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Home Health & Hospice Week

Quality:
Get Ready For 2 More Rehospitalization Quality Measures In The New Year
CMS clears up some questions on new measures in the final rule. CMS has adopted two ne... Read more
Hospice:
Get Your Hospice Coding Procedures Straight
CMS’s focus on this area makes hospice coding more important than ever. Up until... Read more
Hospice:
Get Tricky Coding For ALS Patient Right With This Advice
Tip: Watch for unrelated conditions in hospice coding. Question: Our hospice patient h... Read more
Therapy:
Consider Carefully When Hiring Contract Therapists
Tip: Perform a cost benefit analysis when deciding whether to hire directly or contract ... Read more
OASIS:
Use These 5 Tips To Increase Your OASIS Accuracy
Always consider what your patient can safely do. You spend countless hours making cert... Read more
Patient Privacy:
Prepare Now For Revamped HIPAA Audits
Plus: Understand the new HIPAA enforcement penalty structure. Very likely, sooner or l... Read more
Patient Privacy:
Be Ready To Produce These Documents For A HIPAA Audit
Get ahead by knowing exactly what auditors will expect. Sure, HIPAA auditors will want... Read more
Diagnosis Coding:
Don't Leave Your ICD-10 Training Until The Last Minute
Do you know what you can do today that will pave the way for a successful Oct. 1? Whet... Read more
Industry Note:
Brace For Reimbursement-Draining Provisions To Take Effect In New Year
PECOS edits, PPS rebasing cuts proceed. In a matter of days, it’ll be time to pa... Read more
Industry Note:
CMS Sets Training Date For New Hospice Item Set
Mark your calendar for Hospice Item Set (HIS) training in February. CMS will offer video... Read more
Industry Note:
OIG Report Agitates For HHA Surety Bonds
"Ensuring Quality of Care in Nursing Facilities and Home- and Community-Based Set-t... Read more
Industry Note:
Get A Preview Of ICD-10 Codes For HH Grouper
Want to know how coming ICD-10 codes are going to affect your reimbursement? You may get... Read more
Industry Note:
Therapy, Supplies Codes Added To HH Bundling List
Want to know which new supplies and therapy codes you’ll soon be responsible for u... Read more
Industry Note:
More Detroit HHA Owners Face Fraud Charges
Additional home care providers in the Detroit area will be getting more than coal in the... Read more
Hospice:
Brace For Tougher Enforcement Of Hospice Drug Bundling
Prior authorization coming for all hospice patient drugs. CMS has been putting pressur... Read more
Compliance:
Toe The Hospice Drug Line Or Risk Fraud Charges, Takebacks
Hospice drug coverage isn’t just a reimbursement concern — it’s a comp... Read more
Regulations:
Use These 9 Tips To Master Hospice Drug Compliance
Pointer: Fine tune your formulary to walk the line between compliance and financial heal... Read more
Referrals:
Help Doc Referral Sources Capture Extra Pay For Some Home Care Patients
Watch for chronic care codes coming. With face-to-face and other regulatory burdens ma... Read more
Billing:
Confusion Abounds As Hospice Claims Data Deadline Nears
MAC offers more info on burdensome new requirement. With all the new data you’ll... Read more
Industry Note:
OIG Continues Transfer Policy Scrutiny At Hospitals
 MAC collects $1 million for missed discharges to home care and other postacute pro... Read more
Industry Note:
Newspaper Highlights Regional Home Care Utilization Differences
Home care and other post-acute care providers are in the spotlight for increased Medicar... Read more
Industry Note:
Will Doc Fix Affect Home Care Spending?
You can count on physician efforts to avert the 20 percent cut to their rates in the Fin... Read more
Industry Note:
Watch For New VA Pay By April 1
You may know you don’t have to switch payment methodologies — and possibly r... Read more
Industry Note:
HETS Hospice Info Update Pushed Back
CMS still plans to get rid of the ELGA/ ELGH system for looking up patient eligibility t... Read more
Industry Note:
Duplicate RAPs Trigger Claims System Glitch
Be careful not to submit duplicate RAPs, or you may see significant payment delays. &quo... Read more
Industry Note:
Lack Of Funding Hampers HIPAA Audits
You may get a little breathing room on HIPAA audits. The funding for security rule audit... Read more
Industry Note:
New CERT ADR Deadline Delayed Indefinitely
You don’t have to worry about adhering to the new shorter timeframe for CERT ADR r... Read more
Industry Note:
Healthcare System Closes Home Health Unit
Hospitals and health systems are finding it harder and harder to sustain their home care... Read more
Prospective Payment System:
Billions In Rebasing Cuts Finalized In 2014 PPS Rule
Brace for wave of closures and sales. CMS has pared back the home health agen-cy rate ... Read more
Reimbursement:
LUPA, Supplies Payments Down From Proposed Rule
But LUPA rates still will double — or more. The tweaks CMS made to its rebasing ... Read more
Diagnosis Coding:
Bid Farewell To Extra Money For Certain GI Codes And More
Codes used in tens of thousands of episodes in 2012 get kicked off the case mix list. ... Read more
Industry Note:
Medicare Issues Refunds For Erroneous Prison Takebacks
Don’t expect reimbursement from appealed claims yet. CMS is finally correcting r... Read more
Industry Note:
Use These Tips To Respond To ADRs Accurately And Save Your Reimbursement
New edits and probes continue to hit home health and hospice providers nationwide. For e... Read more
Industry Note:
Medicare HH Contractor Keeps The Heat On Hypertension Claims
Make sure your claims with hypertension codes can withstand medical review, or you&rsquo... Read more
Industry Note:
Give CMS Your 2 Cents On Newest Version Of Hospice Cost Report
You’ve got less than a month to give CMS a piece of your mind on its latest versio... Read more
Industry Note:
ZPICs Train Spotlight On Home Health, Hospice
It’s not just your imagination — you’ve gotten special attention from ... Read more
Industry Note:
Tap This Education Tool For Memory Problems
Looking for a resource to share with your patients with memory problems and their famili... Read more
Industry Note:
Animal Therapy Helpful For Dementia Patients, New Study Shows
A new study suggests your patients may benefit from interaction with animals. Therapy an... Read more
Survey & Certification:
Get To Know Your New IDR Option For HHA Surveys
Informal dispute resolution for home health agencies will debut this summer. The new i... Read more
Regulations:
Use These 5 Tips To Make The Most Of Forthcoming IDR
Eliminate a record of your overturned deficiencies with this advice from CMS. This sum... Read more
OASIS:
Troubleshoot Common OASIS Survey Problems
Quick Quiz: Do you know when a SCIC assessment is required? With punishing new alterna... Read more
Fraud & Abuse:
Home Care Fraudsters Rack Up 5-Year Prison Sentences
Kickbacks to patient recruiters feature in latest fraud cases. Just as home care provi... Read more
Patient Privacy:
Learn From These Recent HIPAA Breaches
You’re getting a breather on HIPAA audits — until January. Laptops, notebo... Read more
Industry News:
Keep An Eye Out For Upcoming Home Health QAPI
Regs encourage continuous level of compliance.   Home health agencies are on th... Read more
Industry News:
MedPAC Proposes Wrapping Hospice Into Medicare Advantage
Hospice patients’ exclusion from Medi-care Advantage plans is under scrutiny by th... Read more
Industry News:
ICD-10 Dry Run Scheduled
If you worry about whether your claims will appropriately process on Oct. 1, 2014, fret ... Read more
Industry News:
MA HIPPS Codes Delayed Again
You’ve got an extra seven months before you need to start worrying about submittin... Read more
Industry News:
Medicare Software Blocks Debility, Failure To Thrive,Dementia Diagnoses In Error
You’ll need to download a software patch if you’re using PC-ACE PRO32 v2.48.... Read more
Industry News:
Take Note Of Change For Overpayment Letters
You’ve got new numbers to keep track of if Palmetto GBA is your HHH MAC. "E... Read more
Industry News:
Resubmit Claims Denied With U5210, U5220
If you’ve had a RAP or claim denied in error with reason code U5210 or U5220, it&r... Read more
Industry News:
Rebrand With Name Change
Providers looking to grow may want to consider rebranding as part of their marketing eff... Read more
Industry News:
12-State Chain Merges Hospice Operations In Conn
Affiliated companies SolAmor Hospice and Life Choice Hospice have merged their Conn-ecti... Read more
Reimbursement:
Brace For 'Shocking' Level Of PECOS Denials In New Year
Get ready to appeal when you spell a physician’s name wrong on the claim. If you... Read more
Edits:
Use These 8 Tactics To Prevent PECOS Denials
Don’t reach for an ABN to solve your PECOS-related denials. Your PECOS edit copi... Read more
Policies & Procedures:
Add This Step To Intake Or Risk Entire Episode Reimbursement
Updates to the list increased to twice per week. Waiting to check PECOS when it’... Read more
Finance:
Home Care Chains' Profits Sag In Third Quarter
Amedisys settles fraud and self-referral charges for $150 million. Medicare rate reduc... Read more
Mergers & Acquisitions:
Rough Reimbursement Seas For HHAs Could Encourage Increased M&A Activity
Major home care industry consolidation is ahead, CEO predicts. Is it time for you to j... Read more
Human Resources:
Become A Great Motivator And Lead Your Team To Success
Employee motivation techniques can be as different as the people who work for you. One... Read more
Industry Note:
Medicare Cracks Down On Inpatient Hospital Billing For Hospice Patients
Your diagnosis coding will determine whether you pay for hospital care. CMS is taking ... Read more
Industry Note:
Use This MAC Tool To Ease CCN Implementation Dec. 9
The deadline to use the new home health change of care notice (CCN) is right around the ... Read more
Industry Note:
Buckle Down On Rehospitalization Efforts
Reducing rehospitalization rates among your patients is good for them, good for your car... Read more
Industry Note:
CERT Sets 60-Day Limit
Set your calendars for the new CERT timeline, or lose you reimbursement. "Effective... Read more
Industry Note:
NPSGs Hold Steady
Home health agencies accredited by the Joint Commission will see the same National Patie... Read more
Industry Note:
Kindred Buy Creates Unit To Rival Gentiva's Size
Post acute care company Kindred Healthcare Inc. continues to increase its home care busi... Read more
Industry Note:
Agencies Expand In N.Y.
The troubling Medicare reimbursement rate outlook isn’t keeping home care provider... Read more
Industry Note:
Louisiana HHA Faces Poor Wound Care Accusations
Are you doing all you can to minimize patient lawsuits? One home health agency in Louisi... Read more
Reimbursement:
PECOS Denial Edits To Hit In January
Often-delayed edits checking for referring physicians’ NPI and PECOS record get a ... Read more
Survey & Certification:
Deemed Agencies Will Bypass New Alternative Sanctions
Tip: Be sure you have surveyors’ new playbook. Want to avoid punishing new alter... Read more
Compliance:
These Factors May Determine Your Survey Fate Under Sanctions
If your larger organization has troubles, then sanctions are more likely. One of the s... Read more
Prospective Payment System:
Medicare Delays Final Payment Rule
But rebasing cuts are still on track for Jan. 1. You’ll have to wait a few more ... Read more
Survey & Certification:
New Alternative Sanctions Not Yet Imposed
Expect sanctions at resurvey time. Three of the five new alternative sanctions for hom... Read more
Hospice:
More Edits Sweep Hospices
Medical reviewers target nursing home patients, long LOS, non-cancer diagnoses. If you... Read more
Regulations:
Beware Homebound Definition Changes
CMS highlights homebound enforcement. The Centers for Medicare & Medicaid Services... Read more
Industry Note:
Medicare Cracks Down On Hospice Drugs
Analgesics presumed to be related to terminal illness in latest initiative. Don’... Read more
Industry Note:
You'll Have One Month To Submit HIS Data
Want to find out more about the Hospice Item Set CMS will require hospice providers to u... Read more
Industry Note:
HHAs Serve As Test Subjects For Fraud Baseline
Home health is serving as a guinea pig in one Medicare fraud initiative, reveals a new G... Read more
Industry Note:
Celebrate National Home Care & Hospice Month
You still have time left to celebrate National Home Care & Hospice Month this month.... Read more
Industry Note:
OIG Recommends $75K Recoup From Colo. Hospice
Medicaid hospice payments continue to draw the attention of the HHS Office of Inspector ... Read more
Industry Note:
Hospice Settles Whistleblower Suit For $3 Million
Whistleblowers may be able to place a target on your agency for a False Claims Act inves... Read more
Industry Note:
PECOS Streamlining May Help Avert Denials
Want to help your stubborn referring physicians who haven’t enrolled in PECOS to d... Read more
Reimbursement:
Edits Targeting Therapy Net Massive F2F Denials Instead
Diagnosis codes alone won’t fulfill F2F. Is the face-to-face documentation for y... Read more
Billing:
Know The Codes Palmetto Is Targeting
HHH Medicare Administrative Contractor Palmetto GBA targeted claims with 2CGK* and 1BGP*... Read more
Medical Review:
Deploy These 8 Strategies To Defend Against F2F Scrutiny
Revamping your admission process may save your reimbursement. If your face-to-face doc... Read more
Patient Privacy:
Be Ready To Give Patients Their Records Electronically
Beware this frequently missed HIPAA mandate. You’re violating new HIPAA requirem... Read more
Hospice:
GIP Features In Supplemental Comparative Billing Report
Hospice diagnosis coding changes will hit hard, report indicates. Don’t be surpr... Read more
Industry Notes:
Keep Your Eye On Washington As Budget Negotiations Unfold
Warning: More Medicare cuts could be on the way in mere months.     The ... Read more
Industry Note:
E-Mail Gaffe Leads To Hospice HIPAA Breach Notification
A slip-up by a hospice employee is leading to some bad press for one hospice — and... Read more
Industry Note:
New Change Of Care Notice Required In December
You’ve got about a month-and-a-half to get up to speed on the new CCN and ABN befo... Read more
Industry Note:
HHH MAC Region Transitions From NHIC To NGS
The HH&H MAC workload for provid-ers in Maine, Massachusetts, New Hampshire, Rhode I... Read more
Industry Note:
Verify Your MAC Info
It may seem like you just did it, but there’s a good reason you need to verify you... Read more
Industry Note:
Nation's Largest Home Care Chain Grows Larger
The nation’s largest home care chain has gotten even larger. Gentiva Health Servic... Read more
Industry Note:
Hospice Owner Convicted
A hospice owner indicted two years ago has been found guilty of Medicare fraud in federa... Read more
Industry Note:
Doc Housecall Co. Owners Found Guilty
Father-and-son owners of a physician housecall company have been convicted of Medi-care ... Read more
Industry Note:
CNA Praised In Fire Rescue
Hospices may be getting a black eye in the press lately, but they also get lots of posit... Read more
Industry Note:
Home Care Therapist Tops OIG's Fugitive List
An indicted physical therapist in the large home care fraud schemes that took place in t... Read more
Quality:
Lighten HHAs' Load For Rehospitalization Measures, Providers Urge CMS
CMS should define ‘unplanned,’ industry tells Medicare officials. HHAs wil... Read more
Regulations:
End To Government Shutdown Benefits Providers Waiting On Medicare Services
Watch for impact on final rule. Home care and hospice providers caught in limbo by the... Read more
HIPAA:
Properly Handle Disclosure Restriction Requests Under New HIPAA Rules
What’s the true impact of this new patient right under HIPAA? For a decade now, ... Read more
Education:
Get Training On PPS Final Rule When It's Hot Off The Presses
Also, check out Eli audioconferences on hospice-nursing home relationships, 2014 hospice... Read more
Industry Note:
Another Contractor Is Looking Over Your Shoulder
Use this expert tip to avoid duplicative medical review of claims. If you’re con... Read more
Industry Note:
More Patients Starting Hospice In Last 3 Days Of Life
Hospice enrollment among Medicare beneficiaries with cancer is up, but so is the number ... Read more
Industry Note:
Congressmen Want To Cap Home Health Episodes
HHAs have a new reimbursement limit proposal to contend with in Congress. In H.R. 3245, ... Read more
Industry Note:
Tap New MAC Education Tools On Finance
Need some help mastering accounting and finance related to Medicare payments? You may ge... Read more
Industry Note:
Qui Tam Bounty Hunters Encourage Whistleblowers
If you’re wondering why whistleblower lawsuits are on the rise, solicitations from... Read more
Industry Note:
HH MAC Experiences Mystery Payment Delays
If you’re seeing reimbursement delays and CGS is your MAC, you’re not alone.... Read more
Industry Note:
Chain Buys Hospital-Based Home Care Units
Gentiva Health Services Inc. has purchased the Home Health and CAP/Avery Home Care servi... Read more
Industry Note:
One More County Plans To End Home Care
The La Crosse County Health Depart-ment in Wisconsin is considering phasing out its home... Read more
Industry Note:
Whistleblower Protests Settlement Amount In Court
Coming to an agreement with the feds to settle a whistleblower lawsuit may not be the en... Read more
Prospective Payment System:
HHAs Protest Dropping 170 Diagnosis Codes From Case Mix
Targeted codes aren’t too acute for home care, experts insist. You may have a ha... Read more
Diagnosis Coding:
Take These Codes Off The Chopping Block, HHAs Tell CMS
Codes slated for case mix removal are needed. Home health agencies are keeping their e... Read more
Reimbursement:
Use These Clues To Understand Case Mix Code Changes
Demise of GERD comes as no surprise. While some of the 170 diagnosis codes CMS plans t... Read more
Appeals:
Rate Of Redeterminations Favoring HHAs Plummets
HHA appeals caseload nearly doubles from 2011 to 2012. While the number of redetermina... Read more
Referrals:
Help Referral Sources Secure Transitional Care Pay
Tip: It’s not just for established patients. Your referring physicians may think... Read more
Industry Note:
Use Q Codes Correctly Or Join The Wave Of Returned Claims
Tip: Include only one Q code line per claim. The month after Medicare started requirin... Read more
Industry Note:
Get This Medicare Notice Down Pat
Not sure which number to put at the top of your Notice of Medicare Non Coverage (NOMNC)?... Read more
Industry Note:
Beware Hospital Therapy Billing Change
Watch out for changes to the therapy reimbursement requests you get from hospitals. The ... Read more
Industry Note:
Tarheel State Hospice Downsizes Visiting Staff
Another hospice is laying off workers in the face of Medicare cuts and aggressive medica... Read more
Industry Note:
VNAs To Merge To Create Efficiencies
Declining Medicare reimbursement is also leading agencies to consider consolidation. F... Read more
Industry Note:
HHA Ponies Up $50K For Excluded Employee
Be sure to check your staff against the OIG’s List of Excluded Individuals and Ent... Read more
Industry Note:
Indicted Hospice Owner Bought 20 Luxury Cars
Federal prosecutors have asked the court for the power to seize 20 luxury cars from a ho... Read more
Industry Note:
Charting Dispute Sparks Wrongful Termination Suit
In a battle of he-said, she-said, your organization may lose even if it wins. Reputat... Read more
Regulations:
HHAs Ask For Relief From Face-To-Face Burden
PPS rule commenters bash physician narrative. Medicare officials may not have mentione... Read more
Compliance:
CMS Goes Overboard On Face-To-Face Regs
Lawmakers urge CMS to let go of unnecessary F2F requirements.  Whether it’s... Read more
Billing:
Make This Claim Change By Next Summer
You may need to list two physicians on your HH PPS claim.  If one physician certi... Read more
Hospice:
Use New SNF Rule To Open Doors To Your Hospice
Tip: Be ready to demonstrate that you furnish all four levels of hospice care. Nursing... Read more
Referrals:
Share These Hospice Facts With SNF Partners
SNFs must contract for requested hospice or transfer the patient. Are your nursing hom... Read more
Marketing:
Point Your SNF Referral Sources To These Resources
Under new requirements, nursing facilities must designate an individual — a clinic... Read more
Industry Note:
Reimbursement Continues To Flow Through Shutdown
Surveys may fall behind due to impasse in Congress. Your Medicare payments shouldn&rsq... Read more
Industry Note:
State Paid $30 Million In Error For Home Care Services
The HHS Office of Inspector General continues its scrutiny of state-funded personal care... Read more
Industry Note:
Comply With New HIPAA Requirements Now In Effect
Is your HIPAA paperwork up to date? If not, you could be in trouble under the new HIPAA ... Read more
Industry Note:
FBI, OIG Raid Texas Home Care Provider Office
Operating your agency may seem like an uphill battle most days, but imagine how much har... Read more
Industry Note:
Miami Patient Recruiter Pleads Guilty
A patient recruiter for a Miami HHA has pled guilty for his role in a $48 million Medi-c... Read more
Industry Note:
State's Largest Hospice Lays Off 100
The diminishing number of hospice pa-tients is taking its toll on providers, including A... Read more
Industry Note:
Medicaid Provider Files For Bankruptcy
Crystal Care Home Health Services in Richfield, Minn., has filed for bankruptcy, reports... Read more
Prospective Payment System:
Providers Decry Proposed Cuts As Final Rule Looms
HHA cuts will be closer to 4% next year, expert claims. When the PPS final rule comes ... Read more
Reimbursement:
Telehealth, F2F Head Up List Of Unreimbursed Costs
14% cut will hit all the harder. How many of these legitimate expenses go on a Medicar... Read more
Regulations:
Agencies Give CMS A Piece Of Their Mind On Rebasing
Medicare reimbursement cuts are unprecedented, commenters say. After years of reimburs... Read more
Mergers & Acquisitions:
Don't Count On Cuts Going Away
Industry consolidation is at hand, experts predict. Are you one of the many HHAs stick... Read more
Hospice:
Enroll As Part B Provider Or Eat Vaccination Cost For Hospice Patients
Billing flu shots for your hospice patients may be harder than you’d think. As f... Read more
Industry Note:
Auditors Examine Hospice Billing In 2 States
GIP, election statements catch reviewers’ eye. The feds continue their scrutiny ... Read more
Industry Note:
Use This Free Tool To Improve
Looking for ideas on boosting care quality at your agency? The Visiting Nurse Associatio... Read more
Industry Note:
Check Out New Medicare Cost Report Forms
Keep up to date on home health agency cost reports forms. CMS has released new forms at ... Read more
Industry Note:
Hospitals To Combine HHA Management, Not Agencies
Three Oklahoma hospitals want to combine forces to furnish home care and hospice service... Read more
Industry Note:
Gentiva Diversifies Payors With Major Acquisition
Gentiva Health Services Inc. plans to acquire Harden Healthcare Inc.’s home health... Read more
Industry Note:
HHA Owner, Clinical Director Charged With Fraud
Two RNs have been charged in a $27 million Medicare fraud scheme in the Boston area. A... Read more
Industry Note:
LA Owner To Pay $15 Million To Settle Fraud Charges
A federal judge has ordered a Los Ange-les HHA owner who pled guilty to Medicare fraud l... Read more
Industry Note:
MAC: Mark These Days On Your Calendar
You might not want to plan to catch up on claims system-related work Oct. 3-5. The Commo... Read more
Regulations:
Retool Patient Notice Procedures For New CCN
Say goodbye to HHABN by Dec. 9. The more things change, the more things stay the same... Read more
Compliance:
Know When To Use The Replacement ABN
Your HHABN may still apply into 2014. Just because CMS has done away with the HHABN do... Read more
Labor Law:
DOL Finalizes Restriction On Companionship Exemption
Aides will see hours cut. Get ready to add a new layer of bureaucracy to your aide sch... Read more
Diagnosis Coding:
CMS Downplays Costs Of Upcoming ICD-10 Conversion
Plus: ICD-10 will allow you to submit code letters as either upper- or lowercase, CMS co... Read more
Industry Note:
Cut These Unnecessary Business Associate Agreements
Are you unknowingly making these common hospice BAA mistakes? You should bring your HI... Read more
Industry Note:
Rules Change For Therapy ABN
If you think you know how to deal with ABNs related to Part B therapy caps, think again.... Read more
Industry Note:
Nix This Claim Type Next Month
Don’t forget that you can no longer use type of bill 33x as of Oct. 1, reminds HHH... Read more
Industry Note:
Watch For Coding Conversion Details Next Spring
Wondering which ICD-10 codes will be linked to LCDs? The Centers for Medicare & Medi... Read more
Industry Note:
Medicare Makes Changes To Extended Repayment Plans
Don’t be surprised to see changes if you need to request an Extended Repayment Sch... Read more
Industry Note:
Joint Commission Offers Advice On Choosing Agencies
An accrediting body is offering help to potential home care patients in choosing a pro-v... Read more
Industry Note:
Nonprofit Hospice Providers In Florida Merge
Hospice by the Sea and Hospice of Palm Beach County/Hospice of Broward County are mergin... Read more
Industry Note:
New HHA Chain-Hospital Joint Venture Focuses On Hospital Readmissions
Gentiva Health Services Inc. and Wake Forest Baptist Medical Center in North Carolina ar... Read more
Industry Note:
Another Health Dept. HHA To Close Its Doors
The Ford-Iroquois Public Health De-partment in Illinois will close its home health agenc... Read more
Industry Note:
HH Fraudster Gets 4 years
A former Detroit HHA operator has received a four-year prison sentence after pleading gu... Read more
Fraud & Abuse:
Payment Suspensions In Dr. Roy Case Start Lifting
HHA owner in high-profile Roy case sentenced to a decade in prison. A year and a half ... Read more
Reimbursement:
Unsuspended Home Health Agencies Face Formidable To-Do List
Tip: When in doubt, resubmit claims. With federal authorities getting more comfortable... Read more
Patient Privacy:
Brace For HIPAA Audits Beginning Next Month
Who counts as a business associate under new definition? Are you feeling l... Read more
Enforcement:
Authorities Rack Up Guilty Pleas, Convictions In Home Care Hot Spots
Fraudsters in Texas, Miami feel the heat. Home care fraudsters continue to make life h... Read more
Industry Note:
Expect RAC Findings To Influence MAC Medical Review
Providers appealing RAC decisions find success. If you’ve heard that recovery au... Read more
Industry Note:
CBO Points To Slower Hospice Outlays
The meteoric rise of hospice spending seems to have come to an end. Medicare hospice spe... Read more
Industry Note:
OIG Wants Bidding Prices For DME.
Your patients might have even more of a hassle securing durable medical equipment and su... Read more
Industry Note:
Palmetto To Hospice: Get Supplier Number For Vaccination Billing
Hospices that don’t have a Part B bil-ling number will have to do some extra paper... Read more
Industry Note:
Joint Commission Highlights Home Care In 'Speak Up'
The Joint Commission’s latest installment in its Speak Up video series addresses h... Read more
Industry Note:
Upcoming Drug Reporting Concerns Hospices
Hospices should get ready for a heavy reporting burden next year. In July, CMS released ... Read more
Industry Note:
County Sheds HHA In Face Of Protest
One New York county will be seeing a change in home care. Livingston County has voted to... Read more
Industry Note:
Ala. Hospice Changes Name
Hospice Complete of Tuscaloosa (Ala.) has changed its name and is now operating as Alaba... Read more
Industry Note:
Hospices Open Inpatient Units In Northeast
Hospice facilities continue to open na-tionwide. In Newton, N.J., the Karen Ann Quinlan ... Read more
Reader Question:
Who Counts As A 'Business Associate?"
Don’t make extra work for yourself under HIPAA regs. Question: Who must I have a... Read more
Regulations:
CMS Revises Guidance To Make Your F2F Load Heavier
Don’t miss these 4 new F2F timepoints for hospitalized and managed care patients. ... Read more
Strategy:
Take These Steps To Combat F2F Denials
Don’t be afraid to appeal face-to-face denials. Medicare’s latest F2F guid... Read more
Medical Review:
MAC Targets Entire State As High-Risk Area For Home Health
Will your area be next on medical reviewers’ hit list for home care? Home health... Read more
Hospice:
The Pressure Is On Get Dementia Coding Right
Always follow coding guidelines for accuracy. Medicare’s recent hospice payment ... Read more
Diagnosis Coding:
What is Dementia?
Understand the characteristics behind the diagnosis. Dementia is classified as a psych... Read more
Industry Note:
OIG Wants More Frequent Hospice Surveys
Hospice goes 22 years with no surveys. Does getting surveyed about once a decade sound... Read more
Industry Note:
Watch Out For These Therapy Denials
For home health agencies furnishing Part B outpatient therapy services in the home, don&... Read more
Industry Note:
Study Shows Home Care Saves Money On Rehospitalizations
A Medicaid transitional care program that includes home visits has reduced hospital read... Read more
Industry Note:
CMS Solicits Feedback On Hospice Quality Data
Information CMS soon will collect from hospices will help shape your hospice quality dat... Read more
Industry Note:
Benchmark Yourself Against These LOS Stats
Are your length of stay stats for non-cancer patients making you stick out like a sore t... Read more
Industry Note:
Facebook Posts Lead To Nurse Suspension, Firing
Is getting fired for Facebook comments the least that can happen to employees? One nurse... Read more
Industry Note:
Avoid These Record Correction Pitfalls, MAC Warns
Are you committing some of the major record correction no-nos that HHH Medicare Administ... Read more
Industry Note:
Don't Resubmit These Claims, MAC Instructs
Hold off on resubmitting claims denied for an incarcerated beneficiary. "Please do ... Read more
Industry Note:
Insurer Gets Into Home Care Business
Insurer Cigna Corp. is getting into the home care business, although it’s home car... Read more
Referrals:
Scrutiny May Squeeze Home Care, Hospice Referrals
Billing report contractor, ZPIC contact docs about home care and hospice referrals. Re... Read more
Hospice:
Take These 8 Steps To Head Off Costly Investigations, Lawsuits
Will your compensation system result in charges instead of legit admits? If you had an... Read more
Compliance:
Compliance Plan May Rescue You If Feds Come Knocking
Address newest hospice hot spots when crafting or updating your program. A robust comp... Read more
Strategy:
Check Your Data -- Before Reviewers Do
You should know how you stack up against your peers, because regulators are looking at t... Read more
Industry Note:
Medicare Reviews Less Than 1% Of Claims
Response timeframes to ADRs may tighten up under GAO recommendation. It may seem like ... Read more
Industry Note:
Provider Pays $750K For Mishandling Overbilling
If your agency accepts the fact that you received an overpayment, you can’t simply... Read more
Industry Note:
Boost Your Charting For Observation & Assessment
Your documentation specifics will be the key to proving that a post-hospital-discharge p... Read more
Industry Note:
AMAPresses CMS On Incarceration Takebacks
Steamed about the reimbursement withheld for supposedly incarcerated beneficiaries? You ... Read more
Industry Note:
Incomplete HETS Info Ups Hospice Claim Risk
Hospices fed up with denials due to in-complete hospice eligibility information aren&rsq... Read more
Industry Note:
OIGWork Plan Clues Must Wait Until New Year
It’s that time of year again — as summer turns to autumn, the OIG typically ... Read more
Industry Note:
Doc House Call Execs Charged With HHA-Related Fraud
The CEO and a staff physician for a physician housecall company have been arrested and a... Read more
Industry Note:
Miami Recruiter, Therapy Co. Owner Plead Guilty
A patient recruiter and a therapy staffing company owner have pled guilty in connection ... Read more
Industry Note:
Newly Opened HHA Serves 5 Counties In Land of Lincoln
Canton, Ill., has a new home health agency. Iris Home Health Services is now serving Ful... Read more
Prospective Payment System:
Counter 1.5% PPS Cut With These Strategies
Rebasing reduction may make or break agencies in 2014. Rebasing the home health pro... Read more
Regulations:
Troubleshoot Common F2F Problems To Ward Off Denials
MAC Tip: Bypass subpar physician F2F statements by requesting the doc’s own notes.... Read more
Billing:
Brush Up On Overpayment Policies Now That CMS Has 5 Years To Request Refunds
Keeping overpayments can get you in hot water with patients, payers, and the law. I... Read more
Clip and Save:
Ensure Payers Correctly Apply Every Refund You Send
Use this sample letter to provide all of the information your payer needs. When you... Read more
OASIS:
Use Case Conferences To Ward Off Costly OASIS Errors
Stop reimbursement-draining mistakes before they start with this strategy. Establis... Read more
Industry Notes:
Check Out Your New Hospice Wage Index, Payment Rates
Plus: Cap amount for 2014 released. The annual wage index gamble for hospices has wrap... Read more
Industry Notes:
HHQI Focuses On The Heart
You have new free tools at your disposal to help improve patient outcomes in relation to... Read more
Industry Notes:
Consider Carefully Before Paying For Therapy You Didn't Know About
You don’t have to pay that therapy invoice if you didn’t know your patient w... Read more
Industry Notes:
Cancel -- Don't Resubmit -- RAPs With Errors
If you discover you made an error on a Request for Anticipated Payment that you submitte... Read more
Industry Notes:
Another Former HHA Owner/Physical Therapist Pleads Guilty To Fraud
Physical therapist and former HHA owner Hemal Bhagat has pled guilty for his role in a $... Read more
Industry Notes:
Former HHA Owner Draws Unusual 15-Year Prison Sentence For Fraud
A former HHA owner was sentenced to a whopping 15 years in prison following a Medi-care ... Read more
Industry Notes:
Hospices Open Inpatient Facilities In MO, AZ
More hospice inpatient facilities are opening every day. The 12-room Saint Luke’s ... Read more
Hospice:
Medicare Sticks With 1% Hospice Payment Increase For 2014 -- Before Sequestration
More payment changes are on the way, CMS signals in final rule. Your costs are likely ... Read more
Diagnosis Coding:
Hospice Failure To Thrive, Debility Claims Start Returning To Provider In Fall 2014
Code all coexisting conditions, CMS also urges in final rule. You’ve got about a... Read more
Regulations:
New Hospice Data Set Required Next Summer
Gear up now for the July 1 start date for HIS.  Get ready to fill out 27 data ite... Read more
Privacy:
Stolen Laptop Leads To HIPAA Privacy Breach Notice For Another HHA
Make sure you’re taking this simple step to head off a HIPAA disaster. If you do... Read more
Industry Notes:
Benchmark Yourself With This Billing Data
Are your average visit numbers per episode closer to 12 or 26? Is your average number... Read more
Industry Note:
Pay Up Or Appeal For Incarcerated Denials
Don’t expect to see denials for supposedly incarcerated beneficiaries cleared up b... Read more
Industry Note:
Missing Doc Signature Means No Billing
Don’t rely on your patient’s say-so to start delivering services. So says HH... Read more
Industry Note:
Figure Out Therapy Hold Impact On Reassessments
If therapy holds are tripping up your reassessment window for the discipline, an educati... Read more
Industry Note:
HHA Faces Lawsuit From Pregnant Ex-Employee
Be sure you handle workplace discipline with open communication or you may face the situ... Read more
Industry Note:
Feds To Sink $30 Million Into Falls Prevention Trial
Do you have a great strategy for preventing falls in your older patients? Then the NIH m... Read more
Industry Note:
Listen In To Reap Benefits From Hospice CBR
You can learn to use your hospice Comparative Billing Report with a newly posted educati... Read more
Industry Note:
VNA Shutters Medicare HHA Business
A 45-year-old nonprofit VNA is closing its home health agency unit due to lower reimburs... Read more
Industry Note:
Former HHA Owner Draws 4-Year Jail Term
The feds continue to put away Medicare home care fraudsters. In Michigan: Former HHA o... Read more
Fraud & Abuse:
CMS Flexes Its Moratorium Muscle With HHAs First
Miami, Chicago hit with freeze on new agencies. Two years after finalizing its power t... Read more
Know Your Facts:
Moratorium-Area Home Health Stats Stick Out Like A Sore Thumb
Number of Miami HHAs nearly 2,000% higher than average. The feds are using data mining... Read more
Compliance:
2 Moratorium Areas For HHAs May Be Just The Beginning
Is an IPS-style industry shakeout on the horizon? Are you sitting in the middle of the... Read more
Hospice:
Gear Up For Expanded Data Reporting On Hospice Claims
CMS is laying the groundwork for hospice payment reform. The data you’ll start s... Read more
Industry Note:
Get Site Of Service Codes Right Or Risk Claims Delays
Codes required on final claims only. If you haven’t gotten your Q codes right on... Read more
Industry Note:
Docs Can Earn Payment For Chronic Care
You can help your referral sources capture extra Medicare reimbursement they’re en... Read more
Industry Note:
Hospice Closes Inpatient Facility To Trim Budget
You may have to consider some painful budget cutting to survive sequestration and the ot... Read more
Industry Note:
Senior Medicare Patrol Project Shrinks
Your patients may not be giving you as much scrutiny as in previous years. So implies a ... Read more
Industry Note:
Quick Quiz: Can You Appeal A Rejected Claim? Find Out Here
If you’re not quite sure when to appeal a Medicare claim, you’re not alone. ... Read more
Industry Note:
Detroit PT Assistant And HHA Co-Owner Pleads Guilty To Fraud
Detroit-area physical therapy assistant, patient recruiter and HHA owner Syed Shah has p... Read more
Industry Note:
Handle Sexual Harassment Complaints Properly Or Risk Big Fines
Be careful in handling sexual harassment allegations, or you may end up paying in court.... Read more
Industry Note:
Sequestration Reductions Cut Into Chain's Profits
Amedisys Inc. earnings are down, but CEO William Borne says figures would have been wors... Read more
Hospice:
$1 Million Fraud Settlement Highlights Dangers To Hospice
Are there whistleblowers lurking in your ranks? A new announced settlement of Medicare... Read more
Referrals:
SNF Kickback Violations Take Center Stage In Enforcement
Furnishing free care to facility referral sources’ patients is a major no-no. Ar... Read more
Human Resources:
Avoid These 5 Most Common Interviewing Errors
Use one tip to avoid wasting your time — and the time of your interviewees. &nbs... Read more
Tool:
Use This F2F Form To Help Your Docs Fulfill Requirement
Know what you can — and can’t — give physicians for review-proof F2F d... Read more
Industry Note:
Whistleblower Turns In HHA For Kickbacks
Government pursues agency over sham jobs for physicians’ spouses. Add another ca... Read more
Industry Note:
Chain Faces Qui Tam Lawsuit
In another whistleblower lawsuit — this one in New Hampshire — a former empl... Read more
Industry Note:
Check Out New Vaccination CPT Code
You can get to know several new vaccine codes this year. The American Medical Asso-ciati... Read more
Industry Note:
Access More Specific Hospice Benefit Info On MAC Site
Hospices served by HHH Medicare Administrative Contractor CGS may be glad to discover an... Read more
Industry Note:
Avoid Claims Error Hit List With MAC Tool
Submit claims with errors frequently, and you could wind up on Medicare’s hit list... Read more
Industry Note:
CMS Reexamines Takebacks For Incarcerated Patients
If you’ve encountered strange Medicare payment recoveries because your patients we... Read more
Industry Note:
Detroit HHA Co-Owner Pleads Guilty To Fraud
Quantum Home Care Inc. co-owner Javed Rehman has pled guilty in a $13.8 million Medicare... Read more
Industry Note:
Ohio HHA Owner Draws 2-Year Prison Sentence
Alpine Nursing Care Inc. owner Divyesh "David" C. Patel has drawn a two-year p... Read more
Industry Note:
Home Care Physician Gets 2 Years In Jail
Visiting Physicians of South Jersey owner Lori Reaves has received two years in prison f... Read more
Regulation:
Say Goodbye To HHABN, Hello To HHCCN
Proposed PPS rule, OASIS C-1 revamp also addressed in forum. Hold off on ordering any ... Read more
Reimbursement:
Heed This CMS Tip On New Q Codes For Billing
Are you coding correctly according to this new July 1 requirement? Home health agencie... Read more
Hospice:
Review Your Nursing Home Agreements, CMS Urges
CMS stays neutral regarding format of contracts with nursing homes. If you thought you... Read more
Therapy:
MACs To Scrutinize 'G' Modifiers On Part B Claims
Whether you’re reporting GA, GX, GY or GZ, know that Medicare is watching closely.... Read more
Patient Privacy:
Guard Against IT-Sparked HIPAA Breaches
HHS OCR puts teeth in its fines for HIPAA violations. Don’t let a computer conve... Read more
Industry Note:
Will Your State Loosen Medicaid Eligibility Requirements?
OIG wants 11 states to bring their policies in line with the law. If your state requir... Read more
Industry Note:
Tap Newly Revised Hospice Claims Submission Billing Guide
Looking for answers to your hospice billing questions, and a training resource for em-pl... Read more
Industry Note:
Respond To ADRs With Success
If you’re feeling bombarded by Addi-tional Development Requests, a tool from HHH M... Read more
Industry Note:
New NIH-Funded Study Evaluates Palliative Home Care For HIV Patients
A new $1.7 million study will examine the effect of home health visits on a less traditi... Read more
Industry Note:
New Jersey Agency Owner Charged With Medicaid Fraud
New Jersey authorities have charged the owner of a Cranford-based home health agency wit... Read more
Industry Note:
Trend Of Hospice Inpatient Facility Openings Continues Nationwide
Despite the feds’ crackdown on the hospice General Inpatient (GIP) care level of c... Read more
Industry Note:
35-Year-Old Hospice Facility Closes Its Doors
Not everyone is opening an inpatient hospice unit. Hospice of St. John in Lakewood, Co.,... Read more
Industry Note:
Register For Chance To Give Your Feedback To CMS On Your Medicare Contractor
Would you like to give CMS an earful about your Medicare contractor? Sign up for a chanc... Read more
Prospective Payment System:
Rebasing To Strip Billions From Medicare HHA Spending
CMS to knock 3.5 percent off payment rates for next 4 years.  It’s time to ... Read more
Payment:
LUPA Rates Go Up While Supplies Rates Decrease
LUPA add-on to get more complicated. Keep track of these tweaks to the home health pro... Read more
Quality:
2 New Quality Measures Emphasize Rehospitalizations
You’ll need to monitor hospital-discharged patients more closely than ever. &nbs... Read more
Reimbursement:
Say Goodbye To 170 Revenue-Generating Diagnosis Codes
Other PPS rule provisions include ICD-10 edits and OASIS changes. CMS is pruning the l... Read more
Industry Note:
Providers Cheer Delay Of ACA Mandatory Insurance
Shared responsibility payments required in law put off even further. You’ve got ... Read more
Industry Note:
Medicare Finalizes SNF-Hospice Written Agreement
Now you’re not the only one required to have a written agreement when you enter in... Read more
Industry Note:
MAC Now Requires F2F For All Episodes
Gear up for major battle over face-to-face physician encounter documentation — bec... Read more
Industry Note:
Keep Communication Open With CERT Contractor
Keep your medical review wires un-crossed by establishing a contact person specifically ... Read more
Industry Note:
CMS Bumps MA HIPPS Requirement To December
You may get a break from your Medicare Advantage payers on Medicare’s requirement ... Read more
Industry Note:
Learn About Your Discharge Requirements
Looking for a quick recap of what Medicare expects. of you regarding discharge? Check ou... Read more
Industry Note:
Get Hospice Monthly Billing Details Right
Hospice monthly billing may not always be as straightforward as it seems. "Provider... Read more
Industry Note:
Hospital, Senior Living Join Forces With Home Care
Home care joint ventures seem to be gaining in popularity. In Cincinnati, The Christ Hos... Read more
Regulations:
Diagnosis Coding Items Head Up OASIS-C1 Changes
Number of M items collected to drop slightly in next OASIS incarnation. Now that you&r... Read more
Assessment:
Say Goodbye To These 8 OASIS Items Under OASIS-C1
Five items will go away altogether while 3 will stay for only certain timepoints, CMS pr... Read more
OASIS:
Correct 3 Mistakes for a Flawless OASIS Review Process
Employ just one tip to save time and money An effective OASIS review process can boos... Read more
Therapy:
Surprise: RACs Perform Manual Medical Reviews For Therapy Claims Over $3,700
Experts concerned that RACs get paid extra for every claim they deny Home health agen... Read more
Industry Note:
Watchdog Agency Targets Duplicative Vaccinations
Tip: Do your due diligence on whether patients have received a pneumococcal vaccination.... Read more
Industry Note:
Medicare Still Trying To Get Outlier Payments Right
It’s time to keep track of more outlier payments. A HHH Medicare Administrator Con... Read more
Industry Note:
HHA Faces Survey Complaint Over End Of Life Care
Be sure your communication with both referring physicians and patients is strong, or you... Read more
Industry Note:
Struggling Nonprofit Hospice Prioritizes Marketing
Dwindling reimbursement and in-creased competition are causing a former hospice mainstay... Read more
Industry Note:
Home Care Providers Hit By ADRs From All Sides
If the blizzard of ADRs hitting the home care industry is confusing you, you aren’... Read more
Industry Note:
Solve Overlap Problems With New Billing Guides
Help avoid denials for claims that overlap with other providers’ claims by using s... Read more
Industry Note:
LTC Chain Buys HHAs On Opposite Sides Of U.S.
Long-term care giant Kindred Health-care Inc. plans to buy the assets of Arrowhead Home ... Read more
Industry Note:
Quaker Charity To Close HHA's Doors
Mercer Street Friends Home Health Care in Trenton, N.J. plans to turn over its 2,000 pat... Read more
Industry Note:
Whistleblower Suit Settlement Dogs Hospice
The hospice that settled a whistleblower lawsuit filed by a competitor is back in court ... Read more
Compliance:
Medicare Cracks Down On F2F Documentation
The other shoe has dropped for this burdensome regulatory requirement. You can watch y... Read more
Regulations:
Under Increasing Scrutiny, Avoid These F2F Pitfalls
Does your docs’ F2F documentation include an explanation of clinical findings? M... Read more
Medical Review:
Use These 7 Tips To Head Off F2F Denials
Tip: If you have to appeal, use the physician’s visit note for support. With med... Read more
Reimbursement:
MAC Fails To Dock Hospitals For Post-Acute Transfers To Home Health
One Medicare contractor is on the hook for paying hospitals millions in error for patien... Read more
Industry Note:
MAC Denies Nearly One-Third Of Claims In Hospice Review
Denial reasons differ for first versus later hospice benefit periods. Make sure your c... Read more
Industry Note:
Use These Benchmarks To Assess Your Billing Practices
Watch for your new hospice comparative billing report to come soon. SafeGuard Services i... Read more
Industry Note:
Add This Requirement July 1
Don’t be surprised if your Medicare Ad-vantage managed care payers ask you to star... Read more
Industry Note:
CMS Implements New Overpayment Rule
CMS has found a clever way to ensure that you repay money that the program overpaid you.... Read more
Industry Note:
Use New MAC Resource For Billing Training
Need to brush up on home health billing basics? Or perhaps you’re looking for a to... Read more
Industry Note:
Know This Signature Rule For Plans Of Care
Give yourself fewer physician signatures to collect by organizing your plan of care corr... Read more
Industry Note:
One State's HH Utilization Draws Attention
Texas home health agencies are squarely under the feds’ microscope. An OIG report ... Read more
Industry Note:
Staffer Embezzles $840K From Home Health Agency
Home health agencies have another cautionary tale about unchecked employees, this time f... Read more
Industry Note:
Hospice Owes Medicare $112 Million, Govt Says
The government has filed its claim in the high-profile bankruptcy case of San Diego Hosp... Read more
Reader Question:
Don't Risk Your Compliance -- Or Your Reimbursement -- With Too-Early Hospice Certification
Know your cert timelines to avoid problems. Question: I know we have until two days af... Read more
Survey & Certification:
Alternative Sanctions Start July 1, Even Without Guidance
Medicare’s about to shift its new punishment policy into gear. Next month is wh... Read more
Regulations:
Hit The Regs To Study New Sanctions Debuting Next Month
2 more sanctions are waiting in the wings for next year’s implementation. Get to... Read more
Compliance:
Take These 7 Steps To Guard Against Alternative Sanctions
Conduct mock surveys before real ones cost you.    Surveyors will b... Read more
Human Resources:
Get The Most From Your Employees With Positive Review Elements
Key: Learn to praise the staff, not just criticize. Are performance appraisals in your... Read more
Reimbursement:
MAC Launches Face-To-Face Documentation Probe
Medicare is getting serious about face-to-face requirements. Payment for your subseque... Read more
Industry Note:
Feds Hope New MSNs Deter Medicare Fraud
Medicare kicks out providers at increasing rate. Medicare has stats to back up what ho... Read more
Industry Note:
Medicare Cost-Cutting Pressure Eases Slightly
Slower Medicare spending means the Medicare trust fund now is projected to last until 20... Read more
Industry Note:
Issue ABN For Non-Covered GIP Care, MAC Instructs
Hospices are wondering how to bill for a higher level of care than Medicare will cover w... Read more
Industry Note:
OIG Recoups Billions In First Half Of FY 2013
From last October to March, the HHS Office of Inspector General recouped $3.8 billion fr... Read more
Industry Note:
Tip: Don't Try To Adjust Redetermined Claims
Keep your claims processing timeline straight to stay away from prohibited actions. So... Read more
Industry Note:
Physician Draws 18 Months For Home Care Fraud
A physician who pled guilty in one of the high-profile home care fraud schemes in Detroi... Read more
Industry Note:
LTC Chain Expands Home Care Services In CA
Kindred Healthcare, Inc., through its Kindred at Home Division, plans to create a joint ... Read more
Industry Note:
Tennessee Chain Opens Another Location
Newport, Tenn.-based Smoky Mountain Home Health and Hospice has opened an office in Taze... Read more
Industry Note:
Hospices Keep Up Pace With Facility Openings
The HHS Office of Inspector General and other authorities are scrutinizing general inpat... Read more
Reimbursement:
Monitor Outlier Takeback Corrections Carefully
Software glitch recoups $10 million from HHAs in error. Medicare has moved quickly to ... Read more
Fraud & Abuse:
OIG Trots Out Laundry List Of Home Care Fraudsters In Semiannual Report
Plus: Watchdog agency takes ZPICs to task for overlooking HHA fraud. As 2014 budget ne... Read more
Documentation:
Stamp Signatures Are Generally A No-Go, But Attestation Statements Can Be Your Friend
Break down CMS’s requirements before you take a chance on the wrong use of signatu... Read more
Compliance:
Know This Rubber Stamp Signature Change
Most home care providers know that a physician must either submit a handwritten or elect... Read more
Clip And Save:
Consider This Sample Signature Attestation Lingo
Medicare Administrative Contractor Novitas Solutions says that although CMS does not req... Read more
Industry Note:
OIG Wants Prorated Hospital Pay For Discharges To Hospice
Move could lengthen hospital stays unnecessarily, CMS counters. Hospice lengths of sta... Read more
Industry Note:
PECOS Records Found Lacking.
Home care providers are still waiting to hear when Medicare will turn on its so-called P... Read more
Industry Note:
Tune In To Free ICD-10 Training Call
If you’re looking for a helping hand getting ready for ICD-10 next year, CMS may h... Read more
Industry Note:
Lighten Your F2F Load
Don’t worry about including face-to-face documentation when your MAC requests supp... Read more
Industry Note:
Pay Attention To Details For Hospice NOEs
Make sure you’re not glossing over the details of Medicare’s hospice benefit... Read more
Industry Note:
Hospices On Payment Hook For Vaccinations
Expect to get calls from other providers seeking payment for vaccinations starting this ... Read more
Industry Note:
Download New Pricer
Download the newest version of the home health PC Pricer at www.cms.gov/Medicare/Medicar... Read more
Industry Note:
Hospice Medical Director Guilty Of Kickbacks
A hospice medical director has been found guilty of taking kickbacks in a Medicare fraud... Read more
Industry Note:
Chain Sheds 50 Locations
After reporting a $122 million loss in the last quarter of 2012, home care chain Amedisy... Read more
Industry Note:
LHC Buys 4 Agencies
Chain LHC Group Inc. plans to acquire the assets of AseraCare Home Health for undisclose... Read more
Education:
Get Training On Conditions Of Participation, HIPAA Changes
Plus, catch up on reimbursement updates and requirements You can receive vital informa... Read more
Reimbursement:
HHAs Hit With Surprise Outlier Recoupments
Questions about outlier calculation process abound.   Abuse of outliers for hom... Read more
Hospice:
New Coding Restrictions Will Hit Many Hospices Hard
Tip: Look to your secondary diagnoses for the ‘real’ principal code.  ... Read more
Diagnosis Coding:
Expert: Guidance Doesn't Square With Coding Conventions
Authorities have been sounding the horn about using non-specific diagnoses improperly la... Read more
Payment:
Hospices Fear Financial Implications Under Expanded Diagnosis Code Reporting
CMS: ‘Hospices are required to provide virtually all the care that is needed ... a... Read more
Survey & Certification:
OIG Wants More HHA Surveys
Surveyors rarely terminate providers, investigators found.     The reaso... Read more
Managed Care:
Medicare Advantage Taking A 2 Percent Bite? Bite Back
Unless your contracts specifically allow your MAO to pass on its 2 percent cuts to you, ... Read more
Emergency Preparedness:
Home Care Community Mobilizes After Oklahoma Tornadoes
How would your organization handle loss of communication, power and water?   &n... Read more
Industry Note:
Get Ready For More State Scrutiny Of Your Data
OIG gives thumbs up to data mining.     You should be paying attention t... Read more
Industry Note:
Senate Confirms Official CMS Administrator
The Centers for Medicare & Medicaid Services has its first permanent Administrator i... Read more
Industry Note:
MAC Gives Thumbs Down To House Call F2F
Have you thought of contracting with a physician to make house calls to fulfill face-to-... Read more
Industry Note:
State Beefs Up Background Checks For Workers
Ohio workers furnishing direct care for the elderly will have to pass beefed up backgrou... Read more
Industry Note:
Strike Force Focuses On Patient Recruiter Kickbacks
More details are emerging about the charges against home care providers in Medicare&rsqu... Read more
Regulations:
Say Goodbye To One Home Health Claim Type
Plus: Revised OASIS-C should be unveiled soon. Medicare is making a claim format chang... Read more
Hospice:
Comply With Hospice Diagnosis Coding Changes Now, CMS Says
Hospices seek clarification on diagnosis coding provisions in proposed rule. The hospi... Read more
Fraud & Abuse:
Home Care Features In Recent Fraud Takedown
Ill gotten gains go to buy luxury cars. The reimbursement your agency earns may go to ... Read more
Referrals:
Help Physicians Get Home Care Coding Right
Lean on 99341-99350 and POS 12 for these visits, experts say. Whether it’s your ... Read more
Industry Note:
Get Ready To Add These Questions To Hospice Intake
CMS wants hospices to start collecting HIS data next summer. CMS has released more det... Read more
Industry Note:
Face-To-Face Required For Initial Home Care Episodes Only, Contractor Reminds Providers
Don’t compound your face-to-face re-quirement burden by collecting unnecessary doc... Read more
Industry Note:
HHS Fails To Follow Up On Concurrent Care Demo Required By Affordable Care Act
Medicare is falling behind on testing curative care for beneficiaries, report Politico a... Read more
Industry Note:
Info On DME Restrictions Coming To Your Patients
Your patients and referral sources soon may be getting letters informing them about rest... Read more
Industry Note:
Watch Out For Duplicate Remittance Advices
A Medicare claims system glitch means you’ll be seeing a slew of duplicate remitta... Read more
Industry Note:
Keep Tabs On New Thresholds For Appeals
Don’t forget that the amount in controversy levels have ticked up this year, remin... Read more
Industry Note:
Non-Hospice Palliative Care Pressures Traditional Providers
The rise of palliative care in non-hospice settings is tightening traditional hospice pr... Read more
Industry Note:
Chain Reports Six-Figure Loss In Latest Quarter
LHC Group Inc. was the only "big four" publicly traded home care chain to incr... Read more
Industry Note:
Payroll Employee Soaks Hospice For $1.6 Million
Keep a close eye on your administrative employees, or you could find yourself in the und... Read more
Hospice:
CMS Cracks Down On Hospice Diagnosis Coding
Will new guidance broaden what you’re required to cover under the hospice benefit?... Read more
Diagnosis Coding:
Future Hospice Payment May Depend On Your Coding
Plus: Coding emphasis carries some positives Diagnosis coding may not affect your hosp... Read more
Strategy:
Use These 5 Tips To Tackle Hospice Coding
Should you spend money on certified coders? Don’t waste time sitting around to s... Read more
Fraud & Abuse:
VITAS Slapped With False Claims Lawsuit
Suit focuses on continuous home care More proof that the feds are cracking down on the... Read more
Reimbursement:
Palmetto Starts Reversing RAP Non-Payments
Get your corrective action plan in pronto to clear up cash flow delays. If you’r... Read more
Industry Note:
Compare Yourself To Your Peers With Billing Report Data
CBR contractor issues benchmarks. You may not have been one of the nearly 5,000 home h... Read more
Industry Note:
OIG Has Hospice Inpatient Care In Its Sights
If your hospice lies at either end of the GIP spectrum, expect to take increasing heat. ... Read more
Industry Note:
Use Claims Error Tool To Reduce Cash Flow Problems
You can facilitate quicker cash flow if you understand why your claims deny. To help wit... Read more
Industry Note:
CMS To Terminate HIQH Next April
If you’ve been ignoring HETS, it may be time to pay attention. By April 2014, th... Read more
Industry Note:
Provider Lays Off Staff Due To Sequestration
The sequestration cuts are hitting providers where it hurts. Hospice of the Bluegrass in... Read more
Industry Note:
Miami Home Health Recruiter Lands 3-Year Sentence
A Miami home health recruiter who pled guilty to conspiracy to receive health care kickb... Read more
Industry Note:
Two Chains' Profits Fall In Latest Quarter
Two publicly traded home care chains saw their earnings fall this quarter. Almost Fami... Read more
Industry Note:
County Sheds HHA In Continuing Trend
Livingston County, N.Y. is planning to sell its county home health agency, reports the L... Read more
Hospice:
Hospice Payment Rates To Tick Up 1% Next Year
CMS may cut how much you get paid for Routine Home Care. BNAF and Affordable Care Act ... Read more
Quality:
Get Ready To Collect These Hospice Data Items
Will ‘HIS’ data set become hospices’ OASIS? The Centers for Medicare... Read more
Diagnosis Coding:
CMS To Ban Debility, Failure To Thrive As Primary Diagnoses On Hospice Claims
Most hospices still aren’t reporting secondary diagnoses, CMS fumes.  If yo... Read more
Strategy:
Use This Tool To Problem-Solve In Your Agency
Consider a ‘learning circle’ to crack tough issues. Whether you need your ... Read more
Tool:
Maximize 'Learning Circle' Potential With These Questions
Tip: Mix specific and open-ended questions.  In addition to questions on specific... Read more
Medical Re view:
CERT Reviewers Deny Claims Based On F2F
Would your face-to-face documentation pass medical review muster? Have you been lettin... Read more
Industry Note:
Medicare Ramps Up Readmission Penalties
Plus: CMS adds two new DRGs to readmission penalty list. Hospitals soon will have even... Read more
Industry Note:
E-Mail Causes Hospice HIPAA Violation
Make sure your staff are thoroughly trained — and reinforced — about HIPAA-c... Read more
Industry Note:
Monitor Your RAPs
With HHH Medicare Administrative Contractor Palmetto GBA setting RAPs to pay nothing if ... Read more
Industry Note:
Trade Groups Merge
The National Association of Indepen-dent Medical Equipment Suppliers will merge with the... Read more
Industry Note:
Counter Physician Signature Problems With Log
Are you having trouble with ordering physicians signing documentation differently at dif... Read more
Industry Note:
HHA Office Worker Pleads Guilty In Detroit
A home health office worker has pled guilty to Medicare fraud in the $24 million Detroit... Read more
Industry Note:
Agency Closes In Face Of Medicaid Investigation
Deaconess Home Health in Milwaukee has closed in the face of a Medicaid investigation, l... Read more
Industry Note:
Kindred Makes Texas Buy
Long-term care giant Kindred Health-care Inc. is aiming to increase its presence in the ... Read more
Industry Note:
San Diego Hospice Facility Goes To Highest Bidder
San Diego Hospice’s inpatient facility has gone to the highest bidder. After 50 bi... Read more
Hospice:
Hospice Payment Reform Is Knocking On Your Door
Prepare now for variable rates under the Medicare hospice benefit. All that visit data... Read more
Know Your Facts:
Skyrocketing Hospice Statistics Contribute To Payment Shift Motivation
Average LOS increased 50 percent from 2000 to 2007.  Here are the statistics that... Read more
Payment:
Hospice Payment Change Will Create Winners, Losers
Profit margins to drop for hospices with long-staypatients in U-shaped model, MedPAC exp... Read more
Diagnosis Coding:
Hospice Payment Changes Won't Stop With Variable Rates
Other elements on the horizon: case mix, site of service considerations.  Law- an... Read more
Reimbursement:
MAC Cuts Off RAP Payments For HHAs With Too Many Cancels
Expect this cash-flow draining tactic to spread across the country. If you’re le... Read more
Industry Note:
CMS Delays PECOS Edits
Plus: Use RAP non-payment as early warning of PECOS edit problem. Home health agenci... Read more
Industry Note:
Self-Disclosure Heads Off CIA Under New Policy
If you discover improprieties that you must self-disclose to the HHS Office of Inspector... Read more
Industry Note:
Beware This Claims Payment Snafu For Low-Visit Claims
A system glitch is resulting in remittance advice errors for LUPA claims. "For Low ... Read more
Industry Note:
Incorrect Hospice PEPPER Reports Go Out -- Again
Don’t base any big initiatives on your hospice PEPPER report data quite yet. About... Read more
Industry Note:
CMS Administrator Finally Up For Confirmation
Congress is one step closer to confirming Centers for Medicare & Medicaid Services A... Read more
Industry Note:
OIG Asks For More Fraud-Fighting Funds
If it feels like the OIG uses more re-sources to go after inappropriately billed and pai... Read more
Industry Note:
Ohio Agency Owes $700K After Audit
If it’s not documented, it’s not done. That maxim proved true once again in ... Read more
Industry Note:
HHA Office Manager Convicted In Fraud Scheme
A federal jury in Detroit has convicted the office manager of a home health agency for h... Read more
Industry Note:
Provider Lays Off Staff In Face Of Sequestration
Sequestration cuts, on top of other financial and regulatory burdens, continue to take a... Read more
Budget:
U.S. President Wants Cuts To HHA Payments Next Year
Hospices generally get a pass in White House budget for 2014. As the opening salvo in ... Read more
Edits:
HHAs Getting Up To Speed On Physician PECOS Requirements
Be sure you’re on top of these costly edits before they hit May 1.  If you ... Read more
Reimbursement:
System Glitch Leaves HHAs Hanging
Claims system problem reminds agencies to always be prepared. Without reimbursement co... Read more
Quality:
Tap This Resource For Quality Assistance
CMS Quality Improvement Organizations can help you improve care and reduce costs. Do... Read more
Industry Note:
Improvement Standard One Step Closer To Getting The Boot
Medicare issues fact sheet following lawsuit settlement overturning policy. Medicare... Read more
Industry Note:
Use These Instructions For Billing With Diagnosis Codes When ICD-10 Hits
Not sure how to handle diagnosis codes on claims that span the Oct. 1, 2014 implementati... Read more
Industry Note:
OIG Shines Spotlight On Miami Home Health Fraud Once Again
The HHS Office of Inspector General is trumpeting its success with its HEAT initiative i... Read more
Industry Note:
Keep Medicare Timely Filing In Mind For Former Hospice Late Claims
Hold up on submitting those hospice late bills. "Hospice add-on claims (also known ... Read more
Industry Note:
Follow This Procedure When Patient Won't Sign ABN
Does your agency have to be on the hook if a patient refuses to sign an ABN? No, says a ... Read more
Industry Note:
Case Study: Hospital Uses Home Care To Curb Readmissions
Medicare’s new payment system for hospitals, which penalizes them for high readmis... Read more
Industry Note:
D.C. HHA Owner Guilty
A former HHA owner in the nation’s capital has pled guilty to creating fake patien... Read more
Industry Note:
Excluded Staff Lead To Ohio HHA Owner's Guilty Plea
An HHA owner in Ohio has pled guilty to Medicare fraud. Divyesh "David" C. Pat... Read more
Industry Note:
Providers Plan To Build More Hospice Houses
The number of the nation’s hospice inpatient facilities continues to grow. In Bo... Read more
Medical Review:
Don't Let F2F Errors Trip Up Your Reimbursement
Reviewers shoot down 20% of claims for physician-related paperwork errors. The content... Read more
Budget:
President Obama Proposes Home Health Copays
Copays would start in 2017, if White House gets its way.   Home health agencies... Read more
OASIS:
Missing OASIS Sinks Claims
Tip: Include OASIS transmission record when you respond to an ADR. Missing OASIS asses... Read more
Reimbursement:
Scratch This Physician-Related Requirement
But you still need to report new Q codes starting July 1.   Home health agencie... Read more
Therapy:
Know Therapy Review Ropes To Minimize Disruption
Hold tight: CMS promises a more permanent solution soon. If you’re furnishing Pa... Read more
Billing:
Three-Fourths Of HHAs Fail PECOS Edits
Tip: Check for extra spaces in your doc names. You have only a few weeks to get your a... Read more
Industry Note:
Watchdog Agency Pushes Surety Bonds
OIG wants even larger bonds for DME suppliers. The OIG is urging CMS to get tough... Read more
Industry Note:
Learn Hospice GIP Lessons From New Resource
Don’t expect caregiver breakdown to qualify your hospice patient for the General I... Read more
Industry Note:
Action Required To Recover Funds Stalled Due To 32061
HHH MAC CGS has turned off Reason Code 32061 that was inappropriately holding up hospice... Read more
Industry Note:
DME Bidding To Hit 91 Cities In July
Get ready for your patients’ access to durable medical equipment to change this su... Read more
Industry Note:
Hospice Notifies 5,000 Patients Of Possible HIPAA Breach
A North Carolina hospice is notifying patients of a possible HIPAA breach, and for once ... Read more
Industry Note:
Late Payments Aren't Really Late, MAC Maintains
You may have noticed sluggish payments this month, but that’s tough cookies, one M... Read more
Industry Note:
Detroit HHA Owner, PT Found Guilty Of Fraud
A Detroit-area HHA owner and physical therapist have been found guilty in a $2.3 million... Read more
Referrals:
Get Ready To Say ' No' To Referrals, Thanks To PECOS Edits
The number of your docs without a PECOS file may surprise you.   Home health ag... Read more
Edits:
Approach Pending PECOS Enrollment With Caution
Will you take the physician’s word for it?   Just like saying “the ... Read more
Fraud & Abuse:
Qui Tam Suit Nets Whistleblower $1.8 Million
Catch up on recent enforcement actions.   The last few weeks have brought a sle... Read more
Diagnosis Coding:
Start Your ICD-10 Engines With This Bite-Sized Introduction
Get comfortable with the guidelines and format now, not later.   With a myriad ... Read more
Strategy:
Use This Resource To Work Toward Patient-Centered Care
Follow these 5 strategies to achieve the best care at lower cost.   If you want... Read more
Industry News:
Home Care Providers In Region C Court Most RAC Scrutiny
Billing, OASIS top RAC hit list. Recovery Audit Contractors continue to crank up their... Read more
Industry News:
CMS Declares Claims Hold
Errors in this month’s Medicare claims system update could affect your cash flow. ... Read more
Industry News:
Pre-Pay Therapy Review Commences
HHAs that furnish outpatient Part B therapy in the home will have major headaches billin... Read more
Industry News:
Claims System Glitch Derails Hospice Payments
Beware this glitch holding up your hospice reimbursement. Claims are being incorrectly r... Read more
Industry News:
Hospitals Lean On Home Care For Readmission Prevention
More hospitals are relying on home care to curb their rehospitalization rates. Hospitals... Read more
Industry News:
Focus On Upcoming Hospice Data Deadlines, CMS Urges
The deadlines for reporting hospice quality data this year have passed, but it’s n... Read more
Industry News:
ICD-10 Typo Panics Home Care Providers
Don’t freak out if you read in a newly revised MLN Matters article that ICD-10 is ... Read more
Industry News:
Workers' Class Action Lawsuit Dogs Beleagured Hospice
Add a class action lawsuit to the list of San Diego Hospice’s woes. A suit w... Read more
Industry News:
Chain Makes Hospice Buy In Alabama
LHC Group Inc. is wading further into the hospice market. It has acquired the assets of ... Read more
Regulations:
Keep Your Eyes Peeled For These HHA Developments In 2013
Get ready for OASIS C-1 revamp.  Home health agencies will have their hands... Read more
Survey & Certification:
Guard Against Plan Of Care Survey Deficiencies
Sidestep this common survey pitfall with excellent physician communication.   W... Read more
Billing:
New Comparative Billing Reports Hit HHAs' Mailboxes
Problem: Benchmarking reports target high wage index providers, trade group protests. ... Read more
Hospice:
Nursing Home Survey Changes Stress Palliative Care Duties
Skilled nursing facilities may need your help now more than ever.   You can hel... Read more
Education:
Point Nursing Homes To These Survey Guidance Specifics On Palliative Care
More than one F tag is involved in end-of-life care compliance for skilled nursing facil... Read more
Industry Note:
HHS Showcases Home Care Fraud In Latest Report
Authorities aren’t giving personal care services providers a pass anymore.  ... Read more
Industry Note:
More Than 1/3 Of Hospitalized Medicare Benes Discharged
With more than a third of hospitalized Medicare beneficiaries discharged to home care, y... Read more
Industry Note:
Avoid Extra HHABN Burden
Don’t get too detailed on the HHABNs you hand out, or you may cause yourself extra... Read more
Industry Note:
Prior Authorization For Therapy Gone
If you furnish Part B outpatient therapy in the home, there’s no longer a way to a... Read more
Industry Note:
Obama Appoints Home Care Rep
Home care will see some representation in the new Long Term Care Commission appointed by... Read more
Industry Note:
Beware: NPI Doesn't Equal PECOS Enrollment
Beware: just because you have a physician’s NPI, doesn’t mean he’s in ... Read more
Industry Note:
Chain Offers CEUs For Physician Education
Looking for a way to help out your referral sources and your patients at the same time? ... Read more
Industry Note:
Hospice Cuts Staff Hours In Face Of Sequestration
The 2 percent sequestration cuts scheduled for April 1 are already affecting home care p... Read more
Industry Note:
Home Care Mergers & Acquisitions Continue
Reimbursement uncertainties such as sequestration cuts don’t seem to be impacting ... Read more
Industry Note:
Physician Sentenced To 5 Years For Home Care Fraud
A Houston physician has drawn a five-year prison sentence for falsifying home health pla... Read more
Industry Note:
Detroit-Area HHA Owner Indicted For Fraud
A Detroit-area pharmacy owner indicted in a massive drug fraud scheme also ran a home ca... Read more
Edits:
MAC Shoots Down Half Of Low Case Mix Claims
MAC Shoots Down Half Of Low Case Mix Claims Does your documentation make the case for... Read more
Documentation:
Pass Low Case Mix Edits By Following These 5 Tips
Pass Low Case Mix Edits By Following These 5 Tips The days when a home health agency ... Read more
Budget:
Brace For 2 Percent Payment Cut On Your Current Episodes
Reduction takes effect based on episode end date. Tighten your budget belt another no... Read more
Diagnosis Coding:
Are You Ready For ICD-10 Implementation Next October?
Cover your bases on ICD-10 preparations. You’ve known the official date for ICD... Read more
Regulations:
Take These 4 Steps To Meet ICD-10 Challenges Head On
Start your impact assessment yesterday The switch to ICD-10 may not be easy, but you ... Read more
Industry Note:
Alabama HHA Settles Whistleblower Suit For $150K
Qui tam suit revolves around homebound status Make sure you’re following Medicar... Read more
Industry Note:
Millions In Hospice Foundation Funds Excluded From Bankruptcy
How would you like your salary splashed across the local news? That’s what Sa... Read more
Industry Note:
Physician Partners Can't Sign F2F
Physician documentation practices that work in other areas just won’t cut it for t... Read more
Industry Note:
Double Up On Your Hospice Data Reporting
Don’t forget: You should be pulling double duty when it comes to hospice quality d... Read more
Industry Note:
CGS And Palmetto Parent Rebrands As Celerian
It may be hard to keep your MAC, ZPIC, RAC, QIO, and other Medicare contractors straight... Read more
Industry Note:
Amedisys Reports Loss
Amedisys Inc. reported a net loss of $122 million on revenues of $362.9 million for the ... Read more
Industry Note:
Private Equity Firm Invests In Texas Hospice
A Texas hospice plans to grow further with an investment from a private equity firm. Hea... Read more
Industry Note:
3 Texas HHA Owners Draw 3-Year Prison Sentences In Medicare Fraud Case
Three HHA owners have drawn threeyear prison sentences in a $1.3 million Medicare fraud ... Read more
Industry Note:
HHA Owner Sentenced To 4 Years For Medicaid Fraud
A West Virginia HHA owner has been sentenced to nearly four years in prison for Med... Read more
Enrollment:
It's Official: PECOS Edits Start Denying Claims May 1
Your reimbursement will hinge on referring docs’ enrollment status. The other sh... Read more
Reimbursement:
Take These 6 Steps To Head Off PECOS Edit Losses
Tip: Check your current RAs to avert financial crisis in May. You’d better get y... Read more
Budget:
Sequestration Cut Budget Plans Hung Up By Uncertainties
Will the 2 percent cut be based on start dates or end dates for episodes? Lawmakers fa... Read more
OASIS:
Beware Case Mix Pitfalls With New M1024 Rules M1024 Rules
Don’t let errors in filling out the OASIS item on diagnosis codes cost you money. ... Read more
Human Resources:
'Do As I Do' Backed By Study
When you lead by example, your team will follow suit. So found researchers at the Fuqu... Read more
Industry Note:
Home Care Therapy Could Save Medicare Money
New study backs up industry’s assertions about therapy services. Law- and policy... Read more
Industry Note:
It may seem like you just got your first hospice PEPPER report
It may seem like you just got your first hospice PEPPER report, but it’s nearly ti... Read more
Industry Note:
Know Your Flu Shot Basics
Confused about billing for seasonal vaccinations? A new job aid from Medicare Administra... Read more
Industry Note:
Feds Raid Scooter Store
No charges have yet been filed after 150 federal and state agents searched the The Scoot... Read more
Industry Note:
Texas HHA Settles Fraud Charges For $93K
A Texas home health agency has forked over nearly $93,000 to settle fraud claims, the HH... Read more
Industry Note:
Ensign On The Acquisition Trail
The Ensign Group, Inc. has acquired Elite Home Health and Hospice from Tri-State Memoria... Read more
Industry Note:
Chain Buys 21 Locations From Addus
Chain LHC Group Inc. has purchased 19 home health agencies and two hospice agencies in f... Read more
Industry Note:
HHA, Hospice Merge In CA
Pioneer Home Health Care, Inc. and Hospice of The Owens Valley in Bishop, Calif., have m... Read more
Industry Note:
Home Care Fraudster Handed 9-Year Sentence
Two home care fraudsters have been handed stiff prison sentences following guilty pleas.... Read more
Industry Note:
Man Pleads Guilty To Selling Patient Info To HHAs
A Detroit-area patient recruiter has pled guilty to his part in a $25 million fraud sche... Read more
Compliance:
Heed 3 New Updates In Your Quality Reporting & OASIS
What to do if you change Home Health Compare vendors. If you feel like you’re sp... Read more
Reimbursement:
Get Your Functional Limitations Reporting Right -- Or Risk Denials
When you can (and cannot) breathe easier when it comes to reporting. Are you fully pre... Read more
OASIS:
Patient With Multiple Functional Deficits? How You Can Earn Cumulative Points
Beware of OASIS and coding interplay with Neuro 1 diagnoses. With more than 73 codes i... Read more
Part B Therapy:
What To Do When Your Patient's Limitations Don't Fit A G-Code Category
ron out your G-code reporting pronto. Not every limitation will fit nicely into one of... Read more
Management Strategies:
Take 4 Steps To Lead Your Staff Through Tough Changes
Reinforce your leadership record to keep everyone on-board. With all the myriad of sca... Read more
Industry Note:
You Could Soon Have More Veterans As Patients
Proposed rule would open up veterans’ care choices to non-VA providers. A propos... Read more
Industry Note:
CMS Survey Could Spark Changes To The Case-Mix System
Did you receive a survey on vulnerable beneficiaries? Pursuant to the Affordable Care Ac... Read more
Industry Note:
National Home Care Study Underway -- How To Participate
If you want your voice to be heard on important industry issues, you’ll have yet a... Read more
Industry Note:
OIG Pushing For More Medicaid Overpayment Collections
CMS is looking to collect more Medicaid overpayments, to the tune of more than $200 mill... Read more
Industry Note:
How To Prepare For Hospice Cost Report Revisions
Start collecting data under the new Uniform Chart of Accounts, if you want to know what ... Read more
Industry Note:
Another Conspirator Pleads Guilty In $24-Million Fraud Bust
A man who sold Medicare beneficiary information pled guilty to charges stemming from his... Read more
Industry Note:
Personal Care Business Owner Nabbed For False Respite Care Claims
An in-home personal care business owner pled guilty to charges that she submitted false ... Read more
PPS 2013:
Oops: How To Fix An FTF Encounter Mistake
Not all is lost if you miss the encounter deadline. With the new face-to-face encounte... Read more
OASIS:
Secure Risk Adjustment For Wounds With M1350
Don’t overlook this essential wound item just because it doesn’t earn points... Read more
Case Mix:
Don't Miss Out On Neuro 1 Case Mix Points
Are you getting an accurate score? Answering the OASIS items associated with earning N... Read more
Regulations:
Will You Soon Get Reimbursement For 'Telehomecare' Interactions?
NAHC’s legislative priorities vary widely from basic to far-fetched. What favora... Read more
Management Strategies:
Take 4 Active Steps To Improve Staff Performance
Don’t delay taking action with underperforming employees. If you’ve ever d... Read more
Industry Note:
Associations Want To Protect You From Burdensome Data Collection
HAA backs hospices in CMS’s proposed additional hospice data reporting. You won&... Read more
Industry Note:
CMS Plans To Replace HHABN With 2 Forms
CMS is proposing to cut through the confusion over beneficiary notices by eliminating th... Read more
Industry Note:
What Are 2013's Top 10 Regulatory Issues For HHAs & Hospices?
What are the top 10 regulatory issues for home care and hospice in 2013? NAHC has drawn ... Read more
Industry Note:
HHA Nailed For Billing Services While Patients Were In Hospital
An HHA was caught billing Medicaid for services when patients were in the hospital and f... Read more
Industry Note:
Soon Better Coverage For Pediatric Palliative Hospice Care
You may soon get better coverage for pediatric palliative hospice care, thanks to the Af... Read more
Industry Note:
Homecare Unlimited Owner Faces 90 Years In Prison
An HHA owner was caught falsifying her Medicaid-provider application, and then billing t... Read more
Industry Note:
Home Health Center Employees Nabbed For Battery & Assault
Four home care employees were arrested for felony battery and neglect, following an inve... Read more
Industry Note:
Cardinal Health Acquiring AssuraMed For $2 Billion
Cardinal Health is buying AssuraMed in a $2-billion acquisition deal aimed at expanding ... Read more
Hospice:
How To Get Ahead Of The Curve On Your Hospice Cap Exposure
Tip: Maintain your own database to manage your cap status. If you were having trouble ... Read more
Coding:
Use These Codes To Report Where You Provided Services
You also must report when a non-certifying doc adds to the care plan. Get ready for ne... Read more
OASIS:
Understand The Right Time Period For Each OASIS Item
Your reimbursement hinges on your accuracy for these items. If you only consider what&... Read more
ICD-10:
Get Ready For Very Different Flu Dx Coding Under ICD-10
Prepare now, or risk a chaotic flu season next year. The ICD-10 implementation date ma... Read more
Management Strategies:
Ask These Specific Questions To Get Top-Notch Performance
How to craft the accountability culture you want. If you’re facing accountabilit... Read more
Industry Note:
New Edits Will Reject These Hospice Claims
ay attention to exact dates for your monthly billing practices. You’ll soon need... Read more
Industry Note:
CMS Adds Code A4435 To Consolidated Billing List
CMS is adding a new code to the consolidated billing list, under the Home Health Prospec... Read more
Industry Note:
FBI Busts HHA Owners For Fraud, Bribery, Money Laundering
A federal investigation has led to 11 arrests in a large-scale Medicaid fraud scheme inv... Read more
Industry Note:
Palmetto GBA Announces 2013 Workshop Series
Palmetto GBA is kicking off its annual home health and hospice workshop series for 2013,... Read more
Industry Note:
Feds Boast Huge ROI On Healthcare Fraud-Fighting
Government watchdogs are raking in the dough from fraud enforcement, and the federal gov... Read more
Industry Note:
San Diego Hospice Files For Bankruptcy
San Diego Hospice filed for bankruptcy reorganization amid an extensive and ongoing inve... Read more
Industry Note:
HHS Lawsuit Settlement Bucks 'Improvement Standard'
A recent court decision is changing the "improvement standard" for home health... Read more
HHAs:
Alternative Sanctions: What 'Temporary Management' Really Means
Plus: Should you fear directed in-service training, plans of correction? Thanks to the... Read more
Good News:
Some ICD-9 Logic Transfers To ICD-10
Learn step-by-step instructions to get into the swing of new diagnosis coding. As you&... Read more
ICD-10:
How To Balance ICD-9 Upkeep With ICD-10 Preparation
Improved documentation should ease your workload. With the flurry of activity over tra... Read more
HIPAA Compliance:
Use This Sample Risk Analysis Plan To Ensure EHR Compliance
How to stay in the good graces of HIPAA compliance auditors. Nip your HIPAA compliance... Read more
Education:
Prepare Yourself For Survey Sanctions, HIPAA Penalties
Bone up on all the new compliance dangers. From new sanctions for noncompliant home he... Read more
Industry Note:
Are You Considering These Key Areas When Assessing Fall Risks?
Medications, poor nutrition are risk factors. Falls are the leading cause of fatal inj... Read more
Industry Note:
Medicare Payments Advisory Board Could Soon Be No More
You may not need to worry about the Medicare Payments Advisory Board any longer, because... Read more
Industry Note:
Can You Still Send Unencrypted Emails Under HIPAA Rule?
Don’t be confused by whether changes to the HIPAA privacy rule bars sending unencr... Read more
Industry Note:
Home Care Patient Recruiters Plead Guilty To $20-Million Fraud Scheme
Two home health agency patient recruiters pled guilty to a $20-million fraud scheme in a... Read more
Industry Note:
CMS Kicks Off 'Bundled Payments' Initiative
CMS has officially begun the Bundled Payments for Care Improvement initiative, which wil... Read more
Industry Note:
Why Louisiana Hospices Are Breathing A Sigh Of Relief
Louisiana hospice providers exhaled a big sigh of relief, as Gov. Bobby Jindal threw out... Read more
Industry Note:
HHA Owner Gets 8-Year Sentence For Medicaid Fraud, Grand Theft
An HHA owner was sentenced to eight years in prison for Medicaid fraud totaling more tha... Read more
Industry Note:
Home Health Workers Union President Convicted Of Embezzlement
A former home care union president was convicted of embezzlement while he headed the Sou... Read more
Industry Note:
Short Hospice Stays A Rising Trend, Not Good For Anyone
Short hospice stays aren’t very useful to patients or payers, but they are a growi... Read more
Hospice:
Heads Up: New CMS Hospice Survey Won't Target Patients
What do you want CMS to ask your patients’ family and friends? Prepare yourself ... Read more
Therapy:
Why Your Outpatient Therapy Claims Still Have A Long Road Ahead
MACs will continue to review claims on a post-payment basis. Don’t think scrutin... Read more
Regulations:
Brace Yourself For A Longer Lookback Period
Medicare now has two more years to collect on overpayments. Your frustration with the ... Read more
HIPAA Compliance:
Snuff Out EHR Security Problems To Avoid Big Fines
Root out vulnerabilities before CMS does it for you. Your electronic health record sys... Read more
Reimbursement:
When You Should Not Report 'Resolved Condition'
Don’t assume your way out of case mix points. While you can no longer report res... Read more
Industry Note:
Get Ready For Serious Scrutiny Of Your HIPPS Claims
Palmetto set to launch medical review edits for high-denial rate codes. Your claims fo... Read more
Industry Note:
You'll Get A 'Fiscal Cliff' Reprieve Until Mid-May
You’re getting another ‘fiscal cliff’ reprieve, now that the House pas... Read more
Industry Note:
Home Care Employee Gets Prison Time For Medicaid Fraud
A Minneapolis man was sentenced to 18 months in prison for defrauding Medicaid of more t... Read more
Industry Note:
HHA Owner To Serve 75 Months In Prison For Fraud, Identity Theft
An HHA owner gets 75 months in prison for health care fraud, alteration of records and a... Read more
Industry Note:
CMS Wants Contractors To Add ICD-10 Codes To NCDs
The Centers for Medicare & Medicaid Services is urging contractors to add ICD-10 cod... Read more
Industry Note:
MN Home Care Firm Under Fire For Medical Assistance Fraud
A home care company is under fire for alleged medical assistance fraud, for purportedly ... Read more
Industry Note:
Software Vendors Now Have Steeper Fines For HIPAA Breaches
Your software vendor will face steeper penalties for HIPAA breaches, as recent changes t... Read more
Industry Note:
MACs May Begin Denying Claims That Fail Ordering/Referring Edits
CMS might soon follow through on its longstanding threat to deny claims that fail the or... Read more
Industry Note:
SNF-Hospice Care Combo Keeps Patients From Dying In Hospitals, Study Finds
A combination of skilled nursing facility and hospice care reduces dementia patients&rsq... Read more
HHAs:
Background Checks: Is Your State Lowering The Boom?
What you need to know to prepare for stricter requirements. Ohio is the latest state t... Read more
Staffing:
How To Develop A 'Targeted Screen' For Better Legal Standing
Protect your HHA from discrimination claims under the new EEOC guidance. If an employe... Read more
Reimbursement:
Do You Know What Happened To Your Patient? Make Sure Your Coding Says So
And why you’re getting more FTF-related denials. If you’re mixing up your ... Read more
Leadership:
Retain Your Best Employees With This Tool
Combat high turnover with simple awareness. High turnover is prevalent in the home car... Read more
Education:
How To Avoid The Top Home Health Coding & Documentation Mistakes
Plus: Get the skinny on everything you need to know about M1024 changes. You don&rsquo... Read more
Industry Note:
Hospices: MedPAC Has No Favorable Recommendations For You
Commission wants more scrutiny of your long-stay patients. Congress won’t give h... Read more
Industry Note:
Huge Home-Care Fraud Scheme Uncovered
A huge home care fraud bust yielded seven arrests of individuals allegedly involved in a... Read more
Industry Note:
Dallas VNA Ends Home Health Services
The Dallas Visiting Nurse Association will end its home care operations in March, and in... Read more
Industry Note:
HHA Owners Convicted of Medicaid Fraud, Identity Theft
HHA owners were convicted of defrauding Medicaid and aggravated identity theft, over the... Read more
Industry Note:
OIG Spending Millions of Recovery Act Funds
The HHS Office of Inspector General is spending Recovery Act Funds like water, according... Read more
Industry Note:
Inadequate Medical Supervision Leads to Settlement
A Maryland HHA will pay nearly $160,000 in a settlement to resolve false Medicaid claims... Read more
Industry Note:
Give Your Opinion on Safe Harbor Provisions
The OIG is soliciting proposals and recommendations for safe harbor provisions, as well ... Read more
Industry Note:
Number of New ACOs is Exploding
Accountable Care Organizations are popping up seemingly everywhere, as HHS announced 106... Read more
Industry Note:
Palmetto to Review HH PPS Grouper
Get ready for Palmetto GBA to review your home health claims, specifically claims with d... Read more
Industry Note:
Future of QIO Program on the Discussion Table
If you have something to say about the future of Quality Improvement Organizations, CMS ... Read more
Industry Note:
HHA Employee Nabbed for 6-Year-Long Fraud Scheme
An HHA employee is charged with carrying out a six-year-long, $1.47-million fraud scheme... Read more
Industry Note:
Countdown to Health Insurance Marketplace Begins
You can celebrate a new pool of insured patients come 2014, just as the U.S. Department ... Read more
Hospice:
7 Crucial Action Points For Hospice Quality Reporting
Don’t mess up key components of your registration. The Hospice Quality Reporting... Read more
OASIS:
How To Interpret ADL Assessment Items The Right Way
Heed these essential tips for better ADL assessment. When completing OASIS items relat... Read more
Why You Should Take Deactivation Very Seriously
And what you cannot take with you when you switch users. One huge pitfall concerning t... Read more
HIPAA Compliance:
Protect Patient Data On Mobile Devices -- Or Risk Big Fines
Focus on 3 safeguard areas to prevent unauthorized access. Securing electronic protect... Read more
Education:
Learn Expert Strategies For A Smooth ICD 10-CM Transition
Why wait until the last minute to devise your game plan? Prepare now for the big ICD 1... Read more
Industry Note:
Still Teetering On The Edge Of The Fiscal Cliff?
Good news, bad news in the fiscal cliff fix. Although hospitals and certain other Medi... Read more
Industry Note:
Give Your Opinion On CMS Contractors
What do you think about the various audit contractors? The Government Accountability Off... Read more
Industry Note:
HHA Gets Caught With Unlicensed/Uncertified Staff
A New Jersey HHA which came under fire for not providing certified home health aides and... Read more
Industry Note:
Get Ready For Better Home Health Software Services
A new mega home health software company has formed after home medical equipment software... Read more
Industry Note:
Hospice Slapped With Big Fine For HIPAA Breach
The Hospice of North Idaho will pay $50,000 to the U.S. Department of Health and Human S... Read more
Compliance:
Get Ready For A Big Crackdown From MACs & ZPICs
Are ZPICs going easier on you than MACs? If your home health agency is in one of certa... Read more
Organization:
Meet Goals With This 7-Step Plan
Don’t let everyday tasks overwhelm you. With a little planning, you can erase an... Read more
Staffing Strategies:
Beef Up Your Grievance Policy To Manage Complaints
 How your complaints process affects more than just staff morale. If you don&rsqu... Read more
OASIS:
Avoid These Common OASIS ADL Item Errors
Could your ADL item response send a patient to the nursing home? The OASIS ADL/IADL it... Read more
Education:
Get Training On This Year's Outlook For Hospices
Plus: Check out crucial HIPAA training and review the HH PPS final rule.  You can... Read more
Industry Notes:
Try This Approach to Assessing Ability
Adjust your phrasing for more accurate answers. When it comes to completing OASIS item... Read more
Industry Notes:
HHA Owners Plead Guilty to $48-Million Fraud Scheme
Two HHA owners pled guilty to a $48-million fraud scheme, which involved paying kickback... Read more
Industry Notes:
Co-Owner of HHA Faces 10-Year Prison Sentence
The co-owner of a former HHA faces a 10-year sentence in federal prison for defrauding M... Read more
Industry Notes:
Beware of LUPA Glitch for High Therapy Episodes
Now a total of 12 states are on their way to operating health insurance Exchange models,... Read more
Industry Notes:
3 More States Sign on to Operate Exchanges
Now a total of 12 states are on their way to operating health insurance Exchange models,... Read more
Industry Notes:
Louisiana Eliminates Medicaid Coverage for Hospice Care
Effective Feb. 1, Louisiana will cut Medicaid payments for hospice care, along with othe... Read more
Industry Notes:
MACs Focus on Medicare Payments for Illegal Immigrants
Medicare payments for illegal immigrants are under the microscope, as the OIG identified... Read more
Available Years:  2013  2012  2011  2010  2009  2008  2007  2006  2005  2004  2003