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Home Health & Hospice Week - 2015; Volume 24, Number 44-45
Value-Based Purchasing:
Pilot State Agencies Gear Up For VBP Launch
Providers still waiting on key info. On the eve of implementation, home health agencie...
Read more
Value-Based Purchasing:
Follow These Steps To Survive And Thrive Under VBP
Set priorities and benchmarks to guide your quality improvement efforts. Whether you a...
Read more
Hospice:
MedPAC Hangs Budget Ax Over Hospices' Heads
Commission’s 0% recommendation for 2017 illustrates cost reports’ importance...
Read more
OASIS:
Improve Your Outcomes By Boosting Your OASIS Vaccine Item Responses
Don’t put CDC guidance aside, despite reworked vaccine items. The four OASIS inf...
Read more
HIPAA:
Providers' Breach Reports Lead To Wide-Ranging HIPAA Investigations
Stolen laptop costs provider $850,000. Under the law, you have to report HIPAA breache...
Read more
HIPAA:
Take These Steps Now To Avoid Fallout From A Required Breach Report
Spot the HIPAA compliance trend and prepare. You may not have a choice about reporting...
Read more
Human Resources:
Put Brainstorming On Your Schedule
7 tips help you generate creative solutions to a problem. Every agency goes through sl...
Read more
Industry News:
Use CASPER Reports To Bolster Hospice Item Set Status
Are you on track to hit the HIS benchmark in the New Year? How are you doing on your H...
Read more
Make The Most Of Your Eli's Home Care Week Subscription
You have more than a decade’s worth of information on a multitude of home health t...
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Industry News:
Brace For Final 2014 Caps
Just because you didn’t report a hospice cap liability back in March, doesn’...
Read more
Industry News:
Dodge This A/R Bullet
Is one simple mistake torpedoing your accounts receivable? You may think that you need t...
Read more
Industry News:
Check Out The Latest HHA Acquisitions Nationwide
Market consolidation continues in the home health arena. In Kentucky: National chain L...
Read more
Industry News:
MAC Readies GIP Edits
Be prepared for extra scrutiny of your hospice claims containing General Inpatient care....
Read more
Industry News:
Chicago HHA Owner, Marketer Indicted
The feds have indicted a Chicago-area home health agency owner for kickbacks and false c...
Read more
Industry News:
New Hospices Go Under Medical Review Microscope
Hospices new to the Medicare program aren’t exactly getting a warm welcome from on...
Read more
Home Health & Hospice Week - 2015; Volume 24, Number 43
Hospice:
Beware Stealth Underpayments When Hospice Payment Reform Launches
Ring in the New Year with tighter billing oversight. If you’re not paying attent...
Read more
Reimbursement:
Prepare For Hospice Payment Reform Billing Now With These 7 Steps
Get friendly with HETS. You may feel you are ready for hospice payment reform taking e...
Read more
Know Your Facts:
CMS To Eye Live Discharge Rates Under Payment Reform
Agency to examine effects of two-tiered system. If you think changes to your live disc...
Read more
HIPAA:
Data Breaches Continue To Rise, According To Report
Breaches rose by 10 percent in first half of this year versus last year’s numbers....
Read more
HIPAA:
Prepare Now For HIPAA Audits
HIPAA auditors could knock on your door any day now. With HIPAA breaches growing despi...
Read more
Medical Review:
Therapy Goal Problems Continue To Cause Denials
MAC lists F2F Probe & Educate review topic as active. Waiting for the therapy goal...
Read more
Industry Note:
MedPAC Prepares To Recommend Post-Acute PPS
Are you ready to share a payment system with other post-acute providers? Would a prosp...
Read more
Industry Note:
Long Wait For Home Care At Veterans Administration Draws OIG Attention
The long wait for Veterans Administration home care services is getting national attenti...
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Industry Note:
Nurse's Family And Medical Leave Act Lawsuit Costs Chain Serious Dough
A Connecticut nurse case manager who sued her employer under the Family Medical and Leav...
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Industry Note:
HHS OIG Recovers North Of $3 Billion In 2015
Any amount over $3 billion may sound like an enormous number in terms of Medicare billin...
Read more
Industry Note:
Medicare Benchmark Report For Physician Home Visits On Deck
Physicians furnishing services in the home may have a wake-up call in store. The Centers...
Read more
Industry Note:
Provider Fends Off ZPIC Recoupment In Federal Court
Don’t give up hope if you get walloped with an unreasonable recoupment based on a ...
Read more
Home Health & Hospice Week - 2015; Volume 24, Number 42
Face-To-Face:
Check This F2F List Twice As Probe & Educate Edits Approach
Sharpen your ADR tracking process. You must kick your face-to-face processes and docum...
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Lawsuits:
Pay More Attention To Overpayments Or Face Penalties
Case hinges on when provider ‘identified’ overpayment. When an employee or...
Read more
Overpayments:
Look Ahead: 3 Potential Aftereffects From Overpayment Case
Warning: Employees reporting overpayments are potential whistleblowers. As the first c...
Read more
Reimbursement:
Take These 4 Steps To Avoid Overpayment Violations
‘If it’s not documented, it wasn’t done’ becomes important in th...
Read more
Industry News:
OIG Highlights Home Health Fraud In National Hot Spots
Recent reports focus on state survey issues. The feds are keeping the pressure on home...
Read more
Industry News:
Don't Dawdle When It Comes To Hospice Billing
You’d better get speedier on your hospice billing for patients who revoke, or you ...
Read more
Industry News:
CMS Ups Therapy Caps For 2016
You have another $20 to work with if you furnish outpatient Part B therapy to patients i...
Read more
Industry News:
Limits On Recovery Audit Contractors On Deck
The Centers for Medicare & Medicaid Services is reining in its Recovery Audit C...
Read more
Industry News:
Beware This HIPAA Compliance Pitfall
You’ve taken every step to secure protected health information at your agency, but...
Read more
Industry News:
Home Infusion Produces Better Results, Study Says
Proponents of home infusion have new study results to boost their case. “Option Ca...
Read more
Industry News:
2 Nonprofit Hospices Affiliate In Michigan
Market consolidation continues for hospices. Arbor Hospice & Palliative Care in Ann ...
Read more
Reader Question:
You Can't Fill Out F2F Form For Docs, MAC Warns
Sidestep this pitfall under new face-to-face physician encounter rules. Question: We h...
Read more
Home Health & Hospice Week - 2015; Volume 24, Number 41
Regulations:
VBP Agencies Should Take Action Now, CMS Instructs
Mark your calendars for upcoming HHVBP education session. Home health agencies in the ...
Read more
Reimbursement:
Unlike ICD-10, You Can Use Old And New G-Codes On Same Claim
Seventh characters, star ratings also addressed in Open Door Forum. Episodes that coul...
Read more
Hospice:
Polish Your Hospice Item Set Skills With New CMS Tools
Service Intensity Add-on billing, CAHPS also addressed in forum. Make sure your Hospic...
Read more
Fraud & Abuse:
Feds Round Up Fraudsters In Lone Star State
Kickbacks, patient recruiters feature heavily in indictments. If you’re wonderin...
Read more
Fraud & Abuse:
Docs Don't Escape Penalties In Home Care Fraud Cases
Sham consulting arrangement leads to one physician’s guilty plea. A group of gui...
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Mergers & Acquisitions:
Hospices Combat Declining Reimbursement With Consolidation
‘Scale matters,’ says one market expert. Hospices are working hard to surv...
Read more
Industry Note:
Joint Replacement Bundling Coming To 67 Cities
Providers get an extra 3 months to prepare for the hospital-driven payment model. You ...
Read more
Industry Note:
Double-Check Your HIPPS Codes Under ICD-10
The Centers for Medicare & Medicaid Services has issued the official billing instr...
Read more
Hospice:
Are You Doing These 3 Things When Inventorying Your BAs?
Don’t skip a step. Question: We are reviewing all our business associates (BAs) ...
Read more
Industry Note:
OIG Work Plan Goes Relatively Easy On Home Care
Home health and hospice providers have a smaller than usual role in the HHS Office of In...
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Industry Note:
Beware HIPPS Recoding Claims System Glitch
Stand by for the solution to another claims system glitch. “CGS is aware of an iss...
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Industry Note:
CMS Ups Deductibles
Home health agencies and hospices have managed to avoid a copayment thus far, but most p...
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Industry Note:
Denial Codes Get Detailed
You may soon be able to get more information about your denied claims. “The Center...
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Industry Note:
LEIE List Format Changes
Say goodbye to the current format for checking the OIG’s List of Excluded Individu...
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Industry Note:
Senior Services Nonprofit Buys New Mexico HHA Chain
The Evangelical Lutheran Good Samaritan Society based in Sioux Falls, S.D. has purchased...
Read more
Home Health & Hospice Week - 2015; Volume 24, Number 40
Face-To-Face:
'Probe & Educate' Claims Reviews For F2F Will Hit Every HHA Nationwide
Reviewers will start with 5 claims per agency. The other shoe is finally dropping on t...
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Face-To-Face:
Don't Count On The Industry's Lawsuit To Save You From F2F
But stick with your appeals. If you think you can duck your head in the sand and wait ...
Read more
Medical Review:
Survive Probe & Educate F2F Review With These 7 Steps
You may have some hard choices ahead. Under Medicare’s new “Probe & Ed...
Read more
Diagnosis Coding:
Final Rule Restores Pay For Seventh Character 'A'
Change will be retroactive to Oct. 1. An ICD-10 change that is taking money out of you...
Read more
Regulation:
HHAs Have Unanswered Probe & Educate Questions
Agencies look to hospital P&E program for clues. Home health agencies now know mor...
Read more
Quality:
Master VBP Measures Before It's Too Late
Strategy to be a top improver carries risks, expert warns. Waste no time in getting to...
Read more
Quality:
Preventable Hospital Readmit Measure For HHAs On Deck
Drug review, discharge to community measures also in the works. Medicare is moving for...
Read more
Industry News:
Tell Referring Docs Advance Care Planning Rate Is Set
Payments start for services Jan. 1 and later. Physicians finally will have more financ...
Read more
Industry News:
CMS Revises Value-Based Purchasing Math
A technical change in how Value-Based Purchasing scores are calculated should increase a...
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Industry News:
ICD-10-Related Claims Glitch Corrected, MAC Says
If you are now receiving returned claims with code 31276, they should be valid RTPs. Med...
Read more
Industry News:
CMS Declares ICD-10 Transition A Success
Despite the problems some home health agencies and hospices have been having with ICD-10...
Read more
Industry News:
LHC Buys High-Profile Fraud Target
A bankruptcy judge in Kentucky has approved the $5.7 million sale of a high-profile frau...
Read more
Industry News:
Amedisys Acquires Florida HHA Chain For $63 Million
Amedisys Inc. will acquire Sarasota, Fla.-based Infinity HomeCare for $63 million, the B...
Read more
Reader Question:
You Won't Get Off The NOE Timely Filing Hook For Your Own Billing Delays
Hospice argues it is processing time, not its own billing, that’s to blame. Ques...
Read more
Home Health & Hospice Week - 2015; Volume 24, Number 39
Prospective Payment System:
1.4% Cut To Hit HHA Rates Jan. 1
At least the cut is improved from proposal. Prepare to do more with less for yet anoth...
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Value-Based Purchasing:
VBP Takes Effect In 9 States Starting In January
Program expected to go nationwide as early as 2018. The 2016 HH PPS final rule contain...
Read more
Quality:
Get To Know Newly Whittled Value-Based Purchasing Measures
Agencies now have 24 measures to manage under the pilot. The 2016 HH PPS final rule gi...
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Value-Based Purchasing:
Final VBP Model Retains Serious Flaws, Experts Insist
Large risk pool menaces small providers. Home health agencies hoping to see big correc...
Read more
OASIS:
CMS Offers BMI Opt-Out For New Pressure Ulcer Measure
Pressure ulcer measure mandatory in new year. At least some of the industry’s co...
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OASIS:
Get Ready For M1308, M1309 Changes For Pressure Ulcer Measure
And expect a new diagnosis item. To support the newly finalized quality measure on wor...
Read more
OASIS:
Boost Your OASIS Submission Stats Or Pay The Price
As expected, the Centers for Medicare & Medicaid Services has finalized its proposal...
Read more
Industry Note:
Split Your Nursing G Codes By Date, MAC Says
HHAs must grapple with G0299 and G0300. Since hospices bill monthly, they generally do...
Read more
Industry Note:
CMS Proposes New Discharge COP For HHAs
Beware one more increased regulatory duty about to drop into your lap. In a proposed rul...
Read more
Home Health & Hospice Week - 2015; Volume 24, Number 38
Reimbursement:
New Nursing G Codes Finally Released For Hospice Reform
Surprise: HHAs must use them too. If you thought hospice payment reform only affects h...
Read more
Regulations:
Proposed Pressure Ulcer Quality Measure Draws Support
Plus: Watch for new OASIS item on diagnoses if proposal adopted. Flashier provisions i...
Read more
OASIS:
Providers Protest Addition Of Height, Weight To OASIS
Home care is not the same as inpatient care, commenters told CMS. Many commenters on t...
Read more
Quality:
More IMPACT Act Measures For HHAs In The Pipeline
Will increased measures mean increased burden for home health agencies? Medicare may h...
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Quality:
Patient-Reported Data Items Top List For Future Quality Measures
Process measures also feature in seven areas for quality reporting development. These ...
Read more
Fraud & Abuse:
False Claims Proved In Hospice Chain's Trial
Jury finds claims false in first phase of trial. A trial that has caught the attention...
Read more
Appeals:
Know When New Medical Review Limits Help You -- And When They Don't
Pre-pay claims denials are exempt. You may be one of many providers that cheered when ...
Read more
Industry News:
ICD-10 Glitch Takes Down Home Health Claims
Sit tight for adjustments, Medicare Administrative Contractors instruct. Home care pro...
Read more
Industry News:
Claims System Error Related To Zip Codes Could Be Hitting Your Claims
Azip code-related claims glitch could be delaying your Notices of Election. Error code 3...
Read more
Industry News:
New Report: Home Care M&A Activity Doubles In Latest Quarter
Market consolidation continues in the home care and hospice arenas, leaving little room ...
Read more
Industry News:
Phoenix Hospice Settles Fraud Charges For $2.2 Million
Another whistleblower suit is leading to a big payout for a former hospice employee. Ser...
Read more
Home Health & Hospice Week - 2015; Volume 24, Number 37
Prospective Payment System:
HHAs Lambaste Proposed Cuts For Case Mix Creep
$350 million spending cut will decimate home health agencies. A double whammy of reimb...
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Reimbursement:
Nix Cut For Case Mix Creep, HHAs Urge CMS
Lawmakers back up request. The Medicare Payment Advisory Commission is cheering on the...
Read more
Payment:
Pay Cuts Threaten Access
Rehospitalizations may climb if reimbursement reductions go through. Medicare needs to...
Read more
Reimbursement:
Help Your Docs Get Paid for 'The Talk' With This Education
Does no national coverage determination mean no reliable payments? Your referring phys...
Read more
Referrals:
Docs Must Get To Know 2 New Codes For ACP
Lack of NCD potential problem. The 2016 Medicare Physician Fee Schedule proposed rule ...
Read more
Regulations:
Consider This ACP Scenario
Docs can enjoy flexibility when coding ACP. In the 2016 Medicare Physician Fee Schedul...
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Referrals:
What Should An ACP Discussion Include?
Life expectancy should be a component, physician group recommends. Your physicians may...
Read more
Industry Note:
Keep An Eye On Dates For Diagnosis Coding
Through’ date is the key. It may seem basic, but losing track of the dates of se...
Read more
Industry Note:
Glitch Hits Home Health Agency, Hospice Claims
An NPI-related claims glitch may be disrupting your payments. Problem: “Palmetto...
Read more
Industry Note:
New Law Heads Off Higher Insurance Premiums
Mid-size home care providers secured a breather on Affordable Care Act health insurance ...
Read more
Industry Note:
Cost Report Changes For HHA-Based Hospices Posted
You have until Nov. 3 to submit comments on the Centers for Medicare & Medicaid Serv...
Read more
Industry Note:
Time Hospice Cap Reporting To Your Advantage
Jan. 1 is looming large for hospices that must tackle payment reform commencing on that ...
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Industry Note:
Closing Hospital Hands Off Home Health Unit
The home health unit of a hospital closing in Independence, Kan., is transferring its ho...
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Home Health & Hospice Week - 2015; Volume 24, Number 36
Value-Based Purchasing:
Focus On Improvement Over Stabilization Major Drawback To Value-Based Purchasing
VBP model’s set-up will encourage providers to cherry pick patients, commenters wa...
Read more
Prospective Payment System:
One Agency's Stabilization Scenario
HHAs serving chronic populations will suffer under VBP, commenter said. Many providers...
Read more
Labor Law:
Comply With Elimination Of Companionship Exemption By Oct. 13
Start tracking hours carefully. The day many home health agencies were hoping would ne...
Read more
Reimbursement:
CMS Clarifies Physician Service Length Estimate
Estimate needn’t be a separate form or order, MAC says. Home health agencies are ta...
Read more
Hospice:
Aggressive Admissions Net Hospice $3 Million Fraud Settlement
Whistleblowers will receive half a million. If you expect your employees to keep your ope...
Read more
Industry Note:
Software Problems Don't Excuse You From ICD-10
Don’t submit paper claims unless you qualify for an exception. If your claim sub...
Read more
Industry Note:
Access Free Benchmarks
Medicare’s PEPPER contractor is bringing out the big guns in its attempt to persua...
Read more
Industry Note:
Heed These Hospice Item Set Pointers From CMS
If you haven’t set up a HIS core team, you’re not following CMS’s advi...
Read more
Industry Note:
Improper Signatures Torpedo Appeals
Don’t shoot yourself in the foot on your Medicare claims appeals. “A paper a...
Read more
Industry Note:
Hospice MCCM Demo Billing Details Released
The up-to-171 hospices that may participate in the Medicare Care Choices Model may recei...
Read more
Industry Note:
Preview Your Star Rating Data For Next Quarter
Don’t be surprised if the data in your HHA star preview reports doesn’t matc...
Read more
Industry Note:
Health System Taps Chain To Manage Home Health Unit
The trend of health system-home care partnerships continues, this time in the form of a ...
Read more
Industry Note:
Sunshine State HHA Joins Post-Acute Chain
Preferred Home Health Services in Orlando, Fla., has joined the Greystone Health Network...
Read more
Home Health & Hospice Week - 2015; Volume 24, Number 35
Value-Based Purchasing:
HHAs Blast Number Of Value- Based Purchasing Measures
HHAs and MedPAC actually agree on something. If Medicare wants to increase home care q...
Read more
Reimbursement:
What Measures Should Make The VBP Cut?
Hospitalization metric is a shoe-in. Value-Based Purchasing in home care is inevitable...
Read more
Prospective Payment System:
Many VBP Measures Aren't Up To Snuff
Vaccination measures top most-hated list. Home health agencies didn’t exactly gr...
Read more
Prospective Payment System:
Too Much Is Not A Good Thing: 29 Proposed VBP Measures
8 of the measures aren’t on Home Health Compare. Home health agency commenters t...
Read more
Diagnosis Coding:
Home Care Providers Grapple With ICD-10
Is your coding prep paying off? Home health agencies have said goodbye to ICD-9 coding...
Read more
HIPAA:
Don't Expect HIPAA To Save You From Whistleblower Suits
Court decision shows some standards, however. One of the few exceptions under HIPAA fo...
Read more
Industry Note:
Don't Let Coding Changes Delay Your NOEs And Reduce Pay
System doesn’t check for NOE-claim coding match. Don’t cost yourself time ...
Read more
Industry Note:
White House Upbraids HHS For Improper Payment Rate, Urges More Aggressive Tactics
Although it might feel like the Centers for Medicare & Medicaid Services is doing ev...
Read more
Industry Note:
CMS Dedicates Tens Of Millions To Reducing Hospitalizations In Newest Funding Push
A new funding push to reduce hospital readmissions underscores the measure’s impor...
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Industry Note:
Make Sure Your Docs Are In PECOS With New Site
Update your bookmarks to make sure you don’t lose out on your rightful reimburseme...
Read more
Industry Note:
Chain Makes VNA Buy In New Jersey
Almost Family Inc. plans to acquire the assets of the Medicare-certified home health age...
Read more
Home Health & Hospice Week - 2015; Volume 24, Number 34
Value-Based Purchasing:
Proposed Value-Based Purchasing Program Risks Way Too Much
Commenters give CMS an earful on the penalty/ reward pool. Medicare proposed one of th...
Read more
Prospective Payment System:
Timeline for VBP Unrealistic, Providers Protest
ICD-10 and other regulatory pressures create overwhelming burden. If home health agenc...
Read more
Labor Law:
Keep Your Eye On October Deadline For Companionship Exemption
Industry strikes out at delay attempt. Get ready to apply FLSA minimum wage and overti...
Read more
Diagnosis Coding:
Take These ICD-10 Steps Before Oct. 1 Hits 3-2-1 ...
After months — maybe years — of preparation, the countdown to ICD-10 liftoff...
Read more
Hospice:
Changes To HHA-Based Hospice Cost Reports On Deck
Make your accounting changes immediately. If you’ve been paying attention to cos...
Read more
Industry Note:
Medicare Works On Post-Acute Resource Use Measures
Cross-setting drug regimen review measure is on its way. Home health agencies should e...
Read more
Industry Note:
Know The HETS Rules To Improve Your Hospice Payment Accuracy
Starting in January under hospice payment reform, knowing how long your hospice patients...
Read more
Industry Note:
Here's Another Medicare Contractor You Never Want To Hear From
Is that person who shows up at your door, but isn’t a state surveyor, really entit...
Read more
Industry Note:
Surveyor Training Tweak May Save Your Survey
Arevision to home health surveyor training may help HHAs avoid unnecessary Conditionleve...
Read more
Industry Note:
Northeast Chain Opens 11th Location
Preferred Home Health Care & Nursing Services, headquartered in Eatontown, N.J., has...
Read more
Industry Note:
Recent Nursing Home-Hospice Partnership Highlights OIG's Blessing On Limiting Access
Baptist Retirement Community and Hospice of San Angelo in Texas are partnering, reports ...
Read more
Home Health & Hospice Week - 2015; Volume 24, Number 33
Fraud & Abuse:
Authorities Crack Down On Home Care Fraud In Nation's Hot Spots
Kickbacks a common feature in many cases. Chicago continues to garner a reputation fo...
Read more
Hospice:
Hospice Whistleblowers To Receive $1.3 Million In 2 Cases
Higher hospice care levels draw scrutiny. Three employees who worked at a regional hos...
Read more
Diagnosis Coding:
7th Character Mess Looms Over ICD-10 Home Care Transition
Watch for forthcoming guidelines. While much of the logic in the ICD-10 code set is co...
Read more
ICD-10:
7th Character Confusion Could Cost You In Case Mix
Home care coders must wrestle with their own scarlet letter during transition. As conf...
Read more
Education:
Get Training On PPS 2016 Final Rule, ICD-10, OASIS-C1
Also, check out Eli audio conferences on hospice basics, CAHPS, payment reform, and more...
Read more
Industry Note:
Don't Expect To Slide By With Sloppy ICD-10 Coding
MAC puts providers on notice. If you thought might get a little leeway as ICD-10 takes...
Read more
Industry Note:
Hospices Will See Stars Soon
Medicare continues to move forward with its plan to assign star ratings to hospices on a...
Read more
Industry Note:
Get Familiar With This Medical Review Contractor -- Yes, Another One
Don’t let an outdated address cause SMRC denials. You need to check and, if necess...
Read more
Industry Note:
Educate Yourself On HIS Requirements, Before Your Reimbursement Depends On It
If you haven’t gotten up to speed on the latest Hospice Item Set requirements, you...
Read more
Industry Note:
Skip ICD-10 Coding Worries For This One Submission
Worried about how to code NOTRs once ICD-10 hits Oct. 1? Don’t sweat it. Questio...
Read more
Industry Note:
Meet This New Contractor For Home Health Cost Report Appeals Support
There’s another contractor switch related to home care and hospice cost reports. ...
Read more
Industry Note:
2 Ohio Hospices Merge, But Keep Names For Now
Hospice of the Western Reserve and HMC Hospice of Medina County have merged. For the nex...
Read more
Home Health & Hospice Week - 2015; Volume 24, Number 32
Compliance:
OIG Green Lights Introductory Visits For Home Health
The catch: Visit must occur after referral. You may want to reconsider your admission...
Read more
Compliance:
Use These 7 Pointers To Keep Your Intro Visits Legit
Beware: The anti-kickback law isn’t the only thing to worry about. Furnishing in...
Read more
Diagnosis Coding:
Keep Diagnosis Codes, OASIS Forms Straight As ICD-10 Nears
You might be surprised by which codes and forms to use when. It’s time for count...
Read more
HIPAA:
Court Decision May Discourage HIPAA Suits Over Laptop Thefts
No injury means no lawsuit, court says. Stolen electronic devices are the bane of home...
Read more
Human Resources:
Improve Your Interview Process
Here are some questions to ask — and avoid — during an interview. While ev...
Read more
Hospice:
Cost Report Changes Afoot For Variety Of Hospice Types
Revisions follow in freestanding report’s footsteps. The Centers for Medicare &a...
Read more
Industry Note:
Submit F2F For All Reviewed Claims -- Even Recerts
Use MAC’s checklist to respond to ADRs. Don’t forget that medical reviewer...
Read more
Industry Note:
MAC Targets HHAs For Medical Review With Their Own LOS, Payment Stats
Your length of stay stats for home care patients continue to be an area of scrutiny for ...
Read more
Industry Note:
Educate Yourself On Valid Exceptions For Late Notice Of Election Filing
Yelling at the customer service reps at your MAC isn’t going to help if your NOE e...
Read more
Industry Note:
Don't Call It A Merger: 2 Nonprofits Affiliate
The 31-year-old VNA and Hospice of the Florida Keys in Key West is forming an affiliatio...
Read more
Industry Note:
34-Year-Old Hospice Closes Inpatient Facility
Reimbursement constraints continue to take their toll on hospices. Hospice of Southern I...
Read more
Industry Note:
National Chain To Increase Hospice Business By About 60% With Southern Acquisition
LHC Group Inc. has agreed to buy Halcyon Hospice LLC for about $58.5 million in cash, th...
Read more
Reader Question:
Warning: Dual Coding Will Bring You Denials
Tip: Practice ICD-10 coding, just not on your claims. Question: Should we put both ICD...
Read more
Home Health & Hospice Week - 2015; Volume 24, Number 31
Therapy:
Beware 5 Common Therapy Mistakes That Cause Denials
Lack of goals may be your claims’ downfall. If you feel like your claims with th...
Read more
Medical Review:
Hit These 11 Therapy Elements Or Risk Reimbursement
Are your therapists including all the crucial criteria? To hold onto your therapy doll...
Read more
Reimbursement:
Follow These 6 Steps To Protect Your Therapy Dollars
Tip: Guide your therapists to better documentation with a template. Home health agency...
Read more
Diagnosis Coding:
ICD-10 Transition On Schedule, CMS Stresses
You can continue to participate in acknowledgement testing until Oct. 1. You’ve ...
Read more
Diagnosis Coding:
CMS Names ICD-10 Ombudsman
Physician fills the role. Physicians may be familiar with the name William Rogers, MD,...
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Fraud & Abuse:
OIG Eyes More Areas For HHA Moratoria
Is your city next on the list? The Centers for Medicare & Medicaid Services hasn&r...
Read more
Therapy:
Beware 5 Common Therapy Mistakes That Cause Denials
Lack of goals may be your claims’ downfall. If you feel like your claims with th...
Read more
Medical Review:
Hit These 11 Therapy Elements Or Risk Reimbursement
Are your therapists including all the crucial criteria? To hold onto your therapy doll...
Read more
Reimbursement:
Follow These 6 Steps To Protect Your Therapy Dollars
Tip: Guide your therapists to better documentation with a template. Home health agency...
Read more
Diagnosis Coding:
ICD-10 Transition On Schedule, CMS Stresses
You can continue to participate in acknowledgement testing until Oct. 1. You’ve ...
Read more
Diagnosis Coding:
CMS Names ICD-10 Ombudsman
Physician fills the role. Physicians may be familiar with the name William Rogers, MD,...
Read more
Fraud & Abuse:
OIG Eyes More Areas For HHA Moratoria
Is your city next on the list? The Centers for Medicare & Medicaid Services hasn&r...
Read more
Industry Notes:
Claims Review Changes May Help Your Appeal
Change won’t apply to appeals prior to Aug. 1. If your claim gets denied in medi...
Read more
Industry Notes:
Strip These Drugs From Hospice Claims.Will hospices' drug costs go underreported?
Hospices’ drug costs may go underreported, thanks to a claims system glitch. The...
Read more
Industry Notes:
Companionship Exemption Lawsuit Continues
The lawsuit regarding the Department of Labor’s elimination of the companionship e...
Read more
Industry Notes:
Double-Check Your Hospice Item Set Submissions
If you leave an important step off your Hospice Item Set procedure, you may pay the pric...
Read more
Industry Notes:
Two MACs Team Up On Cost Report Appeals
If Palmetto GBA is your Home Health & Hospice Medicare Administrative Contractor, yo...
Read more
Industry Notes:
CMS Clarifies: SIA Payments Apply Only To End Of Stay
Hospices may have a lot of confusion about their new billing requirements under payment ...
Read more
Industry Notes:
HealthSouth Buys CareSouth Home Health Chain
HealthSouth Corp.-owned Encompass Home Health is buying CareSouth’s home health bu...
Read more
Industry Notes:
Regional Chain Expands Arizona Presence
The Ensign Group has purchased Apismellis Homecare, a Medicare and Medicaid certified ho...
Read more
Reader Question:
Don't Let ICD-10 Delay Your NOEs -- And Cut Into Your Reimbursement
Your switch to the new coding system is less than a month away. Question: What should ...
Read more
Home Health & Hospice Week - 2015; Volume 24, Number 30
Labor Law:
More Overtime Pay May Be On Your Plate
U.S. Appeals Court reverses companionship exemption decision. The legal fight over eli...
Read more
Compliance:
Choose Your Companionship Exemption Strategy Carefully
Use risk analysis to determine your course. Are you ready to gamble with your FLSA com...
Read more
Labor Law:
Companionship Exemption Case Retains High Profile
Watch out for Medicaid changes. A number of mainstream news outlets covered the Aug. 2...
Read more
Face-To-Face:
Flaws Bedevil Newest F2F Form
Docs include de facto narrative in latest version. Home health agencies might not be a...
Read more
Hospice:
Get Up To Speed On Hospice Payment Reform Billing
CMS issues new instructions. If you’re entering the patient’s Social Secur...
Read more
OASIS:
Get The Jump On ICD-10 Now
Know which forms and code set to use for episodes spanning the transition date. Oct. 1...
Read more
Diagnosis Coding:
Consult This Handy Reference For Correct OASIS, Code Dates
What do you do when your ‘From’ and M0090 dates split before and after Oct. ...
Read more
Industry News:
Trial In Hospice Whistleblower Suit Begins
One hospice chain’s sky-high live discharge rate is getting tested in court. A w...
Read more
Industry News:
Medicare Tests Payments Bundled Across Care Settings, Including Home Care
Bundled payments across care providers may be coming your way sooner than you think. The...
Read more
Industry News:
Catch Up On Training For Home Health Program For Evaluating Payment Patterns Electronic Report (PEPPER)
If you missed out on Medicare PEPPER contractor TMF Health Quality Institute’s hom...
Read more
Home Health & Hospice Week - 2015; Volume 24, Number 29
ICD-10:
Physicians' Sweetheart Deal For ICD-10 Unfair, Providers Protest
Home care providers need a break too, they tell CMS. Wouldn’t it be nice to get ...
Read more
Diagnosis Coding:
Hospices Must List All Of Patients' Diagnoses On Claims
Unlike payment reform, new coding rule takes effect Oct. 1. Hospices are warily eyeing...
Read more
Hospice:
Take These 5 Steps To Succeed Under Hospice 2016 Rule
It’s time to kick your diagnosis coding documentation up a notch. Your payment w...
Read more
Billing:
RN, LPN G Codes For Hospice Won't Be Out For A While
Consult an imminent transmittal for other payment reform billing details. Hospices hav...
Read more
Compliance:
Cover All 4 Compliance Bases Under OIG's Guidance
New guide stresses compliance in healthcare organizations as a ‘way of life.&rsquo...
Read more
Compliance:
Consider These Benefits Of Self-Reporting Non-Compliance
What should you do when you uncover a problem internally? Even the best agencies can f...
Read more
Industry Notes:
2 New Measures Under Consideration For Home Health Quality Reporting
Medicare may soon measure your performance on falls, dyspnea. In addition to polishing...
Read more
Industry Notes:
Care At Home Demo Extended 2 Years
A demonstration project for home-based primary care has been extended two years. Congres...
Read more
Industry Notes:
Senior Medicare Patrol Remains Vigilant
The Senior Medicare Patrol project continues to educate beneficiaries about potential fr...
Read more
Industry Notes:
MAC Shoots Down This Excuse For Late NOEs
Don’t expect your MAC to let you off the hook for NOE filing deadlines based on a ...
Read more
Industry Notes:
Beware: Fines May Come From Unexpected Quarters
Even if you manage to avoid alternative sanctions at survey time, you could still get st...
Read more
Industry Notes:
Don't Let Rogue Texting Defeat Your HIPAA Compliance
Want to know why encryption is so important for your work communications? Ask one health...
Read more
Industry Notes:
CMS Sets Newest Timeline For DME Bidding
The next recompete of Round I competitive bidding for durable medical equipment supplier...
Read more
Home Health & Hospice Week - 2015; Volume 24, Number 28
Hospice:
Hospice Payment Reform Hits Jan. 1
Hospices will see 1.1% pay increase overall. In the New Year, figuring out how many da...
Read more
Reimbursement:
SIA Will Apply To Nursing Home Residents Too
Prepare to change how you bill nursing visits. Your nursing home patients won’t ...
Read more
Reimbursement:
Above-Cap Hospices Fare Worst Under New System
Who stands to benefit under the new system? The payment model changes are supposed to ...
Read more
Finance:
Say Good-Bye To BNAF Cuts
Plus: Prepare for CBSA transition. Seven years of Budget Neutrality Adjustment Factor ...
Read more
Hospice:
More Hospices Likely To Exceed Caps Under New Rule
Change to slice half a billion dollars from reimbursement. The Centers for Medicare &a...
Read more
Diagnosis Coding:
Get Ready To Drastically Expand Your Hospice Diagnosis Coding
Hospices have to take on increased coding and ICD-10 almost simultaneously. New diagno...
Read more
Hospice Item Set:
Clean Up Any HIS Submission Messes Before Jan. 1
You’ll lose out on payment if you don’t. Nearly a quarter of hospices woul...
Read more
Industry Notes:
Queue Up Your Face-To-Face Support For Medical Review
Recerts are no longer off limits. Starting Aug. 11, you’d better get your face-t...
Read more
Industry Notes:
Court Decision Expected In F2F Case Soon
Meanwhile, the National Association for Home Care & Hospice continues to pursue its ...
Read more
Industry Notes:
DOL Proposed Rule Could Cost You In Overtime
Watch out for how a new overtime law proposal could affect your compensation budget. The...
Read more
Home Health & Hospice Week - 2015; Volume 24, Number 27
Face-To-Face:
Medical Review Contractor Denies Half Of HHA Claims
MAC is initiating takebacks based on SMRC review. Medicare’s “probe and ed...
Read more
Value-Based Purchasing:
Follow These 10 Steps To Boost Your VBP Scores -- And Avoid Payment Penalties
Kick your quality improvement plan into gear with VBP only 5 months away. Whether...
Read more
HIPAA:
Beware This Single Biggest Source of HIPAA Breaches
Hint: Most breaches are due to passive errors, not deliberate disclosures. Based ...
Read more
Patient Privacy:
Know What Constitutes a Breach -- And What Doesn't
Encryption is your best friend when it comes to preventing breaches. Don’t go th...
Read more
Fraud & Abuse:
HHA Fraudster Draws More Than 6 Years In Prison
Hiding stolen evidence in a jail cell is not a great idea. The feds continue to crack ...
Read more
Industry News:
HHA Moratoria Extended In Fraud Hot Spots
Which cities might be next? If you were planning on expanding to certain high-volume, ...
Read more
Industry News:
Baby Boomers To Swell HHA Patient Rolls
Competition may be tight, but you should have more potential clients on the horizon. W...
Read more
Industry News:
Pay Attention To These 2 New Measures Displayed On Home Health Compare
Don’t forget that Home Health Com-pare now is displaying two new quality measures ...
Read more
Industry News:
California Hospice Faces Employee Lawsuit After Management Change
If you don’t secure employee buy-in during a management transition, the result mig...
Read more
Industry News:
For-Profit Chain Boosts Profits, Moves Executive Headquarters To Nashville
Amedisys Inc. is reporting increased earnings as it moves its headquarters to Nashville....
Read more
Industry News:
Louisiana Hospice Acquires 2 Locations
EPI Group and Lafayette, La.-based Heart of Hospice have acquired for undisclosed terms ...
Read more
Industry News:
Nonprofit Hospice Closes Inpatient Hospice Facility
Nonprofit Hospice Care Corp. is closing its inpatient care facility in Elkins, W. Va., r...
Read more
Home Health & Hospice Week - 2015; Volume 24, Number 26
Compliance:
MAC Backtracks On End Date Physician Requirement
Agency can include service length estimate on POC to sign, MAC allows. The new regulat...
Read more
Hospice:
Hospice Concurrent Care Demo Rolls Out On Big Scale
First phase begins Jan. 1. Hospices hope a new pilot project could broaden the hospice...
Read more
Reimbursement:
Hospices Question Demo Pay Adequacy
Plus: Did CMS drag its feet on the concurrent care pilot? A larger-than-expected respo...
Read more
Hospice:
More Problems Dog MCCM Demonstration
Pilot will take a decade to show results. Money isn’t the only concern when it c...
Read more
Diagnosis Coding:
Get Friendly With Your New ICD-10 Manual
The book may be a little thicker than your ICD-9 manual, but don’t let that discou...
Read more
Industry Notes:
Therapy-Based Denials Cost HHAs Millions In Latest Review
Do your therapy evals contain these 11 items? It’s not only high-therapy claims ...
Read more
Industry Notes:
Learn Face-To-Face Compliance Tips From HHH MAC's Pilot Project
If you feel like ripping your hair out when dealing with your physicians and face-to-fac...
Read more
Industry Notes:
Now's The Time To Download PEPPER Benchmarking Report For Your HHA
Download your HHA PEPPER report now to see the data reviewers may use to single you out ...
Read more
Industry Notes:
Beware New Hospice Denial Codes Indicating NOE-Delaying ICD-9, ICD-10 Problems
Get to know three new reason codes that will point the way to diagnosis coding troubles ...
Read more
Industry Notes:
New HHA Star Ratings Raise Fraud Concerns
Medicare’s newest star ratings for HHAs are getting some mainstream press attentio...
Read more
Industry Notes:
Health System, Chain Launch Joint Venture
UC San Diego Health and Dallas-based AccentCare have created a jointly owned home health...
Read more
Reader Question:
Is Your Vendor A Business Associate Under HIPAA?
Get your BA agreements in place before audits roll out. Question: We are contracting w...
Read more
Home Health & Hospice Week - 2015; Volume 24, Number 25
Reimbursement:
Beware Denials From New Requirement For Physician Service Length Estimate
Latest clarification from CMS offers little comfort. A little-noticed provision in the...
Read more
Compliance:
Ward Off Length Estimate Denials With These 9 Tips
Don’t let indecision lead to noncompliance — and losses. Home health agenc...
Read more
OASIS:
Examine Your OASIS Submission Stats For Payment Prediction
Tip: Every qualifying OASIS counts now. As of July 1, your OASIS submission statistics...
Read more
Hospice:
Physician Payment Proposal Could Affect Hospice Utilization
Medicare signals it’s ready to support advance care planning. Medicare appears r...
Read more
Diagnosis Coding:
Docs Get An ICD-10 Breather -- But You Don't
Here’s another reason to feel like second-class citizens under Medicare. Beleagu...
Read more
Industry Notes:
Get Going On OASIS-C1/ICD-10 Training
Tip: Start assigning ICD-10 codes next month. You don’t just have to worry about...
Read more
Industry Notes:
Home Health Compare Begins Displaying Star Ratings
Your Home Health Compare star ratings are up and running, but it’s already time to...
Read more
Industry Notes:
NIH Offers Education Materials For Pediatric Palliative Care
If you’re looking for education materials relating to pediatric palliative care, t...
Read more
Industry Notes:
Claims System Fix For LUPA Glitch Leads To Errors
A new claims system edit may be kicking out claims in error. On the other hand, it may b...
Read more
Industry Notes:
CMS Tees Up IMPACTAct Cross-Setting Measure
Get ready for yet another quality measure. The Centers for Medicare & Medicaid Servi...
Read more
Industry Notes:
IACS-To-EIDM Transition Wraps Up
The troubled IACS-to-EIDM system transition is complete, CMS says. “CMS transition...
Read more
Industry Notes:
Fraud Data Crunching Leads To 10-To-1 ROI
CMS is tooting its own horn when it comes to its fraud-fighting data crunching. “T...
Read more
Reader Question:
Give Docs Guidance On Length Estimate Limits
Tip: Disregard episode duration. Question: What should the physician say is the length...
Read more
Home Health & Hospice Week - 2015; Volume 24, Number 24
Value-Based Purchasing:
P4P To Hit In January -- And It's A Big Hit
OASIS accuracy will determine your risk under new payment model. In recent years, rate...
Read more
Quality:
VBP May Not Be A Surprise, But It Still Contains A Shock
These are the winners and losers under the Value-Based Purchasing proposal. Except for...
Read more
Value-Based Purchasing:
Is Your State In The Pilot?
Even if it’s not now, it may be by the fall. If your state is in Medicare’...
Read more
OASIS:
Hone These 29 Measures To Succeed Under VBP
Would your scores on these measures put you in the prize or penalty pool? Home health ...
Read more
Quality:
Large VBP Pool May Be Inevitable
VBP incentive must be of ‘sufficient magnitude,’ Medicare says. Home healt...
Read more
Reimbursement:
CMS To Strip $350 Million More From HHA Reimbursement
Another year, another blow to home health agency payment levels. Home health agencies ...
Read more
Industry Notes:
Keep Your OASIS Submission Standards High
70 percent won’t be good enough starting next year. CMS is moving forward with i...
Read more
Industry Notes:
First IMPACTAct Quality Measure For HHAs Proposed In 2016 PPS Rule
You’ll have another new quality measure to deal with, if a proposal in the 2016 HH...
Read more
Industry Notes:
Learn The Difference Between NCDs and LCDs Before You Face Claims Denials
If you’ve ignored the alphabet soup of LCDs versus NCDs thus far, it’s time ...
Read more
Industry Notes:
Docs' PECOS Status May Doom Your Claim
Don’t bother appealing claims if they encounter denials for certain PECOS errors, ...
Read more
Industry Notes:
Accrediting Body Fell Down On The Job, OIG Says
Accreditation, which gives home health agencies a virtual exemption from alternative san...
Read more
Home Health & Hospice Week - 2015; Volume 24, Number 23
Fraud & Abuse:
Feds Use Drug Bust Tactics In Latest Medicare Fraud Strike
Home care providers targeted in latest national takedown. Don’t feel like you ar...
Read more
Strategy:
Take These Steps In Face Of Compliance Scrutiny
Old saying applies: An ounce of prevention is worth a pound of cure. The feds continue...
Read more
Enforcement:
Diversify Your Referring Docs Or Face Scrutiny
Miami leads enforcement head count. The latest national health care fraud takedown ext...
Read more
Hospice:
Hospice Agrees To $10 Million Settlement After Self-Reporting
Eight-figure repayment due to lack of GIP documentation. You’d better make sure ...
Read more
Lawsuits:
Whistleblower Rakes In $200K Cut Of Fraud Settlement
Latest Medicare fraud cases center around marketing. The record-breaking national heal...
Read more
Hospice:
Hospice Facility Openings Continue Nationwide
From 3 to 16 beds, new facilities are serving their communities. GIP care may be on en...
Read more
Mergers & Acquisitions:
Market Consolidation Revs Home Care M&A Engine
Affiliations seem to be gaining popularity. Unreliable reimbursement and ever-increasi...
Read more
Mergers & Acquisitions:
Hospitals Shed Hospice, Home Care Units
Competition squeezes out non-specialists. It’s not all acquisitions and mergers,...
Read more
Industry Notes:
Watch Out For This Hospice Denial Error
Take evasive action for this claims system glitch, or wait it out. Hospices will final...
Read more
Industry Notes:
Furnishing Patient Care In The Home Saves Medicare Program Money, Demo Shows
An Affordable Care Act demonstration encouraging care at home is doing well. The Indepen...
Read more
Industry Notes:
Don't Forget That You Can Appeal CERT Denials, MAC Reminds Providers
Don’t take a CERT denial as the last word. Comprehensive Error Rate Testing denial...
Read more
Industry Notes:
Get Your PECOS System Facts Here
CMS is trying to demystify Medicare enrollment and the PECOS system with some new educat...
Read more
Industry Notes:
Beware: Social Media Exchanges Can Lead You Into A HIPAATrap
Handling PHI over social media can be tricky. While the rules can be confusing, you may ...
Read more
Home Health & Hospice Week - 2015; Volume 24, Number 22
Surveys & Certification:
Warning: Alternative Sanctions Are Picking Up Steam
Number of agencies facing sanctions up 73 percent in last few months. The chances of y...
Read more
Compliance:
Sidestep The Alternative Sanctions Freight Train With These 10 Tips
Mock surveys are the most reliable way to avoid condition-level deficiencies. If your ...
Read more
Know Your Facts:
13 States Have Imposed Alternative Sanctions - So Far
If your state isn’t on the list yet, just wait. The likelihood of your getting s...
Read more
HIPAA:
Small Provider Slapped With 6-Figure HIPAA Settlement
Pharmacy serving hospice patients sees settlement based on paper records breach. It ma...
Read more
HIPAA:
Safeguard Your 'Black Market Gold' Paper Records
Although there has been intense focus in the healthcare industry on securing electronic ...
Read more
OASIS:
OASIS Submission Benchmarking Begins July 1
Get your past OASIS submission stats in an forthcoming report. Will your OASIS submiss...
Read more
Industry Notes:
Hospice Fails OIG Review
Would your personnel records stand up to scrutiny? A case study for why more frequent ...
Read more
Industry Notes:
IACS-To-EIDM Transition Rescheduled For Next Month After Earlier Delay
If you haven’t taken advantage of the IACS restoration to get your PS&R access...
Read more
Industry Notes:
HIGLAS Update May Disrupt Cash Flow
Be aware that your cash flow may fluctuate for a little while if CGS is your HHH Medi-ca...
Read more
Industry Notes:
Most Providers Pass ICD-10 Diagnosis Code Testing With Flying Colors
If you’re not ready for ICD-10, it’s time to catch up with your peers. The l...
Read more
Industry Notes:
Docs' NPIs No LongerA Strict Requirement For NOEs
For hospices that have been struggling to get attending physicians’ NPIs on ...
Read more
Industry Notes:
Get Answers To Your Burning NOE Filing Questions With MAC's Educational Resources
One MAC is offering a helping hand when it comes to billing hospice NOEs on time. Back...
Read more
Home Health & Hospice Week - 2015; Volume 24, Number 21
OASIS:
Avoid OASIS-Claims Matching Reimbursement Drain
Double-check your software if you’re seeing billing mismatches. If Medicare&rsqu...
Read more
Billing:
No OASIS? No Problem - For Now
Warning: Lack of matching OASIS may flag your claims for medical review. For now the M...
Read more
Appeals:
Prepare For Medicare Appeals Process To Change Drastically
Early stage appeals need to be more accurate, home care reps urge. Nearly everyone agr...
Read more
Reimbursement:
Are Medicare Appeal Fees In Your Future?
OMHA proposals to shorten appeals timeframes could restrict your appeal rights, advocate...
Read more
Know Your Facts:
Appeals Timeframes Continue To Lengthen
Expect typical processing time for appeals decisions to exceed 540 days. Due to the ov...
Read more
Industry Notes:
Wait Until October For These Payment Fixes
Date set for correction of 2 recoding errors. If you’ve seen problems with your ...
Read more
Industry Notes:
Examine These New Changes To the HIS Manual
You can take a look at the updated Hospice Item Set Manual before you listen to CMS&rsqu...
Read more
Industry Notes:
Here's How To Handle ICD-10 For Claims Spanning Oct. 1
With the Oct. 1 start date for ICD-10 implementation less than four months away, now&rsq...
Read more
Industry Notes:
DOJ Probes Amedisys Again, This Time Over Hospice
The feds are combining two of their favorite investigation targets — hospice patie...
Read more
Industry Notes:
Bill To Kill 'Super-MedPAC' Advances In House
Many home care providers will be happy if a bill recently passed out of committee succee...
Read more
Industry Notes:
CMS Revises ACO Program To Increase Participation
You’d better polish up your negotiating skills, because it looks like Medicare Acc...
Read more
Industry Notes:
GAO Urges Inter-Agency Cooperation For Home Care
The federal government may be able to make home care available to more seniors if separa...
Read more
Industry Notes:
Whistleblower Sparks $6.5M Fraud Settlement
A Tennessee home care organization and its owner have agreed to pay $6.5 million to sett...
Read more
Home Health & Hospice Week - 2015; Volume 24, Number 20
Face-To-Face:
Brace For Ramped Up F2F Review Under Medicare's New 'Probe And Educate' Initiative
Reviews will hit in 4 months. If your claims aren’t in tip top shape face-to-fac...
Read more
Education:
Use These Resources To Get Up To Speed On New F2F Rules
Have you looked at the F2F manual revisions yet? Were you hoping you could duck your h...
Read more
Medical Review:
Get A Sneak Peek At 'Probe And Educate' Review Procedures
Review can ramp up to hundreds of your claims relatively quickly. Wondering how the ne...
Read more
Referrals:
Help Your Docs Obtain Chronic Care Pay With These Tips
Pointer: Docs must pick one or the other between CCM and CPO. Many of your referring p...
Read more
Compliance:
Don't Fall For These 5 Common Compliance Myths
Check out these misconceptions and why you shouldn’t keep believing them. You co...
Read more
Compliance:
Beware Whistleblower-Driven Investigations
Employees often blindside owners, managers. A top compliance myth that has taken down ...
Read more
Industry Notes:
MAC Ups Number Of Medical Review Targets
Palmetto adds ‘live discharges’ to its hit list. Hospices aren’t jus...
Read more
Industry Notes:
Hospice Services Help Surviving Spouses Long After Care Ends, Study Shows
The Medicare hospice benefit may be under fire, but there’s no doubt it helps pati...
Read more
Industry Notes:
Study: HHA Profit Margins Cut Drastically Under Rebasing
Medicare reimbursement reductions are cutting home health agency operating margins to th...
Read more
Industry Notes:
PEPPER Training Session Nothing To Sneeze At As Report Date Set
Figure out how to use Medicare’s new home health agency benchmarking report by tun...
Read more
Industry Notes:
Don't Be Stingy With Your Patient Records Under HIPAA, HHS Instructs
If your patients ask to see their records, you should be ready to hand them over. A pati...
Read more
Industry Notes:
Access These Free Training Sessions Offered By CMS
Want a way for your employees to brush up on Medicare basics? You can access a 30-minute...
Read more
Home Health & Hospice Week - 2015; Volume 24, Number 19
Quality:
New Rating System Will Have You Seeing Stars
Patient survey stars will be a moving target. If home health agencies are having a tou...
Read more
Quality:
Check Out These Risk Adjustment Factors For Star Ratings
CMS tries to compensate for factors out of an agency’s control. If you feel like...
Read more
OASIS:
Sharpen Your OASIS Skills As Star Ratings Come Online
Reach for the stars by pumping up your OASIS training. Ready or not, your star ratings...
Read more
Marketing:
Use Your Star Ratings For Marketing Success
Warning: Payors may implement star rating minimum requirement. If you aren’t pre...
Read more
Hospice:
Start Preparing For Hospice Payment Reform This Minute
Run the numbers to see how proposed rule will impact your bottom line. Your reimbursem...
Read more
HIPAA:
Employ These Mobile Device Tips To Protect Against HIPAA Violations
Beware of file-sharing apps and public Wi-Fi connections. Mobile devices have revoluti...
Read more
Industry Notes:
Feds Want Tighter Background Checks For HHA Staffers
About 4 percent of reviewed employees had criminal convictions. You may have more hoop...
Read more
Human Resources:
3 Steps Help Your Staff Move Forward After A Conflict
As a mediator, it’s your job to draw the map that leads from conflict to resolutio...
Read more
Industry Notes:
Hospice Patients' Diabetes Care Too Aggressive, Study Says
A new study published in the American Journal of Hospice & Palliative Care Medicine ...
Read more
Industry Notes:
Hospice Benes In SNFs Cost Medicare More Money
Hospice services furnished in nursing homes got another knock by a new study published i...
Read more
Industry Notes:
Check This New Site For ALJ Appeal Status
If you feel like your ALJ appeal gets sucked into a black hole once you file it, you now...
Read more
Industry Notes:
Clear Your Schedule For Hospice Item Set Training
Hospices should mark their calendars for Hospice Item Set training from CMS. On June 1...
Read more
Industry Notes:
Health System, County Shed Home Care Units
Two recent cases are signs of the hard times HHAs face. In Connecticut: St. Joseph Hea...
Read more
Industry Notes:
Kickbacks And Bribes Feature In Latest Miami Fraud Case
The Medicare Fraud Strike Force has produced yet more results. A Miami HHA owner has ple...
Read more
Home Health & Hospice Week - 2015; Volume 24, Number 18
Quality:
Your Star Rating Is Just Around The Corner
Plus: A second star rating for patient surveys is on deck for January. If you’ve...
Read more
Hospice:
System May Simplify SIA Billing
Plus: Quality reporting penalties clarified in Open Door Forum. Hospices had many ques...
Read more
OASIS:
Foster A Question-Friendly Culture For Best Results, Reimbursement
Are you making this ‘dumb question’ mistake? When completing the OASIS or ...
Read more
Education:
Strengthen Your Staff's Problem-Solving Skills With 6 Expert Tips
Encourage employees to ask questions and find answers. “Someone once said, &lsqu...
Read more
Compliance:
Here's What The Delay To The 60-Day Overpayment Final Rule Means For You
Don’t count on the 1-year postponement as a reprieve. You won’t see a fina...
Read more
Compliance:
These Overpayment-Related Cases Could Define Obligations
Suits’ outcome could impact 60-day rule. The fact that the Centers for Medicare ...
Read more
Industry Notes:
Pursue Cert As Early As Possible, CMS Instructs
Securing certification prior to billing may not cut it under new guidance. You’v...
Read more
Industry Notes:
Avoid Cash Flow Disruption Caused By Revalidation Delays, MAC Advises
Don’t let insufficient information delay your cash flow. “When Nationa...
Read more
Industry Notes:
Ignore Fingerprint Request From Your HHH MAC At Your Own Risk
If you get a request for fingerprints from your MAC, take it seriously. Medicare...
Read more
Industry Notes:
Accountable Care Organizations Reduce Medicare Spending By Hundreds Of Millions
Accountable Care Organizations have gotten mixed reviews, but their money-saving capabil...
Read more
Industry Notes:
Southeast Post-Acute Chain Buys N.C. HHA
PruittHealth Home Health has acquired Toe River Home Health Agency in Burnsville, ...
Read more
Industry Notes:
Senior Living Community Launches Home Care Unit
Add retirement communities to the crowded home health marketplace. Senior living facilit...
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Home Health & Hospice Week - 2015; Volume 24, Number 17
Hospice:
60 Days Magic Number Under Hospice Payment Reform
Get ready for a 2-tier reimbursement model. Hospices with long-stay and nursing home p...
Read more
Hospice:
2016 Rule Blindsides Hospices With Payment Reform Proposal
More complex methodologies discarded. If Medicare’s hospice payment reform isn&r...
Read more
Reimbursement:
2016 Hospice Payment Changes Are Just The First Step
Your claims and cost report data could determine the next phase of reform. If you were...
Read more
Reimbursement:
Beware Big Wage Index Swings Starting Next Year
Plus: Cap changes are in the works. With major payment reform taking center stage in t...
Read more
Quality:
CMS Pushes 30-Day Deadline For HIS Submission
Submitting Hospice Item Set data within a month no longer just a guideline. If you can...
Read more
Quality:
5 Star Ratings On Deck For Hospices
Your HIS, CAHPS data will soon be on display. The date may be unclear, but you can bet...
Read more
Diagnosis Coding:
Coding Requirement Puts Hospices On Guard
CMS accuses industry of gaming the system. Medicare’s proposed instructions for ...
Read more
Industry Notes:
Tune In For New F2F Form Information
CMS reschedules canceled call. Home health agencies can find out more about the newest...
Read more
Industry Notes:
Medicare Claims Appeals System Is Buckling Under Its Own Weight,Senator Says
The overloaded Medicare appeals system is getting attention on Capitol Hill. The Office ...
Read more
Industry Notes:
HHH Medicare Administrative Contractor Notes Claims Recoding Errors
If your claims seem to be recoding incorrectly, you’re not alone. “The CGS P...
Read more
Home Health & Hospice Week - 2015; Volume 24, Number 16
Face-To-Face:
Medicare Issues Streamlined F2F Forms While HHAs Crushed By Burden
Physicians unlikely to comply, expert predicts. The latest versions of the face-to-fac...
Read more
Reimbursement:
Palmetto Continues To Decimate Claims For F2F Errors
Significant therapy visit denials also lead to reduced reimbursement. Your claims may ...
Read more
Medical Review:
Will Your Documentation, Coding Back Up Your Diabetes Claims?
Make sure you have these 3 bases covered for daily insulin injection coverage. Don&rsq...
Read more
Diagnosis Coding:
Check For These Diagnosis Codes To Support Insulin Injection Need
Some codes missing from CMS’s list may surprise you. Wondering exactly which pat...
Read more
Fraud & Abuse:
CMS Ramps Up Fraud Pilot
Plus: Community physician pleads guilty in home care fraud case. The results of an unt...
Read more
Industry Notes:
OIG Throws Spotlight On Chain's Fraud Settlement
Amedisys records loss for recent quarter. National chain Amedisys Inc. has recorded a ...
Read more
Industry Notes:
Recert Survey Leads To Stiff CMPs.
Don’t think CMPs will only come into play if you are undergoing a complaint-driven...
Read more
Industry Notes:
OIG Issues Guidance For Health Care Boards.
Think the feds aren’t keeping an eye on providers’ compliance plans? Think a...
Read more
Industry Notes:
Beware Newly Identified Claims System Glitch
You’ll have to wait and see on a claims glitch that may be disrupting your cash fl...
Read more
Industry Notes:
Therapy Cap Elimination Almost Made It Into Doc Fix
Providers of Part B therapy, including home health agencies who furnish the service in p...
Read more
Industry Notes:
Social Security Numbers Ordered Off Medicare Cards
You and your patients won’t have to deal with the risks of their Social Security N...
Read more
Industry Notes:
Hospices Can Now Access New HIS Data Reports
You’ve now got more Hospice Item Set data at your fingertips. Three new hospice pr...
Read more
Industry Notes:
HHA That Employed Excluded Nurse Goes Under
Be careful to check your employees against the OIG’s exclusion list, or you could ...
Read more
Industry Notes:
Learn From HIPAA Examples Of What Not To Do
Looking for the HHS Office for Civil Rights’ “Wall of Shame” page, whi...
Read more
Home Health & Hospice Week - 2015; Volume 24, Number 15
Survey & Certification:
New CMPs Are Closing Agencies - Are You Next?
Surveyors ramp up use of alternative sanctions that took effect last July. If you thou...
Read more
Compliance:
Head Off Fatal CMPs With These 7 Steps
Tip: Reach outside your organization for a fresh set of eyes. Civil money penalties ca...
Read more
Education:
Consult These Resources For Survey Information You Need
With CMPs hanging over your head, make sure you’re up to speed on Medicare require...
Read more
Compliance:
Use These Top Survey Citations To Fuel Your Compliance Effort
Make sure your POCs are ironclad. Finding out now whether you’re making any of t...
Read more
Accreditation:
Consider Accreditation As Civil Money Penalty Deterrent
You’ll need to weigh cost versus risk. If an ounce of prevention is worth a poun...
Read more
Medications:
Feds Want Lower Use Of Antipsychotics At Home
GAO report focuses on antipsychotics for dementia patients. For some time, nursing hom...
Read more
Industry Notes:
Surety Bond Requirement For HHAs Signed Into Law
Mandate hurts agencies struggling to comply. Now that the Medicare Access and CHIP Rea...
Read more
Industry Notes:
Tutor Docs In CPO With This New MAC Tool
Help your referring physicians obtain the reimbursement they are entitled to for care pl...
Read more
Industry Notes:
CMS Signals Intention To Pull Back NPI Requirement For Hospice NOEs
If you’ve been running into NOE submission delays thanks to a requirement to inclu...
Read more
Industry Notes:
OSHA Offers Workplace Violence Guidance For Home Health Workers
Take heed of new guidance from OSHA on protecting your workers from workplace violence. ...
Read more
Industry Notes:
Palmetto Revamps NCLOS Data To Align With Coding
Hospices are in the hot seat for length of stay, even though it’s dropped this yea...
Read more
Reader Question:
Know When To File A Hospice Redetermination - And When Not To
Warning: Correcting the omission of the GW and GV modifiers may not be as easy as you th...
Read more
Home Health & Hospice Week - 2015; Volume 24, Number 14
Medical Review:
Risk Denials For All Diabetes Patients If You Don't Know This New LCD
New policy sets out tough requirements for any patient with a Type II diabetes dx. If ...
Read more
Medical Review:
Don't Have An HbA1c On File? Don't Submit Claim, MAC Says
Add diabetes LCD to your physician education hit list. What can you do if the physicia...
Read more
Assessment:
Consider This Advice To Protect Your Insulin Injection Claims
Consider a referral for PT or OT evaluation. Palmetto GBA’s new LCD addressing d...
Read more
Coverage:
Defend Your Pay For Insulin Patients With These 5 Steps
Put HbA1c tracking at the top of your to-do list. Palmetto GBA’s new LCD address...
Read more
Legislation:
Doc Fix Bill Imposes New Surety Bond Requirement On HHAs
SGR elimination headed into law. Home health agencies and hospices won’t have to...
Read more
Fraud & Abuse:
Feds Keep The HEAT On Home Care, Hospice Providers
Patient recruiters and kickbacks feature in fraud enforcement actions. You may feel li...
Read more
Fraud & Abuse:
Nurses, Marketers And More Charged In Fraud Case
Plus: Investigation of physician practice leads to HHA’s door. While the OIG con...
Read more
Industry Notes:
Look Over Your Cap Statements Carefully For Sequester Impact
Demand letter doesn’t spell out details. Another Medicare Administrative Contrac...
Read more
Industry Notes:
CMS Re-Enables IACS Registration As Transition To EIDM Stalls
If you’ve been wrestling with access to your PS&R data due to the IACS-to-EIDM...
Read more
Industry Notes:
Resubmit These HHA Claims RejectedWith Reason Code 38308, MAC Instructs
Examine your claims rejected with reason code 38308. HHH MAC “National Government ...
Read more
Industry Notes:
Nurse Fired For Comments Posted To Facebook
Let your employees know their social media posts can count against them at work. Pro-vid...
Read more
Industry Notes:
Chicago Hospices Merge In Squeezed Market
Chicago-based Horizon Hospice & Palliative Care, Barrington, Ill.-based Journey...
Read more
Home Health & Hospice Week - 2015; Volume 24, Number 13
Legislation:
Watch Senate For New HHA Surety Bond Burden
Doc fix bill could cost HHAs $130 billion, trade group warns. Serious lobbying by heal...
Read more
Therapy:
Get Ready To Cough Up More Therapy Documentation
Your documentation will make or break therapy claims -- even for later episodes. You&r...
Read more
Diagnosis Coding:
Keep ICD-10 Transition On Track As Deadline Nears
Start training now for maximum return. Don’t count on yet another ICD-10 delay a...
Read more
HIPAA:
Brace For Coming HIPAA Audits -- After This Pause
Expect more comprehensive audits instead of desk reviews. The HHS Office for Civil Rig...
Read more
Compliance:
Now Is Not The Time To Relax About HIPAA
OCR will audit Business Associates too. Ignore the HHS Office for Civil Rights’ ...
Read more
Industry Notes:
Look For Final F2F Form Later This Month
Will face-to-face form wrinkles get ironed out? &n...
Read more
Industry Notes:
Learn From These NOE Exception Examples
Not sure how to qualify for an exception to Medicare’s timely filing deadline for ...
Read more
Industry Notes:
Review Your Star Rating
Keep an eye peeled for your five-star preview report. The Centers for Medicare & Med...
Read more
Industry Notes:
Make This Hospice CAHPS Deadline Or Lose Pay
Don’t miss the May 1 deadline to turn in your hospice CAHPS survey vendor authoriz...
Read more
Industry Notes:
Examine The Changes In OASIS-C1/ICD-10
Even though OASIS just went through a major overhaul last fall, the changes aren’t...
Read more
Industry Notes:
Hospital Hospice Cost Report Changes To Be Retroactive
Hospital-based hospices may have a tough time complying with CMS’s proposed deadli...
Read more
Industry Notes:
Peer At PEPPER Preview
CMS’s PEPPER contractor is offering a preview of the new HHA PEPPER in an April 30...
Read more
Industry Notes:
Learn These Hospice Payment Reduction Details
If you’re wondering exactly how the process will work when CMS docks your pay for ...
Read more
Industry Notes:
SSN Problems Afflict IDs
It’s a common complaint: You ask your patient for her Medicare card and she doesn&...
Read more
Home Health & Hospice Week - 2015; Volume 24, Number 12
Reimbursement:
No Foolin': OASIS Claims Matching Begins In A Few Days
Monitor closely to be sure your payments are correct under the new process. Get ready ...
Read more
OASIS:
OASIS-Based Denials On The Horizon
Get your OASIS submission ducks in a row before your reimbursement depends on it. Thin...
Read more
Hospice:
Beware These Hospice Red Flags
Half of hospice spending goes to long-stay patients, stats show. MedPAC thinks hospice...
Read more
Hospice:
MedPAC Voices Distrust Of For-Profits
Advisory body highlights LOS disparities. For-profit hospices have taken a beating fro...
Read more
Know Your Facts:
LOS Is Down, But MedPAC Still Wants A Hospice Pay Freeze
Neuro conditions lead the pack for long stays. When you struggle day in and day out to...
Read more
Human Resources:
Follow Up Promises With Action
Build trust with employees, and you’ll earn loyalty that lasts. Arguably the big...
Read more
Industry Notes:
Doc Fix Hammered Out By Lawmakers May Pound HHAs
Current legislation would reduce payment update for HHAs, hospices. Will this be the y...
Read more
Industry Notes:
HHAs Can Obtain Free Government Benchmarking Report This Summer
Home health agencies no longer need to feel left out when it comes to government benchma...
Read more
Industry Notes:
Class Action Lawsuit Underway Against Hospice Cap Calculations With Sequester
Don’t forget to submit your self-calculated aggregate cap for 2014 by March 31, or...
Read more
Industry Notes:
System Incorrectly Denies Claims For Nonexistent Physician PECOS Problems
Pay attention: Some PECOS edit de-nials may not be valid. “Some home health clai...
Read more
Industry Notes:
Put Off RAC Recoupments, Study Urges CMS
A new study shows why Medicare should delay recoupment of RAC-denied claims until after ...
Read more
Industry Notes:
Glitch May Short You For Therapy Visits Furnished
A claims glitch means you may not be getting your full reimbursement for therapy, but a ...
Read more
Home Health & Hospice Week - 2015; Volume 24, Number 11
Reimbursement:
MedPAC Pushes For Copays, Lower HHA Reimbursement
HHA profit margins fall three years straight — with more to come. MedPAC’s...
Read more
Know Your Facts:
MedPAC Highlights Record-Breaking Number Of HHAs
Influential advisory body to Congress points to historic differences. Wondering why Me...
Read more
Legislation:
Doc Fix Threatens Home Health Agency Pay
Copay out, rate cut in at press time. Getting rid of the persistent need for “do...
Read more
Human Resources:
Walk The Line Between Friend And Supervisor
Make sure your workplace friendships enhance rather than interfere with your work. Jug...
Read more
Industry Notes:
IPAB Looms, But No Payment Cuts Made Yet
The window to repeal the presidentially appointed board is narrow. Opponents of the In...
Read more
Industry Notes:
Hospice PEPPER Report Targets New SNF And ALF Data
You should have an idea of whether your data makes you stick out like a sore thumb next ...
Read more
Industry Notes:
Beware SMRC F2F Review
The HHS Office of Inspector General thinks the Centers for Medicare & Medicaid Servi...
Read more
Industry Notes:
Worrying ICD-10 End-To-End Testing Results May Signal Reimbursement Snarls Ahead
Are you going to hit a huge payment slowdown when ICD-10 takes effect Oct. 1? That&rsquo...
Read more
Industry Notes:
Palmetto: Beware This Submission Error Cause
Wondering why your submissions to Palmetto GBA are encountering errors? It may be as sim...
Read more
Industry Notes:
Avoid, Clean Up 34923 Errors With This MAC's Advice
If your hospice claims are getting torpedoed by occurrence claim span (OCS) errors, Medi...
Read more
Industry Notes:
Amedisys Announces HIPAA Breach After Discovering Missing Laptops
Be sure you have a reliable process in place for getting your electronic devices back fr...
Read more
Industry Notes:
Medical Identify Theft Skyrockets, According To Latest Study
Medical identity theft can be just as devastating — if not more so — as any ...
Read more
Home Health & Hospice Week - 2015; Volume 24, Number 10
Referrals:
IMPACT Act Showcases Hospital Readmission Rates First
CMS fast-tracking measures across post-acute settings. You may see your referrals affe...
Read more
Quality:
Take A Look At The First Round Of IMPACT Measures
Stay tuned to rulemaking for final call. In addition to the hospital readmission measu...
Read more
Quality:
Prepare To Report Your Own HHA Readmission Rates, Too
PEPs won’t be your only penalty for readmitting patients within a month of dischar...
Read more
Education:
Get Training On Care Planning, Survey Readiness & Face-To-Face
Also, check out Eli audioconferences on 2015 home health prospective payment system chan...
Read more
Hospice:
Hospice Facilities Open From Coast To Coast
Will more inpatient availability help with feds’ concerns about GIP utilization? ...
Read more
Diagnosis Coding:
Be Ready For Concurrent ICD-9/ICD-10 Coding
CMS accepts 81 percent of ICD-10 test claims. It appears that ICD-10 really will be im...
Read more
Industry Notes:
Follow Your MAC's Instructions To Submit Hospice Cap
Warning: If you’re a week late, CGS will suspend your payments. How exactly sequ...
Read more
Industry Notes:
Face-To-Face Problems Lead To Denial Rate Of 55% In Recent Review
Palmetto GBA continues to shoot down claims billing for 20 or more therapy visits. The M...
Read more
Industry Notes:
Prepare For Star Ratings This Summer With New Info
Curious for more information on your upcoming star rating from Medicare? The Centers for...
Read more
Industry Notes:
Medicare Requires Both OASIS And CAHPS For Full 2017 Payment Update
The CAHPS data you’ll have submitted starting next month — or not — wi...
Read more
Industry Notes:
If You Pay Docs For Services, Watch Out
Will your payment arrangements with your referring physicians stand up to scrutiny? If n...
Read more
Industry Notes:
New Uber-Style Home Visit Service For Nurses Starts Up In Metro Areas
You may soon see market competition from an unexpected source — an Uber-style nurs...
Read more
HIPAA:
Install Encryption On Laptops Or Pay The HIPAA Price
Tip: Even remote management isn’t enough to prevent a HIPAA violation. Just beca...
Read more
Home Health & Hospice Week - 2015; Volume 24, Number 9
Face-To-Face:
MAC To Require F2F For Every HHA Claim Reviewed
Warning: Other two contractors probably aren’t far behind. Scrutiny of ...
Read more
OASIS:
Use This CMS Guidance To Support F2F Documentation
With all eyes on your F2F documentation, go the extra mile to ensure compliance.  ...
Read more
Hospice:
CMS To Include Sequestration In Hospice Cap Calculation -- But Not Right Away
Class action lawsuit waits in the wings. Hospices are getting a breather o...
Read more
Reimbursement:
Use Newly Released Tools To Hit Your Hospice Cap Deadline
Follow these 8 pointers to ease your transition to self-reporting. You&rsq...
Read more
Industry Notes:
MAC Targets Therapy Usage In Medical Review
Be prepared to defend low clinical, functional domain scores. Wondering what will land...
Read more
Industry Notes:
Know -- And Report -- Facility NPIs When Your Hospice Patients Aren't At Home
If Reason Code 34952 errors are killing your hospice claims, you’re not alone. Med...
Read more
Industry Notes:
Give CMS Feedback On F2F Physician Form
If you want to find out more about the face-to-face physician documentation template CMS...
Read more
Industry Notes:
Update Your CBSA Codes For Transition Year Or Face Returned Claims
Your claims with outdated CBSA codes may be slipping by now, but soon they’ll come...
Read more
Industry Notes:
Pittsburgh Hospice COO Faces Medicare Fraud Charges
The chief operations officer for a Pittsburgh hospice faces Medicare fraud charges, acco...
Read more
Industry Notes:
Federal Judge Sentences Boston Hospice Owner To More Than 7 Years In Prison
HHA owner Michael Galatis has been sentenced to more than seven years in prison followin...
Read more
Industry Notes:
LHC Partners With Missouri Hospital On Joint Venture
LHC Group Inc. has entered into a home health joint venture with Missouri Delta Medical ...
Read more
Industry Notes:
Almost Family Acquires NY-Based Chain, Expands Private Duty Line
Almost Family Inc. has agreed to purchase WillCare HealthCare based in Buffalo, N.Y. Wil...
Read more
Home Health & Hospice Week - 2015; Volume 24, Number 8
Hospice:
Feds Focus Enforcement Resources On Hospices
Whistleblowers rake in nearly $700K in one fraud settlement. Hospices’ efforts t...
Read more
Kickbacks:
Fraud-Fighters Turn Attention To Physicians Involved In Home Care Scams
Beware: The feds may be examining your employee roster. The feds continue to demonstra...
Read more
Fraud & Abuse:
Miami Fraudsters Head Up Home Health Hit List
Patient recruiters feature prominently in busted fraud schemes. Miami is holding up it...
Read more
Marketing:
Help Your Docs Claim CCM Reimbursement For Your Patients With These 9 Musts
Referring doc isn’t online? He may not be able to collect for CCM. Although your...
Read more
Referrals:
Who Can Provide Chronic Care Management?
If you’re wondering which of the practitioners in your referring physicians’...
Read more
Industry Notes:
Providers Win A Breather On Overpayment Recoupments
Penalties are likely still coming when you repay past 60 days. You’ve got anothe...
Read more
Industry Notes:
Hospices Wait On Cap Info
If you haven’t submitted your aggregate hospice cap calculation yet, you’re ...
Read more
Industry Notes:
Congressional Hearing
Don’t count on another ICD-10 delay to save your bacon this fall. On Feb. 11, the ...
Read more
Industry Notes:
New Edits Aim To Prevent LUPA Overpayments
New LUPA-related edits may throw a wrench in your billing. The problem: Under two bill...
Read more
Industry Notes:
Iowa Agency Pays $5.6 Million To Settle Face-To-Face, Physician Order Charges
Your problems with the face-to-face physician encounter requirements could get you in mo...
Read more
Industry Notes:
Be Sure Your Doc's NPI Info Matches PECOS, Or Risk Your Reimbursement
If you’re having trouble with PECOS edit-related claims denials, one MAC is offeri...
Read more
Industry Notes:
Small Providers Can't Skip HIPAA Risk Analysis
Don’t expect to get off the hook for HIPAA compliance just because you aren’...
Read more
Home Health & Hospice Week - 2015; Volume 24, Number 7
OASIS:
Avoid These 2 Common OASIS Claim-Killers
What kind of story does your OASIS assessment tell auditors? When your OASIS documenta...
Read more
Therapy:
Get Therapists, Nurses On The Same Page Or Risk Reimbursement
Common mistake: Physical therapy and nursing tell two different stories. If you can&rs...
Read more
Reimbursement:
Know When A LUPA Isn't The Worst Thing In The World
Some payment is better than no payment. Normally, home health agencies try to avoid re...
Read more
HIPAA:
Watch Out For These HIPAA Trends In 2015
Prediction: State law claims will continue to facilitate breach lawsuits. What does 20...
Read more
Human Resources:
Avoid Flu Fallout With These 4 Expert Tips
Don’t forget employees’ kids when encouraging vaccinations. Is your agency...
Read more
Industry Notes:
Resubmit Incorrect NOEs Immediately, When Errors Fall Into "Billing" Category
CMS removes one administrative obstacle to achieving compliance with 5-day deadline. Y...
Read more
Industry Notes:
Check Out New F2F Tools
One HHH Medicare Administrative Contractor is offering a helping hand when it comes to f...
Read more
Industry Notes:
PS&R Access Blocked By EIDM Postponement
The Centers for Medicare & Medicaid Services has postponed the transition from the I...
Read more
Industry Notes:
Watch Out For HHA Surety Bond Threat This Legislative Year
Copays aren’t the only thing from the Obama administration’s budget causing ...
Read more
Industry Notes:
CMS Unveils Latest Prior Authorization Form For Hospice Drugs
You can now take a look at CMS’s latest version of the hospice drug prior authoriz...
Read more
Industry Notes:
Consider Consent Form For Emailing Patients
Would you like to communicate with patients via email, but are worried about HIPAA conce...
Read more
Industry Notes:
Keep An Eye Out For Hospital-Based Hospices' Cost Report Revisions
If it’s not love at first sight with the revised cost report for hospital-ba...
Read more
Quality:
Get Ready For Your Star Ratings This Summer
About half of agencies will fall in 3-star range. Home health agencies are disappointe...
Read more
Home Health & Hospice Week - 2015; Volume 24, Number 6
Face-To-Face:
CMS Offers New F2F Form For Physicians
Experts give thumbs down to 5-page physician face-to-face document. Home health agenci...
Read more
Face-To-Face:
Appreciate These Pros Of The New F2F Form
Tune in to Open Door Forum for more details. You may not be happy with the new F2F for...
Read more
Budget:
Copay Threatens Home Health Again This Year
Obama administration also wants to ratchet down payments further. The newly released b...
Read more
Legislation:
Value-Based Purchasing Gets A Boost
The Department of Health and Human Services’ recent announcement that it will purs...
Read more
Diagnosis Coding:
Focus On These 2 Key Areas For ICD-10 Transition
It’s never too early — or late — to start preparing for the coding swi...
Read more
HIPAA:
Consider These 5 Tips To Bolster HIPAA Risk Management
Pointer: Make sure your suggestions take operations into account. HIPAA compliance is ...
Read more
Industry Notes:
Sharpen Your OASIS Submission Accuracy By April 1
Pay based on OASIS HIPPS code, not claims. It’s no joke — starting April 1...
Read more
Industry Notes:
Who Can Perform F2F?
As you’re wrapping your head — and your organization — around the new ...
Read more
Industry Notes:
Sequestration Plagues Hospice Cap Calculations
Hospices wondering whether to include sequestration funds in their aggregate cap calcula...
Read more
Industry Notes:
HHA Moratorium Continues In 6 Metro Areas
Home health agencies in current moratoria areas won’t see any changes for at least...
Read more
Industry Notes:
Beware These Payment-Draining Claims Malfunctions
Watch out for a few claims glitches that could be slowing your cash flow. Glitch #1: &...
Read more
Industry Notes:
Court Shoots Down Suit On Hospice Religious Concerns
A federal court has dismissed an EEOC lawsuit against Fremont Regional Hospice in Canon ...
Read more
Industry Notes:
Whistleblower Lawsuit Against Hospice Chain Proceeds
A South Carolina hospice chain is the latest hospice company to face whistleblower alleg...
Read more
Industry Notes:
Hospital Sheds Home Care After Years Of Losses
Murray-Calloway County Public Hos-pital in Kentucky has agreed to sell its home health a...
Read more
Home Health & Hospice Week - 2015; Volume 24, Number 5
Face-To-Face:
Obtain Physician Info ASAP For Face-To-Face Compliance
Quick documentation retrieval will boost your claims success. Home health agencies hav...
Read more
Education:
Ready, Set, Go On Educating Docs About F2F
Caution: Educational resources are scarce. How will you ensure the free flow of docume...
Read more
Hospice:
Use Your 2-Month Cap Window Now Or Risk Payment Freeze
Beware delays stemming from IACS-to-EIDM system transition. Don’t forget you hav...
Read more
Reimbursement:
Steer Clear Of These 6 Cap Reporting Pitfalls
Tip: Expect cap adjustment down the road. The learning curve on the new requirement to...
Read more
Industry Notes:
HHS Sets The Stage For Medicare Payment Changes
Your outcomes will be more important than ever under new payment emphasis. If you thin...
Read more
Industry Notes:
MAC Shoots Down 70% Of High-Therapy Claims
Be sure your records for high-therapy claims are up to snuff, because they are under the...
Read more
Industry Notes:
Medicare Officials Move Forward With Plans For Home Health Agency 5-Star Rating System
The Centers for Medicare & Medicaid Services is moving ahead with plans to rate home...
Read more
Industry Notes:
Proportion Of Hospice Chains Providing Medicare Services Shoots Up Over Last Decade
If you need proof that the hospice industry is changing rapidly, look to a study publish...
Read more
Industry Notes:
Department Of Labor Signals Plan To Appeal Companionship Exemption Ruling
You can pay your employees using the companionship exemption for overtime, but keep an e...
Read more
Industry Notes:
Are Whistleblowers Violating HIPAA Privacy Regulations? One Health Care Provider Tries To Make The Case
If your organization is facing a whis-tleblower lawsuit for violating the False Claims A...
Read more
Home Health & Hospice Week - 2015; Volume 24, Number 4
Hospice:
Hospice Payment Reform On The Horizon
The final structure may surprise you. Skilled visits in the last days of death and ext...
Read more
Know Your Facts:
Sunday Deaths Much Less Likely To See Skilled Visits
Live discharges grow from 13% to 18% over decade. The Centers for Medicare & Medic...
Read more
Payment:
Take A Look At This Tiered Payment Model For Hospice
Certain routine days would pay more than $500 in one payment system iteration. Exactly...
Read more
Referrals:
Help Your Physician Referral Sources Access More Payment
20 eligible patients could earn your docs up to $10,000 annually. Physicians referring...
Read more
Reimbursement:
Review Scope of CCM Services With Your Docs
CMS uses existing criteria for new physician Chronic Care Management payments. The Cen...
Read more
Referrals:
Help Docs Know Their CCM Practitioner Arsenal
Good news: General supervision a go. Unlike the original Chronic Care Manage-ment prop...
Read more
Industry Notes:
F2F Delay Isn't Out Of The Question
How much noise are you willing to make? Once Jan. 1 passed, many home health agencies ...
Read more
Industry Notes:
MedPAC Highlights Profit Margins
As expected, the Medicare Payment Ad-visory Commission will once again urge Congress to ...
Read more
Industry Notes:
Submit HIS Data Or Face 2017 Pay Reductions
The Hospice Item Set data you’re submitting now will affect your 2017 payment rate...
Read more
Industry Notes:
Put This ICD-10 Site In Your Training Toolbox
CMS continues to help providers prepare for the Oct. 1 transition date to ICD-10. One su...
Read more
Industry Notes:
Review Your Discharge Ins and Outs
Brush up on your discharge responsibilities with a new booklet from CMS. For example: ...
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Industry Notes:
Don't Count On Extensions When It Comes To ADRs
When you get a documentation request from your MAC or another Medicare entity (such as a...
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Industry Notes:
Brace For Long Battle Over Companionship Exemption
You may still be doing your happy dance over the recent federal court ruling vacating th...
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Industry Notes:
CMS Administrator Departs Next Month
Say goodbye to CMS Administrator Marilyn Tavenner. The former nurse will resign at the e...
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Home Health & Hospice Week - 2015; Volume 24, Number 3
Face-To-Face:
Doc's Clinical Note Must Be Present To Prove Eligibility Under New F2F Rule
These 3 items must be present in the clinical note or you won’t get paid. At fir...
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Labor Law:
Court Decision Takes Overtime Worries Off Agencies' Plates
A D.C. federal court judge has vacated the part of the Department of Labor rule that wou...
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Face-To-Face:
New F2F Rule Has A Few Signature Perks
Use this recommended strategy to reduce physician burden. Home health agencies are wea...
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Compliance:
HHAs Call For F2F Delay In Face Of Challenges
Documentation process and content problems plague HHAs trying to comply. New face-to-f...
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Hospice:
Hospice Spending Soars For Assisted Living Residents
Check out these quality measures CMS is considering. If CMS heeds the OIG’s advi...
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Industry Notes:
Overlapping Claims Might Cause Unexpected Adjustments
Claims system overhauled to curb hospital stay, Medicare Advantage-related overpayments....
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Reimbursement:
Agencies In 100 Counties Lost Rural Add-On As Of Jan. 1
MAC reminds agencies to use updated CBSA codes. Are you using the up-to-date CBSA code...
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Industry Notes:
Brush Up On This New Claim Field
Wondering what that new “UTN” field in the Fiscal Intermediary Shared System...
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Industry Notes:
New Claims System Glitch Strikes HHA Claims
You’ll need to sit tight if you are experiencing cash flow delays due to a claims ...
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Industry Notes:
HHAs Praised For Helping Elderly Patients In Cold Weather
Brutally cold weather that comes with winter can be especially difficult on homebound pa...
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Industry Notes:
Hospice Competition Heats Up In Florida
Numerous health care organizations are jumping at an opportunity to establish a hospice ...
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Industry Notes:
Health System Sells Home Care, Hospice Units
Ambercare has acquired Gila Regional Medical Center’s Home Health and Hospice pro-...
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Industry Notes:
Non-Medical Home Care Chain Makes Ohio Buy
Chain Addus HomeCare Corp. has strengthened its Ohio presence by acquiring six-location ...
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Industry Notes:
Post-Acute Chain Acquires Hospice In Texas
The Ensign Group’s acquisition streak continues, with its purchase of Hospice of t...
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Home Health & Hospice Week - 2015; Volume 24, Number 2
Quality:
New 5-Star Rating System Likely To Mark You As Sub-Par In Consumers'Minds
Open Door Forum participants express concern about normal distribution model. It may a...
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Outcomes:
Risk Adjustment May Make Or Break Your Star Rating
Plus: Vaccination measures raise questions. The risk adjustment CMS uses for Home Heal...
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OASIS:
Keep The Pedal To The Metal For OASIS-C1 Training
Both the ongoing transition and upcoming changes are training triggers. OASIS-C1/ICD-9...
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Hospice:
Know Your Notice Of Election Filing Exemptions
Hint: Pointing the finger at staffing problems isn’t going to cut it. Is your ho...
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HIPAA:
Neglect Your HIPAA Risk Assessment At Your Peril
A HIPAA Security Rule policy gathering dust on the shelf won’t do you any good. ...
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Industry Notes:
Get Manifestation Coding Right Or See Returned Claims
New coding-focused edit took effect Jan. 1. You’d better put a manifestation dia...
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Industry Notes:
New CAHPS Exemption Form Available For Small Hospice Providers
Are you small enough to get out of new CAHPS requirements for hospice? If so, you’...
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Industry Notes:
F2F, POC Problems Plague High-Therapy Claims
Face-to-face, plan of care and OASIS requirements continue to torpedo high-therapy claim...
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Industry Notes:
MedPAC To Congress: Rebasing Won't Harm HHAs
Home health agencies should be able to take rebasing reductions to Medicare reimbursemen...
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Industry Notes:
Pony Up More Than $500 For Revalidation,Enrollment
The paperwork headache isn’t the only pain involved with a revalidation request. I...
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Industry Notes:
2 Non-Profit Hospices Join Forces In Buckeye State
Two Ohio non-profit hospices are teaming up. Hospice of Dayton and Cleveland-based Hospi...
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Industry Notes:
IRS Mileage Rate Creeps Back Up From 2014 Level
Mileage rates are back up this year. The Internal Revenue Service-determined optional st...
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Industry Notes:
Multi-State Chain Acquires Arizona Location
The Ensign Group has acquired Alarys Home Health, a Medicare and Medicaid certified home...
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Home Health & Hospice Week - 2015; Volume 24, Number 1
Quality:
Resolve To Work On Your Quality Measures -- Pronto
Waiting for rulemaking could cut 8 percent off your payments. You don’t have tim...
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Strategy:
These 5 Tips Could Help You Avoid VBP Disaster
Don’t wait around for official rulemaking. Home health agencies’ plates ar...
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Compliance:
Use These 7 OIG Pointers To Ace Your Compliance Plan
Don’t overlook your ACA compliance plan responsibilities. Ready to get your comp...
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Compliance:
Tend To Your Culture Of Compliance
Follow this compliance director’s 7 tips. The road to a successful compliance pl...
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Diagnosis Coding:
Diversified Providers Should Prepare For Extra ICD-10 Work
Not all payers will be ready at the same time. What was once an Oct. 1, 2014, start da...
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Labor Law:
HHAs Can Use Companionship Exemption A Bit Longer
But stay tuned, since that may change quickly. Thanks to a victory in a trade group la...
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Industry Note:
Meet New Home Health RAC
RACs must meet new overturn cap. If you get hit by Recovery Audit Contractor review, i...
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Industry Note:
Beware An Error In The New PPS Grouper
Beware an error in grouper logic in the latest PPS grouper software. "The error &he...
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Industry Note:
Heed This Revalidation Advice From MACs
If you enrolled in Medicare before March 25, 2011, the Affordable Care Act requires you ...
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Industry Note:
MAC Puts Expanded F2F Review On Hold
You’ve got one less face-to-face headache to deal with — for the moment. T...
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Industry Note:
National Chain Deals With HIPAA Breach
HIPAA penalties aren’t the only possible damage from a slip with patients’ p...
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Industry Note:
News Outlets Take For-Profit Hospices To Task
Hospices continue to take a beating in the national press. Two new articles from The Was...
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