead Guilty To Fraud
Four HHA owners and a patient recruiter have pled guilty in Dallas federal court to healt... Read more
Industry Note:
Health System Closes Hospice Facility
Tucson-based Carondelet Health Net-work will close its 11-bed Holy Family Center hospice ... Read more
Available Years:  2012  2011  2010  2009  2008  2007  2006  2005  2004  2003