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Home Health & Hospice Week

OASIS:
Hit These Important OASIS-C2 Points Before Jan. 1 Implementation
Major pressure ulcer changes may throw your OASIS staff — and your payments &mdash... Read more
OASIS:
Get Up To Speed On OASIS-C2 With These Resources
Free tools, seminars and guidance documents are available — if you know where to f... Read more
Reimbursement:
MedPAC Sharpens Budget Ax For Home Health Rates
Influential commission calls for 5 percent cut. If you thought the Medicare Payment Ad... Read more
Hospice:
MedPAC Readies Hospice Rate Freeze Proposal For 2018
Advisory body predicts a 7.7 percent profit margin for 2017. Hospices won’t find... Read more
HIPAA:
Don't Let Patient Satisfaction Efforts Derail HIPAA Compliance
Do you have unprotected PHI going out in your mail? Value-Based Purchasing, 5-Star rat... Read more
Human Resources:
Achieve Employee Improvement With Standardized Feedback Process
Tip: Start with stating observations instead of throwing accusations. Are you frustrat... Read more
Industry Note:
OIG Focus On Physician Topic Could Affect Home Care
Watchdog agency singles out Chronic Care Management billing for scrutiny. Do your refe... Read more
Industry Note:
Medicare Allows Another NOE Timely Filing Exception
Don’t let Medicare’s own billing system problems continue to cost your hospi... Read more
Industry Note:
Provide Patient Transport Under New AKS Safe Harbor
Are you sailing in a safe harbor of the Anti-Kickback Statute? Consult the HHS Office of... Read more
Industry Note:
Hold Your Hospice Vaccination Claims, MAC Advises
Hospices have one more billing headache to deal with, and a portion of claims to hold. ... Read more
Industry Note:
3 Sentenced For Medicaid Home Health Fraud
Three people have received nearly nine years in prison sentences, collectively, after pl... Read more
Industry Note:
VNSNY Battles Misallocation Accusations
The Visiting Nurse Service of New York is under fire for misallocating disaster relief f... Read more
Prospective Payment System:
Say Goodbye To Therapy, 60-Day Episodes Under PPS Payment Reform
CMS may take the next step as soon as this summer, expert predicts. Medicare’s p... Read more
Payment Reform:
Report Unveils Winners, Losers Under HHGM Reform System
Therapy episodes would get reimbursed less. If your claims are dominated by episodes w... Read more
Prospective Payment System:
4 Steps Make Up Your New HHRG Under Payment Reform
The patient’s source of admission would matter under payment revamp. Under Medic... Read more
Pre-Claim Review:
PCR Affirmation Rate Continues To Climb, But Demo Program's Flaws Persist
Claims volume far from full. Medicare is touting its improving approval rates in the P... Read more
Pre-Claim Review:
Know The Certifying Physician's OASIS Responsibilities
Refer to latest Frequently Asked Questions for Pre-Claim Review answers. Question: Und... Read more
Hospice:
Examine Medicare's New Model Hospice Election Statement
How does your current statement stack up? As promised, Medicare has given you a bluepr... Read more
Compliance:
Should You Adopt The New Hospice Election Statement Model Form?
Consider these 3 options carefully. Now that Medicare has issued its model hospice ele... Read more
Industry Note:
Major Hospice Chain Settles Kickback Allegations
VITAS denies wrongdoing in whistleblower suit. When one of your referral sources gets ... Read more
Industry Note:
Just In Time For The Holidays, OIG Bumps Up Nominal Gift Cap Amount
It may be too late for this year’s holiday gifts, but you’ve got a bit more ... Read more
Industry Note:
DOL To Appeal Preliminary Injunction Against Overtime Rule
The pause on the Department of Labor’s overtime final rule is under fire, and you ... Read more
Industry Note:
Hospice Claims Glitch Now Corrected
You should no longer see claims held up in error with code U5112, HHH Medicare Administr... Read more
Labor Law:
Overtime Rule Injunction Could Bode Well For Home Care
Court ruling comes as a surprise. A federal court has halted a Department of Labor rul... Read more
Compliance:
Move Ahead Or Roll Back? HHAs Face Quandary After OT Ruling
Agencies that have already announced salary changes are in a bind. A federal court dec... Read more
Policy:
HHS Secretary Nominee Praised As Home Care Ally
CMS head pick contains more question marks. Whether the Trump Administration benefits ... Read more
Regulations:
Take A Peek At Health Care Crystal Ball
Home care providers hope for more benefits than drawbacks. While the health care polic... Read more
PACE:
Medicare Looks To Pick Up The PACE With Looser Requirements
Non-profit PACE programs now allowed. Changes to Medicare’s PACE program may aff... Read more
Regulations:
Will PACE Switch To For-Profits Follow Hospice Path?
Former CMS head has doubts. Big money is entering the Programs of All-Inclusive Care f... Read more
PACE:
PACE Needs A Revamp, Home Care Providers Say
HH commenter warns of ‘profit-seeking organizations  with good writing skills... Read more
Industry Note:
Medicare Springs 4 New Nursing G Codes On HHAs
Learn new PPS billing rules. The Centers for Medicare & Medicaid Services has issu... Read more
Industry Note:
MAC Launches Pre-Pay Audit Of BG HIPPS Code Claims
Home health agencies in 13 states are about to have 100 claims reviewed in a prepayment ... Read more
Industry Note:
Are You One Of The Few Not Checking Your Benchmarks In Your PEPPER Report?
Want to see how many of your peers are accessing their PEPPER reports? Check out pepperr... Read more
Pre-Claim Review:
PCR Continues Placing Hoops For IL HHAs To Jump Through
For the first time, CMS reveals partial affirmation rate. Home health agencies in Pre-... Read more
Pre-Claim Review:
HHAs Work For Regulatory, Legal Remedy To PCR
MAC readies Florida education sessions. Home health agencies and their representatives... Read more
Pre-Claim Review:
Consult These New PCR Resources For Help
One MAC tries harder to educate physicians on home health documentation. Medicare and ... Read more
Compliance:
OIG Targets Home Health Surveys In Latest Work Plan
Medicaid PCS also tops to-do list. If the HHS Office of Inspector General’s Work... Read more
Fraud & Abuse:
OIG HHA Fraud Factors
Do you fall into the HHS Office of Inspector General’s high-risk profile for fraud... Read more
Hospice:
OIG Shines Spotlight On 3 Hospice Areas In 2017
Expect related services to go under the watchdog agency’s microscope. The feds d... Read more
Fraud & Abuse:
Latest Fraud Convictions, Sentences Feature Kickbacks
Tip: Hiding evidence in your jail cell does not lead to a lenient sentence. A recently... Read more
Reimbursement:
CMS Clears Up Some 2017 Billing Questions
Do you know how to claim disposable NPWT? As Jan. 1 approaches, home health agencies a... Read more
Quality:
New Hospice Quality Information Will Be Coming To You Next Month
Plus: Only half of hospices access free benchmarking reports from CMS. Stay tuned to t... Read more
Reimbursement:
CMS Debunks 3 OASIS-Claims Matching Myths
OASIS corrections won’t derail your claim. If you’re worried about how Med... Read more
Industry News:
Use Updated HHCCN Form Come January
Keep up to date with your ABN/CCN compliance with a revised form. Background: Back in ... Read more
Industry News:
Will Proposed Bundling Initiatives Get Scuttled?
One more reason a Trump administration might benefit home care providers: Potential dela... Read more
Industry News:
Medicare Cost-Sharing Increases
Your patients will pay more for their nonhome care services in 2017. CMS announced a Par... Read more
Prospective Payment System:
Dropping Quality Measures Might Also Drop Your Scores
CMS finalizes elimination of 34 measures. It’s always a pleasant surprise when M... Read more
Quality:
Lengthy Window Stays Intact For New Spending Measure
Hospice services will count toward spending. You’ll be responsible for patients... Read more
Quality:
Agencies' Fates Ride On Accurate Risk Adjustment
CMS punts on sociodemographic standards. As with Value-Based Purchasing, numerous pro... Read more
Regulations:
Prepare For Changes Under Trump Administration
Will you say goodbye to some onerous regulatory burdens? Whether you were cheering or... Read more
Industry Notes:
CGS Agencies Finally Catch Up On PCR Submission Method
Get familiar with esMD for quickest submission. Submission difficulties are just one ... Read more
Industry Note:
Medicare Names New National Recovery Audit Contractor For Home Health, Hospice & DME
Expect more Recovery Audit Contractor scrutiny, thanks to the new contract awarded for a... Read more
Industry Note:
Heed HIS Coding Tip Offered By CMS
Make sure your orders back up your Hospice Item Set answers. So says a new “HIS co... Read more
Industry Note:
Avoid This Costly Human Resources Mistake
Are you asking employees and applicants about their family medical history? Then you may... Read more
Industry Note:
Comply With New LSC As Enforcement Ramps Up
This month, your compliance record is on the line if a surveyor comes calling. Beginn... Read more
Prospective Payment System:
Medicare Strips $130 Million From 2017 HH Spending
CMS rejects home health agencies’ suggestions for change. The 2017 Home Health P... Read more
Prospective Payment System:
CMS Is Fine With Agencies Closing
‘Home health market ... to remain robust,’ CMS maintains. Many commenters ... Read more
Reimbursement:
New Outlier Policy To Chop One-Third Of Outlier Episodes
Medicare reimbursement of outlier episodes to be based on 15-minute units starting in ne... Read more
Value-Based Purchasing:
VBP Changes For 2017 Miss The Big Picture
Lack of stabilization measures, too-big outlier pool remain major problems. If you wer... 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... Read more
Supplies:
CMS Clarifies NPWT Billing
Billing for disposable devices more limited than first appeared. Brush up on your 34x ... Read more
Billing:
Learn From This NPWT Billing Scenario
Do you know how to bill this type of visit? Make sure your staff know to count NPWT ve... Read more
Quality:
Say Goodbye To 6 HHQRP Measures, Hello To 4 IMPACT Act Measures
New measures unchanged from proposed rule. If you’re wondering how the IMPACT Ac... Read more
Industry Note:
NAHC Readies Lawsuit Against Pre-Claim Review
Buckle up for a bumpy ride. Illinois home health agencies continue to stagger under th... Read more
Industry Note:
Claims Without OASIS Returned Starting April 1
If you’ve been operating under the mantra “No OASIS, No Problem,” get ... Read more
Industry Note:
Beware CBSA RTPs
Are your hospice claims returning to provider (RTP) incorrectly for Core-Based Statistic... Read more
Pre-Claim Review:
PCR Pushes Illinois Agencies Closer To Closure
Reimbursement crash looms next month. Medicare officials may be saying things are look... Read more
Pre-Claim Review:
6 Things Illinois Agencies Want Changed About PCR
Physician education by CMS is a must. Home health agencies in Pre-Claim Review’s... Read more
Prospective Payment System:
Outlier Changes Will Reduce Access For Costly Diabetics
One-third of outlier episodes wouldn’t receive payments under new methodology. E... Read more
Prospective Payment System:
Outlier Proposal May Shoot Itself In The Foot
Medically complex patients at risk under revamped methodology, commenters warn. In a p... Read more
Reimbursement:
New Outlier Calculation Misses The Mark
Calculation should weight initial visit unit heavier, commenters urge. How much would ... Read more
Fraud & Abuse:
Beware More Outlier Fraud
Self-reporting a weak point. Don’t think a new outlier payment methodology will ... Read more
Industry Note:
CERT Report Pushes Prior Auth
Only DME rivals the home health error rate. The “Medicare Fee-for-Service 2015 I... Read more
Industry Note:
Publicly Traded Home Care Company To Buy Controlling Interest In 89-Location Health System-Based Chain
Almost Family Inc. is buying the controlling interesting in an 89-location health system... Read more
Prospective Payment System:
VBP Neglects Major Home Care Focus, Agencies Tell CMS
Improvement emphasis is disservice. Lack of stabilization measure inclusion in Medicar... Read more
Quality:
VBP Risk Adjustment Doesn't Compensate Enough
Add socio-demographic adjusters, commenters urged CMS. If Medicare doesn’t want ... Read more
Value-Based Purchasing:
Change In VBP Comparison Groups Meets Mostly With Favor
Small providers somewhat nervous about cohort revamp proposal. Home health agencies in... Read more
Appeals:
VBP Appeals Expansion Appeals To HHAs, But Longer Timeframe Needed
Questions remain about appeals decisions’ impact on other agencies. Medicare pla... Read more
Benchmarks:
Set VBP Benchmarks Ahead Of Time, MedPAC And Other Commenters Urge
Retroactive benchmarks curb quality improvement, critics say. Home health agencies in ... Read more
Value-Based Purchasing:
Reduce VBP Risk Pool To Be In Line With Other Provider Types
Public reporting, population base blasted. Commenters on the 2017 Home Health Prospect... Read more
Fraud & Abuse:
Hospice Execs Sentenced In Fraud Cases
Benchmark: National live discharge rate is 18%. Hospices with sky-high live discharge ... Read more
Fraud & Abuse:
States Crack Down On Home Care Providers
One states sees 80% spending spike over 2 years. As Medicaid spending on home care soa... Read more
Industry Note:
More PCR Education On Deck
Palmetto offers additional in-person training. Don’t expect that Pre-Claim Revie... Read more
Industry Note:
Learn New Hospice Vaccine Billing Ins And Outs
Hospices can get their newly updated vaccine billing instructions in a recently reissued... Read more
Industry Note:
Tampa HHA Owner Convicted Of Medicare Fraud
The owner of Gold Care Home Health Services Inc. in Tampa, Fla., has been convicted of M... Read more
Industry Note:
Hospice Owner Admits To Physician Kickbacks
Hospice medical director relationships are once again in the fraud and abuse spotlight. ... Read more
Prospective Payment System:
NPWT Switch Would Shortchange HHAs, Patients
Disposable device visits won’t count. How much are your time, expertise and othe... Read more
Reimbursement:
Let HHAs Bill NPWT Visits Under HH PPS, Commenters Urge
Proposed policy encourages use of durable NPWT instead of disposable. If a Medicare pr... Read more
Pre-Claim Review:
Pre-Claim Review Preparation Rolls On In Face Of Industry, Lawmaker Opposition
MAC tries to educate Florida docs about PCR. Although the Pre-Claim Review program is ... Read more
HIPAA:
HHS Targets Small HIPAA Breaches For Increased Scrutiny
New focus could impact home care providers. It may be October, but you’d better ... Read more
Medical Review:
MAC Offers F2F Documentation Advice
Does your certifying docs’ documentation contain these elements? One of Illinois... Read more
Compliance:
Lack Of Breach Reports Also Red Flag
How do you compare to your peers? If you pride yourself on your spotless HIPAA record,... Read more
HIPAA:
Don't Let A Lost Phone Torpedo Your HIPAA Compliance Record
Small breaches, charitable status won’t save you from big penalties. Pay close a... Read more
Industry Note:
Hospice RHC Reimbursement Woes Continue
Some billing problems resolve, others don’t. Hospices have a plethora of billing... Read more
Industry Note:
Home Health Compare To Refresh Oct.19
Check out your preview reports for your Home Health Quality of Patient Care Star Ratings... Read more
Industry Note:
Value-Based Purchasing Participation Lags
More than 400 HHAs under Value-Based Purchasing are risking their reimbursement by not c... Read more
Industry Note:
CMS Gears Up To Remove SSNs From Bene Cards
Your billing will be changing in a yearand- a-half thanks to the Medicare Access and CHI... Read more
Pre-Claim Review:
CMS Delays Pre-Claim Review In 4 States -- For Now
Medicare spokesperson says denial rate lower than reported. Home health agencies in Fl... Read more
Compliance:
Don't Put Off PCR Readiness, Despite Program Pause
You’ll have only 30 days’ notice before program hits your state. The adage... Read more
Medical Review:
Take These PCR Prep Steps Now
Don’t depend on CMS for physician education. While home health agencies and indu... Read more
Pre-Claim Review:
Illinois HHAs Out In The Cold
Pre-Claim Review will ‘change home health as we know it,’ expert warns. Il... Read more
Hospice:
OIG Finds Fault With Hospice NOEs, Certs
Surveyors tasked with new focus. Watch for new model language for hospice Notices of E... Read more
Compliance:
Avoid NOE Problems With These Pointers
Sidestep the most common pitfall from a recent OIG review. Don’t be surprised to... Read more
Documentation:
Hospice Certification Compliance Is As Easy As 1-2-3
Do your own review, before lackluster certs lose you reimbursement. Will your physicia... Read more
Industry Note:
Finalize Your Emergency Prep Plan Before The Holidays
Don’t forget to address terrorism, cyber-attacks. Check out your new emergency p... Read more
Industry Note:
Hospital Readmissions Fall In Last 5 Years
Efforts to reduce hospital readmissions — including increased use of home care &md... Read more
Industry Note:
Kindred Pays $3.1 M For Hospice CIA Violations
Billing Medicare for ineligible hospice patients has led to a $3.1 million penalty for o... Read more
Industry Note:
Hospices Merge In The Carolinas
Non-profit Hospice of Laurens County in South Carolina will merge with Hospice & Pal... Read more
Industry Note:
Dwindling Referrals Lead To County HHA Sale
The latest county-run home health agency to go on the market is in North Carolina. Harne... Read more
Prospective Payment System:
Home Health Pay Cut Threatens Access To Care
Reimbursement is below cost of care already, rural provider tells CMS. If Medicare wan... Read more
Payment:
Case Mix Recalibration's Time Component To Shortchange Chronic Care Patients
Enough with the case mix reshuffling, commenters tell CMS. Another payment year’... Read more
Reimbursement:
MedPAC Claims Home Health Cuts Don't Go Far Enough
An 8.8% profit margin is still too high, Medicare watchdog says. While you may feel Me... Read more
Pre-Claim Review:
MAC Says PCR Denial Rate Lower Than Reported
Good news: You can now save a Pre-Claim Review request in progress. Whether request de... Read more
HIPAA:
Breach Reports Caused By Stolen Laptops Lead To $2.7M HIPAA Settlement
Don’t let mobile device theft send you down slippery HIPAA slope. A recent multi... Read more
Industry Note:
Faxed PCR Requests Don't Receive Faxed Responses In These Cases
Shorten PCR turnaround by knowing the ropes. If you fax a Pre-Claim Review request to ... Read more
Industry Note:
Number Of PPS Proposed Rule Comment Letters Drops Significantly
Home health agencies’ voices are getting quieter as Medicare keeps hacking away at... Read more
Industry Note:
Your Patients May Need New DME Supplier In New Year
Medicare is patting itself on the back for cutting hundreds of millions of dollars annua... Read more
Industry Note:
State Cracks Down On Private Duty Agencies
The New Jersey Division of Consumer Affairs fined 36 private duty home care agencies mor... Read more
Industry Note:
MAC Offers NOE Correction Advice In FAQ Update
Don’t make extra work for yourself and risk reimbursement delays when you don&rsqu... Read more
Industry Note:
County Puts HHA On The Block After Persistent Losses
Another county is shedding its home health agency. The Bladen County Board of Commission... Read more
Industry Note:
HHA Adds Doc House Calls To Its List Of Services
More home care agencies are reaping the benefits of venturing outside their home care si... Read more
Industry Note:
HIPAA Phase 2 Audits In High Gear
Back in July, the HHS Office for Civil Rights announced that Phase 2 of the HIPAAAudit p... Read more
Pre-Claim Review:
PCR Denial Rate Soars To Reported 80%
Crushing burden comes to more states soon. Brace yourselves: Those expecting the Home ... Read more
Pre-Claim Review:
Home Care Industry Races To Head Off PCR
Register for Palmetto’s PCR educational sessions in Florida, Texas. Illinois hom... Read more
Reimbursement:
Benefit From These 6 Lessons Learned In PCR's Early Days
Critical: Get docs to incorporate your records — with proof. A silver lining to ... Read more
Fraud & Abuse:
Feds Crack Down On Docs In Home Care Fraud Schemes
Physician receives 4 years for bogus hospice certs. It’s not just home health ag... Read more
Marketing:
Benefit From Social Media While Avoiding These Pitfalls
Plan ahead to maximize online presence. If you fail to present a robust online presenc... Read more
Marketing:
Ask These Questions In A Social Media Self-Audit
Have you googled yourself lately? Here are some key points that you may want the answe... Read more
Industry Note:
Court Shoots Down FLSA Class Action For Aides
Aides not similarly situated, judge rules. Home care providers may face fewer lawsuits... Read more
Industry Note:
MAC Offers Information For Disaster Relief
Wondering what regulatory relief you are entitled to when a natural disaster or emergenc... Read more
Industry Note:
PCR Generates One More Billing Headache
In addition to legitimately related problems, the Pre-Claim Review demonstration is also... Read more
Industry Note:
QIC Change Affects 27 States And Territories
A Qualified Independent Contractor transition effective Sept. 1 may affect you. Old wa... Read more
Industry Note:
Western Chain Makes Texas Acquisition
Cornerstone Healthcare Inc., the Ensign Group’s home health and hospice portfolio ... Read more
Industry Note:
HHA Fraudster Receives 20-Year Prison Sentence
Miami continues to attract fraud-fighting scrutiny. A Miami-area HHA owner and manager h... Read more
Industry Note:
Avoid This Common HETS Search Mistake
Just because you can’t find a beneficiary in HETS, doesn’t mean she’s ... Read more
Prospective Payment System:
Medicare May Have A Major PPS Overhaul Up Its Sleeve
Therapy utilization cut on deck for payment. A topic that has been a minor, rather vag... Read more
Prospective Payment System:
Payment Reform Would Drop Therapy Visits From HH PPS
Plus: Episodes shortened to 30 days if new payment model adopted If you thought regula... Read more
Diagnosis Coding:
Check Out New Coding-Based Categories Under Payment Reform
Vague codes will mean returned claims under HHGM. Your mastery of ICD-10 diagnosis cod... Read more
Hospice:
Medicare Choices Model Continues, Despite Difficulties
Plus: Hospice Compare still on track. Hospices had high hopes when Medicare announced ... Read more
Fraud & Abuse:
Don't Have A Compliance Program? That May Be A Medicare Death Sentence
Are you putting yourself at risk? Your compliance program may not save you in an inves... Read more
Compliance:
Heed These 10 Dos and Don'ts For Compliance Plan Success
Key: You can’t ignore non-compliant staffers. Once you and your staff decide to ... Read more
Industry News:
VBP Agencies Receive First Performance Reports
Comparison stats still a ways off. About 1,800 home health agencies in the nine Value-... 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... Read more
Industry News:
La Flooding Packs Double Whammy For Home Care
The flooding in the Baton Rouge, La., area has impacted about 80 home health agencies se... Read more
Industry News:
HHA Plans To Appeal OIG Audit Findings
One Massachusetts home health agency audited by the OIG isn’t taking the watchdog ... Read more
Industry News:
Goodbye Summer, Hello Pre-Claim Review In TX, FL
Medicare appears to be moving full steam ahead on Pre-Claim Review demonstration’s... Read more
Industry News:
F2F Code Trips Up HHAs, MAC Warns
Don’t let a misleading error description lead you astray when it comes to face-to-... Read more
Industry News:
Make Sure Your Claims Don't Include These Value Codes
If you’re receiving returned claims with reason code 10405, you may be stuck for a... Read more
Industry News:
Vegas Non-Profit Hospice Makes Acquisition
Las Vegas-based Nathan Adelson Hospice will acquire Las Vegas Solari Hospice Care, owned... Read more
Pre-Claim Review:
Pre-Claim Review Starts With A Trickle
You can’t afford to wait and see — prepare now. As pre-claim review gets o... Read more
Pre-Claim Review:
Heed 7 Tips For PCR As Program Launches
Immediate review of physicians’ documentation is critical. With pre-claim review... Read more
Hospice:
Take These 9 Steps To Prepare For Hospice Compare
Are you collecting all the data you’re supposed to? If not, your composite score w... Read more
Quality:
Boost Your CAHPS Recommendation Score Before Compare Hits
Are you covering these key family/caregiver needs? Many Hospice Compare details are un... Read more
Fraud & Abuse:
OIG Leader Emphasizes Compliance Importance
Watchdog singles out hospice fraud and abuse as particular risk. Expect the enforcemen... Read more
Human Resources:
Boost Staff Accountability With These Tactics
Use these questions to encourage staff behavior changes. When one employee isn’t... Read more
Industry Notes:
Benes To Get Faster Appeals Decisions -- But You Won't
Fast track will last at least 3 more years. An Aug. 1 federal court decision about Adm... Read more
Industry Note:
Former Amedisys CEO Perishes In Flooding
The severe flooding in Southern Louisiana has taken a steep toll on home care providers ... Read more
Industry Note:
Home Care App Start-Up Secures $42M Financing
A start-up based on the premise of furnishing home care with an Uber-like app has secure... Read more
Industry Note:
Pediatric Chain Acquires Las Vegas Provider
Pediatric home care provider Epic Health Services Inc., a portfolio company of Webster C... Read more
Industry Note:
Follow The Map To These New GEMs
The Centers for Medicare & Medicaid Services has posted the General Equivalency Mapp... Read more
Industry Note:
New Quality Measures On Transfers Prepped
Want to find out more about how IMPACT Act data requirements will affect you? Dial into ... Read more
Industry Note:
AHRQ Offers Tools For Curbing Readmissions
The old saying “haste makes waste” suggests that timely planning is key to l... Read more
Pre-Claim Review:
Pre-Claim Review Launches In Illinois A Few Days Late
Senior poll shows beneficiary opposition to demonstration program. Home health agencie... Read more
Education:
Know Where To Get Your Pre-Claim Review Info
Keep up to date on vital pre-claim review demonstration project information by using the... Read more
Fraud & Abuse:
Fraud Hot Spots Continue To Generate HEAT
Two physicians receive home care-related fraud convictions. The feds are keeping fraud... Read more
Fraud & Abuse:
Whistleblower Suits Lead To $18 Million Settlement
Plus: State cracks down on home care fraud. Off the beaten path? Don’t assume yo... Read more
HIPAA:
Take These 3 Actions When A HIPAA Security Event Occurs
Beware inadequate policies and procedures. With the increase in data breach incidents ... Read more
Compliance:
Follow These 7 Steps When A HIPAA Breach Happens
Document your investigation carefully in case of a lawsuit. Try as you might to preven... Read more
HIPAA:
Look At Big Picture To Handle HIPAA P&P
Tip: Make sure someone at your agency is ready to take incident reports 24/7. Under HI... Read more
Industry Note:
Medical Necessity Drives OIG Audit Findings
Virgin Island HHA under the watchdog agency’s microscope. Sloppy documentation c... Read more
Industry Note:
New HHA Moratoria Expands Statewide -- With Some Possible Exceptions
If you thought the Centers for Medicare & Medicaid Services might ease up on morator... Read more
Industry Note:
ICD-10 Codes Taking Effect Oct. 1 Affect HH PPS Payments, Grouper Update Shows
Check out how the new ICD-10 diagnosis codes taking effect Oct. 1 will change your prosp... Read more
Industry Note:
Hospices Get New Billing Code For Late Certs
Come Jan. 1, hospices will have a new condition code to use to identify when an occurren... Read more
Industry Note:
Sale Of Bankrupt HHA Falls Through
The sale of a troubled Indiana home care company has fallen through. A few months ago, A... Read more
Pre-Claim Review:
This Is Not A Test
PCR demo launches in initial state. As the Aug. 1 launch date for the pre-claim review... Read more
Hospice:
Hospice 2017 Pay Increase Improves Slightly To 2.1%
Pay raise will add an estimated $350 million to hospice payments next year. If you wer... Read more
Quality:
It's Official: 2 New Quality Measures Adopted For Hospice
Start collecting new HIS item data April 1. Get ready to answer for your visit utiliza... Read more
Hospice:
Get To Know Your 9 Hospice Quality Measures
One new measure is a star rating proxy. And then there were nine. The Centers for Me... Read more
Quality:
Final Rule Includes More Hospice Compare Details
HIS and CAHPS data both will make the Hospice Compare cut. The biggest change in Medic... Read more
Hospice Item Set:
Hospice Assessment Tool Coming, Despite Concerns
Can hospices shoulder the extra burden? Hospices are not convinced that a patient asse... Read more
Reimbursement:
Timely Reporting Threshold Jumps To 80% Jan. 1
Access new HIS report to keep tabs on your compliance. It’s time to tighten up H... Read more
Human Resources:
Boost Retention With Employee Appreciation Day
A low-cost activity can yield big benefits. Appreciation is one of the most powerful m... Read more
Industry Note:
F2F Fuels Agency's Alleged $7.5 Million Overpayment
OIG auditors seize on physician narrative. Are you prepared for the HHS Office of Insp... Read more
Industry Note:
MAC Investigates Reported Claims Payment Errors
Meanwhile, other claims glitches still go unexplained. HHH Medicare Administrative Contr... Read more
Industry Note:
DOL Increases FLSA Penalty Amounts Significantly
Watch out for increased penalty amounts from the Department of Labor taking effect this ... Read more
Prospective Payment System:
4 New Quality Measures Proposed For HHAs
Drug regimen review measure will require new OASIS items. You’ll have a group of... Read more
Quality:
Take A Closer Look At Your New Quality Measures
IMPACT Act to make more of an impact. Home health agencies will start being judged on ... Read more
Pre-Claim Review:
One Billing Hurdle Eliminated In Pre-Claim Review
Adjusted claims won’t require a complete do-over. With the onset of pre-claim re... Read more
Regulations:
Give CMS Your PPS Rule Feedback By Next Month
Plus: Hundreds of HHAs still slacking on VBP. Medicare’s proposed rule for 2017 ... Read more
Hospice:
Some Payment Reform Errors Fixed While Others Linger
Hospice Compare on track for 2017 debut. If trying to figure out why your hospice paym... Read more
HIPAA:
OCR Ramping Up HIPAA Enforcement, Stats Show
Warning: HIPAA investigations can drag on for years. Both federal and state authoritie... Read more
HIPAA:
Steer Clear Of These 5 HIPAA Hot Spots
Be sure you aren’t committing these common HIPAA sins. Watch out for these HIPAA... Read more
Industry Notes:
Proposed Doc Fee Schedule May Support Home Care Patients
Chronic care management, diabetes prevention addressed. Your most complex patients may... Read more
Industry Note:
Hone Your Use Of PEPPER Reports With Training
Now that you’ve got your free PEPPER benchmarking report in your hands, it’s... Read more
Industry Note:
Whistleblower Files Suit Against Texas DADS
Home care and hospice providers aren’t the only ones that have to worry about whis... Read more
Industry Note:
Multi-State Chain Opens New Location
The Greystone Health Network is opening a new home health branch in Sun City Center, Fla... Read more
Industry Note:
Ohio Retirement Communities Merge HHAs
Two Cincinnati-area retirement communities are combining their home health agencies.&nbs... Read more
Pre-Claim Review:
Illinois HHAs Brace For Pre-Claim Review's Start
Nearly half of nation’s HHAs will be under PCR by January. The heavy burden of M... Read more
Medical Review:
Use This Checklist When Submitting PCR Requests
The pressure is on for HHAs to obtain physician documents quickly. Getting it right fr... Read more
Face-To-Face:
Get F2F Right Or Lose Reimbursement Under PCR
F2F form no longer cuts it. The pre-claim review demonstration doesn’t impose an... Read more
Face-To-Face:
Make Sure Your PCR Request Includes These 5 F2F Musts
Missing F2F elements will mean delayed, or denied, reimbursement. If you’re not ... Read more
Pre-Claim Review:
Use These 8 Tips To Survive Pre-Claim Review
Start self-auditing F2F now. Nearly half the HHAs in the nation will undergo 100 perce... Read more
HIPAA:
Keep An Eye Out For HIPAA Audit Notice
Does a contact verification message from OCR equal a guaranteed audit? Question: We re... Read more
Human Resources:
Accentuate The Positive To Improve Retention
Employees feel motivated when they know they are valued. In these days of declining re... Read more
Industry Note:
You Can Put Your UTN Here Under Pre-Claim Review
Heed these new PCR details. With the pre-claim review demonstration coming at lightnin... Read more
Industry Note:
CMS Releases Finalized ICD-10 Codes For October
You’ve got only a few short months to get up to speed on the new ICD-10 diagn... Read more
Industry Note:
Watch Out For Denials With Reason Codes 31157, 32072
If you’ve received fishy denials with physician-related reason codes, you’re... Read more
Industry Note:
Compare Your Stats To New PEPPER Charts
See whether you stick out like a sore thumb to reviewers and authorities by using new PE... Read more
Industry Note:
Home Doc Co. Pays Millions To Settle Fraud Charges
Home health agencies and hospices are not the only health care providers furnishing care... Read more
Industry Note:
Mary Free Bed Rehabilitation Hospital
Mary Free Bed Rehabilitation Hospital in Grand Rapids and Residential Home Health have c... Read more
Industry Note:
Competition Leads To Hospital HHA Closures
Two more hospitals are closing their home care units. Titusville Area Hospital in Pennsy... Read more
Prospective Payment System:
CMS Proposes $180 Million Cut To Home Health Pay In 2017
Repeated cuts will lead to access problems. The number of home health agencies, users,... Read more
Know Your Facts:
CMS Bases Reimbursement Decisions On These Stats
Home health agencies continue to get squeezed by lower payment rates, despite declining ... Read more
Payment:
LUPAs Go Up While Supplies Go Down
Rebasing passes LUPAs by. Home health agencies may feel under-reimbursed for their ser... Read more
Prospective Payment System:
Prepare For Major Changes To Outlier Reimbursement
New winners, losers under methodology revamp. Time will be of the essence when it come... Read more
Outliers:
CMS Proposes Outlier Safeguards Under New Calculation Method
FDL will increase under time-based system. Medicare officials have already anticipated... Read more
Value-Based Purchasing:
Significant Tweaks To VBP On Deck
Just who your agency is compared to can make or break your VBP payments. The Value-Bas... Read more
Value-Based Purchasing:
VBP Appeals Function Clarified, Expanded
Plus 4 measures dropped. The Centers for Medicare & Medicaid Services also propose... Read more
Supplies:
More Reimbursement For Wound Care Patients Using NPWT Proposed
Consolidated billing exception in the works. A rare carve-out for non-routine medical ... Read more
Pre-Claim Review:
HHAs Receive Pre-Claim Review Instructions
Physician signature requirement will be a major obstacle to payment under demo. Home h... Read more
Pre-Claim Review:
Pre-Claim Review Documentation Requirements
In its new operational guide for pre-claim review, the Centers for Medicare & Medica... 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... Read more
HIPAA:
Other Shoe Drops With HIPAA Audits
Hundreds of providers will receive HIPAA scrutiny this year. You’ve been hearing... Read more
HIPAA:
Follow This Advice To Prepare Now For HIPAA Audits
Check and double-check your HIPAA policies and procedures. The HHS Office for Civil Ri... Read more
Industry Note:
HHAs Stuck With Loss Of Companionship Exemption -- At Least For Now
Remedy still sought. The U.S. Supreme Court has declined to hear the industry’s ... Read more
Industry Note:
OASIS-C2 Manual Out
Get ready for OASIS-C2’s January implementation by reading the tool’s new gu... Read more
Industry Note:
HHA PEPPERs Hit In July
Mark your calendar to download the next installment of free billing benchmarks from Medi... Read more
Industry Note:
Chain To Go To Charity
Bayada Home Health Care CEO J. Mark Baiada plans to donate the home care chain to a yet-... Read more
Hospice:
Avoid GIP Denials With These 8 Pointers
GIP stays of more than a week will draw reviewers’ attention. More and more whis... Read more
Medical Review:
Protect Your GIP Dollars With Beefed Up Documentation
Cover pain and symptom changes. Medical reviewers have hospice General Inpatient care ... Read more
Documentation:
Want To Keep Your Rightful GIP Reimbursement? Don't Spare The Details
Tip: Remember to document that needs can’t be met at home. Significant reimburse... Read more
Fraud & Abuse:
560 HHAs, 4,500 Docs Land On OIG's Red Flag List
Medicare uses 5 data measures to identify providers for scrutiny. If you serve a lot o... Read more
Industry Note:
Another National Fraud Takedown Features Home Care Providers
CMS suspends Medicare payments in many cases. A nationwide sweep led by the Medicare F... Read more
Industry Note:
Revamp Of Nondiscrimination Notices Required By October, Final Rule Says
You’ll need a new notice of non-discrimination for your patients, based on a final... Read more
Industry Note:
Hospices Must Wait For Missing Service Intensity Add-On Payments
You’ll have to wait a while longer to get some Service Intensity Add-on payments y... Read more
Industry Note:
National Chain's Buy Increases Its Footprint In Arkansas
Kindred Healthcare Inc. has agreed to buy the home care operations of the Arkansas Depar... Read more
Industry Note:
Medicare Adds To Public Moratorium Data
You now can get more data about providers and beneficiaries in moratoria areas. The Cent... Read more
Reader Question:
Get Your Information Ducks In A Row For Pre-Claim Review Request Submission
Prepare to match pre-claim requests’ Unique Tracking Numbers with final claims. ... Read more
Reader Question:
Watch Your Mail For Letter Informing You Of Hospice Quality Reporting Status
If you didn’t comply with Hospice Item Set and/or CAHPS data submission requiremen... Read more
Pre-Claim Review:
Expect Serious Payment Delays Under Pre-Claim Review Demo
CMS ‘confident that you’ll be able to pull it together’ for demo, offi... Read more
Pre-Claim Review:
Access Problems Persist Under Review Demo
Eliminating prior authorization doesn’t eliminate access issues. Care problems r... Read more
Regulations:
CMS Releases More Pre-Claim Review Details In Latest Forum
CMS sticks to Aug. 1 start date. Home health agencies are still waiting on many of the... Read more
Compliance:
Unanswered Demo Questions Plague HHAs On Short Timeline
Will MAC be ready in 6 weeks? Home health agencies in the five demonstration states ha... Read more
Reimbursement:
Consider Yourself On 100% Prepay Review In Demo States
There is one big difference. What’s the difference between the new preclaim revi... Read more
Industry Note:
FBI Raids Texas Hospice
Raid part of ‘much broader investigation,’ according to local news . Anoth... Read more
Industry Note:
Orlando Mass Shooting Touches Home Care World
A home care worker was one of the 49 victims in the mass shooting in Orlando on June 12.... Read more
Industry Note:
MAC Readies HHA Claims Adjustments For Claims Glitch, It Warns
Watch out for adjustments to your home health agency claims, and they could go either wa... Read more
Industry Note:
Troubled HHA Sells For Potential $3 Million Out Of Bankruptcy
Alliance Home Health Care in Indianapolis will buy troubled Nightingale Home Healthcare ... 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... Read more
Industry Note:
HHAs, Hospital Systems Join Forces
Curbing readmissions is making joint ventures between home care providers and health sys... Read more
Industry Note:
Hospital Sheds Home Health Operation
On the other hand, shrinking margins have caused one hospital to shed its home care prog... Read more
Reader Question:
Use Electronic Submission For Quicker Pre-Claim Review Determinations
Multiple avenues for submission available. Question: How should we submit pre-claim re... Read more
Prior Authorization:
CMS Plunges Ahead With Prior Authorization Demonstration
First state hit with start date as early as Aug. 1. Despite vociferous protests across... Read more
Medical Review:
How The Prior Auth Demonstration Will Work
MACs will have 10 business days to issue a decision under demo. With CMS intimating it... Read more
Fraud & Abuse:
HHAs Continue To Get Slapped With Fraud Rep
Home health ‘ripe for corrective action,’ federal watch dog says. Scrutiny... Read more
Enforcement:
Hospice Industry Increasingly Profiled For Fraud
The OIG’s fraud hotline does sometimes produce results, case shows. Hospices sho... Read more
Referrals:
Help Your Nursing Home Partners Learn How To Handle Hospice Assessments
Did they miss an important MDS update on hospice? Help keep your nursing home referral... Read more
Referrals:
Facilities Shouldn't Treat Palliative Care Like Hospice
Help your nursing home partners lighten their SCSA burden. Give your skilled nursing f... Read more
Industry Note:
CMS Uses Your Own Data For Targeting
Watch for Medicare to continue Fraud Prevention System ramp-up. Know your data, so you... Read more
Industry Note:
Sequestration-Related Claims Glitch May Be Behind Your Recent Takebacks
If you’ve been wondering why you received a rash of takebacks recently, a sequestr... Read more
Industry Note:
Clock Is Running Out On Your Chance To Give Feedback On Hospice Proposed Rule
If hospices want to give the Centers for Medicare & Medicaid Services a piece of the... Read more
Industry Note:
HHAs' First IMPACT Act Measure On Pressure Ulcers May See Revisions
Not totally sold on the first IMPACT Act quality measure home health agencies must deal ... Read more
Industry Note:
Chain Expands Presence In 2 States With Acquisitions
LHC Group is purchasing Professional Healthcare Resources based in Annandale, Va., and E... Read more
Reimbursement:
Check Your Patients' HbA1c Test Dates In Light Of New LCD
Hemoglobin testing poised to torpedo serious amount of claims. A HHH Medicare Administ... Read more
Quality:
9 Tips To Bulletproof Your Diabetic Patients' Claims
Patients’ testing requirement will rely heavily on treatment goals. If you haven... Read more
Coverage:
Take Diabetes Care Planning A Step Further
Stable patients have care planning needs too. Anewly revised LCD from Palmetto GBA may... Read more
Quality:
Home Health Curbs Hospital Readmissions, Studies Show
Want lower hospital costs? Use home visits. While home health agencies are under everi... Read more
Human Resources:
7 Rules For Goal Setting Success
Aim high, but be specific about the smaller steps you’ll take to get there. If y... Read more
Industry Note:
MAC Tells Physicians To Hand Over Records For F2F
Medicare training falls short. A new educational article from National Government Serv... Read more
Industry Note:
DOL Offers OT Break To Medicaid Agencies
If you’re a Medicaid-funded home care agency, you’ll get a breather on the D... Read more
Industry Note:
Gauge Your ICD-10 Progress With This Free Tool
Not sure where you stand in terms of your ICD-10 progress at this point? The Centers for... Read more
Industry Note:
Hospice Doesn't Raise LTC Costs, Study Says
A new study boosts hospices’ efforts to show their benefit in the long-term care s... Read more
Industry Note:
Joint Venture Targets Hospital Readmission Prevention
BAYADA Home Health Care and Cape Regional Health System have entered into a joint ventur... Read more
Industry Note:
Murder Investigation Sparks Hospice Scrutiny
Beware family power struggles for hospice patients, or you may get stuck in the middle o... Read more
Industry Note:
Imminent Hospice Item Set Data Specs Released
Check out your new Hospice Item Set data specs, which the Centers for Medicare & Med... Read more
Enrollment:
Your Enrollment Burden To Get Significantly Heavier Under Proposed Rule
Reg can result in de facto exclusions. Get ready to lay out major time and money to co... Read more
Regulations:
Target Program Integrity Efforts For Enrollment
Providers won’t be the only ones affected. Newly proposed fraud-fighting provisi... Read more
Compliance:
Lookback Period One Of Enrollment Reg's Biggest Flaws
Rule needs a host of changes to be workable, commenters insisted. A new proposed rule ... Read more
Fraud & Abuse:
Enrollment Rule Contains Good News On Moratoria
CMS wants to correct devastating provision. It may be too late for some providers, but... Read more
Enrollment:
Stay Alert For Revalidation Date
Fail to reenroll and you won’t be able to bill. The feds are happy that their ne... Read more
Industry Note:
New Overtime Rule Could Affect Your Agency
DOL more than doubles OT salary threshold. The overtime hits just keep coming to home ... Read more
Industry Note:
GAO Wants Prepay Review From RACs
You’ll face more prepayment medical review if the Government Accountability Office... Read more
Industry Note:
Vaccination Billing To Ease For Hospices
Medicare is removing one billing hassle for hospices this fall. Old way: Currently, ho... Read more
Industry Note:
Review PPS Basics With Free Updated Tool
If you’re looking for a brief educational tool on the Home Health Prospective Paym... Read more
Industry Note:
New Fire Safety Requirements Hit Hospices This Summer
Check Medicare’s latest fire safety requirements to see whether your hospice inpat... Read more
Industry Note:
Investment Firm Makes $65 Million Home Care Buy
Private investment firm Blue Wolf Capital will acquire National Home Health Care Corp. f... Read more
Industry Note:
Paper Records Still Pose HIPAA Threat, Breach Shows
Don’t focus all your HIPAA compliance efforts on electronic PHI. In a HIPAAbreach ... Read more
Prior Authorization:
Get Home Health Prior Auth Clues From DME Experience
Expansion of the program is likely to be quick. Home health agencies are hoping that M... Read more
Quality:
5-Star HHA Number Drops Dramatically In HH Compare Update
CAHPS methodology leads to big fluctuation in 5-star ratio. If you haven’t check... Read more
Regulations:
Keep An Eye On How IMPACT Act Will Impact You
Plus: Check your OASIS submission stats before they cost you. Medicare is picking up s... Read more
Hospice:
Payment Reform Billing Problems Plague Hospices
Plus: HIS changes may give rise to hospice case mix system. Under hospice payment refo... Read more
Strategy:
Follow 5 Tips To Navigate The Tougher Hospice Environment
Medicare data monitoring kicks into high gear. The feds have gotten serious about trac... Read more
Industry Note:
University Health System Settles Home Care Fraud Charges
DOJ outlines atypical settlement. Whistleblower lawsuits aren’t threats to only ... Read more
Industry Note:
New DOL Guidance Gives Compliance Assist
If you’re trying to figure out when sleep counts — and when it doesn’t... Read more
Industry Note:
Beware New Clerical Error Correction Process
Don’t try to use the clerical error reopening form if Palmetto GBA is your HHH Med... Read more
Industry Note:
Missing Diagnosis On NOE Will Result In Return
Starting this fall, a hospice Notice of Election missing a principal diagnosis will get ... Read more
Industry Note:
Mergers & Acquisitions Stats Trend Upward
The home care mergers and acquisitions market is picking up, according to an analysis of... Read more
Industry Note:
Ensign Group Makes Hospice Buy In Iowa
The Ensign Group Inc.’s home health and hospice portfolio subsidiary, Cornerstone ... Read more
Industry Note:
Hospice Provider Expands Post-Acute Presence
Pensacola, Fla.-based post-acute company Covenant Care has acquired Medicare-certified h... Read more
Industry Note:
Physicians Convicted For Sham Hospice Certs, Kickbacks
Following a two-week trial in federal court, a jury convicted two California physicians ... Read more
Industry Note:
Don't Flub Your Address Requirements On 855
Don’t get your address requirements on the Medicare enrollment form mixed up &mdas... Read more
Value-Based Purchasing:
Home Health VBP Participation Inches Up
Florida leads the way on lagging HHAs. The red tape that comes along with the Home Hea... Read more
Compliance:
Pay Attention To Medicare's Hospice Fraud Concerns Before It's Too Late
Warning: Your own data will land you under reviewers’ microscope. Medicare&rsquo... Read more
Hospice:
Proposed Rule Outlines Red Flags In Hospice
The number of data elements CMS tracks continues to grow. Check out the areas that the... Read more
Know Your Facts:
Downward-Trending Hospice Stats Won't Stop Scrutiny
Neuro patients’ LOS is 150 percent longer than cancer patients, rule points out. ... Read more
Reimbursement:
60-Day Rule Can Turn Your Innocent Overpayments Sinister
Use 3 key strategies now to avoid big problems. Serious consequences for not returning... Read more
Compliance:
Understand The Meaning Of 'Identification' For 60-Day Rule
You have some breathing room on start date, according to final rule. One of the most c... Read more
Industry Note:
NPP F2F Does Not Require Physician Signature
Lighten your face-to-face load where you can. The face-to-face physician encounter req... Read more
Industry Note:
Gauge HIS Submission Status With New QAO Report
Check your new quarterly Quality Assessment Only (QAO) Interim Report in your CASPER fol... Read more
Industry Note:
DME Bid Winners That Will Serve Your Patients Announced
If you’re in a Round 2 Competitive Bidding area for durable medical equipment, you... Read more
Industry Note:
Home Care Company May Command $1 Billion Price
Private-equity firm Webster Capital is exploring the sale of pediatric-focused home care... Read more
Industry Note:
Detroit-Area HHA Buys Hospice
Royal Oak, Mich.-based Custom Home Health Inc. has acquired Troy-based Advanced Professi... Read more
Industry Note:
Don't Miss Survey About Your Medicare Contractor's Service
You will have opportunity to give CMS your two cents about how your HHH Medicare Adminis... Read more
Hospice:
Medicare Proposes 2% Pay Increase For Hospices
Cap year switch to take place in 2017. MedPAC may be agitating for a hospice rate free... Read more
Quality:
Prepare For 2 New Hospice Quality Measures Next Year
Proposed measure focuses on visits in last days of life. If this year’s watchwor... Read more
Quality:
7 Quality Measures To Comprise New Composite
A few more tweaks planned for HIS tool. Hospices have been submitting data for these s... Read more
Referrals:
Polish Your Processes In Prep For Publicly Reported Ratings
Hospice Compare, 5-star ratings on deck in new proposed rule. You’ve had a lot o... Read more
Assessment:
Assessment Tool For Hospice Looms
Will hospices get their own OASIS? If you’ve been wondering if and when HIS woul... Read more
Industry Note:
End In Sight For F2F Probe & Educate Reviews?
Plus: If it hasn’t yet, your turn will come. If you’re not passing the Pro... Read more
Industry Note:
Corrected Claims Glitch Could Cause Takebacks
Your claims that must be recoded to or from a high-therapy HIPPS code should now be payi... Read more
Industry Note:
Non-Profits Merge Under Reimbursement Pressures
Industry consolidation continues as reimbursement pressures squeeze home care and hospic... Read more
Industry Note:
Home Health Start-Up Aims High
A San Franciso-based home health start up has national aspirations. Jet Health disclosed... Read more
Industry Note:
Senators Speak Out Against Prior Authorization
The comment period on CMS’s home health prior authorization demonstration may be o... Read more
Industry Note:
Doc Draws 9-Year Sentence For Home Care Fraud
After pleading guilty in February to receiving kickbacks in exchange for writing bogus h... Read more
Industry Note:
Are You Using This HIPAA Safeguard Process?
If you’re not using two-factor authentication to safeguard your agency’s PHI... Read more
Regulations:
Probable Fraud Pilot Duplicates Oversight, Wastes Effort
Beware extrapolation repercussions of pilot up for renewal. A recent Federal Register ... Read more
Enforcement:
Case That Gave Rise To 78 HHA Payment Suspensions Wraps Up
Six-week trial produces three HHA owner convictions. The federal prosecution of the la... Read more
Fraud & Abuse:
Kickbacks Feature In Latest Round Of Fraud Cases
Fraud Strike Forces turn up the HEAT. The Dallas trial of the largest Medicare home he... Read more
Hospice:
Hospice Fraud Case Stokes Public's Fear Of End Of Life Service
Hospice owner ordered overdoses to manage cap, FBI alleges. The FBI investigation of a... Read more
Regulations:
New Revalidation Requirements May Threaten Your Cash Flow
Look up your application due date on CMS website. Don’t miss your Medicare reval... Read more
Industry Note:
Get Ready For Pressure Ulcer Ravamp
Say goodbye to term ‘ulcer,’ for one. It will soon be time for your clinic... Read more
Industry Note:
Invite Docs To Probe & Educate F2F Call, MAC Encourages
Don’t miss out on your chance for education straight from the horse’s mouth ... Read more
Industry Note:
ICD-10 Update Includes Home Care Impact
Set aside some time later this year for ICD-10 update training. The five-year freeze cod... Read more
Industry Note:
CMS Extends BPCI Alternative Payment Model
The more than 100 home health agencies participating in Medicare’s Bundled Payment... Read more
Industry Note:
New Physician APM Targets Chronic Conditions, Outcomes
A large new Medicare alternative payment model for physicians may help your patients. Un... Read more
Industry Note:
CMS Offers New Data Tool Based On Demographics
You probably know if your patient population is at risk for relatively low outcomes base... Read more
Industry Note:
Medicaid HHA Owner Draws Prison Time
After pleading guilty to Medicaid fraud last October, the CEO of a Charlottesville, Va. ... Read more
Regulations:
Hundreds Of Commenters Slam Prior Authorization Demo
‘Scary,’ ‘appalled’ and ‘ridiculous’ are just a few ... Read more
Quality:
Hospital Readmissions Will Soar Under Prior Authorization Demo
SNF and rehab facility use would go up too. Medicare says reducing rehospitalizations ... Read more
Fraud & Abuse:
Prior Auth Not A Good Fraud-Fighting Tool, Commenters Insist
If Medicare wants to adopt stiffer fraud-fighting activities, it should at least choose ... Read more
Hospice:
Alternative Payment Model Push To Affect Hospices Too
Managed care may be in hospices’ future. As Medicare talks about ramping up hosp... Read more
Reimbursement:
Hospices Look For NOE Filing Solution
Electronic submission a must, industry rep tells top CMS official. Your NOE deadline h... Read more
OASIS:
OASIS-C2 Paves Way For VBP
Stay tuned for final form. If you reviewed the new OASIS-C2 form when Medicare issued ... Read more
Industry Note:
Educate Referring Docs On New ACP Billing Clarifications
CMS issues Care Planning billing FAQ. Physicians who refer patients to your hospice ca... Read more
Industry Note:
OASIS Denials, Surety Bonds Stressed In OIG Report
As budget negotiations start to kick into gear for 2017, the HHS Office of Inspector Gen... Read more
Industry Note:
OIG Targets Hospice Patients In ALFs, Nursing Homes
The HHS Office of Inspector General would like to see some reimbursement-lowering mechan... Read more
Industry Note:
Newest Hospice PEPPER Reports Available
You can take a look at the latest set of benchmarks in your hospice PEPPER report for th... Read more
Industry Note:
Companionship Exemption Case Stalls At Supreme Court
The vacancy on the U.S. Supreme Court is not good news for home care providers. The nint... Read more
Industry Note:
CMS Shirks Fraud-Fighting Duties, Providers Gripe
Medicare needs to do more to boot fraudsters out of the system, attendees of the Nationa... Read more
Payment:
CMS Pushes Alternative Payment Methodologies
‘Regular’ Medicare becoming a thing of the past. If Medicare wants to redu... Read more
Face-To-Face:
F2F Documentation Requirements 'A Problem,' CMS Official Admits
You’ll have to look to lawmakers for relief. Conference attendees gave CMS an ea... Read more
Regulations:
HHAs Start To Feel CJR Impact As Referrals Are Threatened
Hospital-imposed visit number limits bedevil agencies. If you haven’t taken step... Read more
Regulations:
Prior Authorization Will Cause Major Damage, HHAs Warn
Increased bureaucracy will have no benefit, but major detriments. Home care providers ... Read more
OASIS:
OASIS-C2 1 Step Closer To Implementation
3 new items on deck. Now that OASIS-C2 is less than eight months away from its start d... Read more
Hospice:
OIG Shoots Down One-Third Of GIP Claims Reviewed
Watch out: Hospice-specific RAC in the works. Expect increased scrutiny of General Inp... Read more
Lawsuits:
AseraCare Lawsuit Dismissal Gives Hope For Fighting Whistleblower Cases
Different medical opinions not enough to carry False Claims case, judge says. Whistleb... Read more
Industry Note:
Beware This LUPA Billing Glitch
Hospice pay reform change causes HHA underpayments. A newly reported billing error rel... Read more
Industry Note:
Medicare Administrative Contractor To Address F2F Probe & Educate In Call
If you’re as confused about Face-To-Face requirements as many HHAs, you can find o... Read more
Industry Note:
Health System Sheds Hospice Program, Closes Historic Inpatient Unit
Hospice Care of the Southwest and BSA Hospice in Amarillo, Texas, are merging to form BS... Read more
Industry Note:
Chain Enters Arizona Joint Venture With Hospital
LHC Group and Northern Arizona Healthcare have entered a joint venture agreement, the La... Read more
Payment:
Falling Payment, Utilization, And Margins Not Enough, MedPAC Insists
MedPAC profit margin claims based on faulty cost reporting system, audits, experts charg... Read more
Reimbursement:
Not Just Cuts: MedPAC Also Pushes Copays, Surety Bonds
Say goodbye to therapy money under latest recommendations. If Congress listens to the ... Read more
Hospice:
Non-Cancer Diagnoses Catch MedPAC's Eye
Commission officially recommends 2017 rate freeze to Congress. Flat spending and a dec... Read more
Finance:
Publicly Traded Companies Gear Up For VBP
Plus: Chains stress their acquisition focus. Industry consolidation is the name of the... Read more
HIPAA:
Don't Become A HIPAA Hostage
Should you pay a ransom to get your PHI back? Jaws dropped in the healthcare industry ... Read more
Compliance:
Take These 7 Steps To Fend Off PHI Hackers
How often are you training your staff on HIPAA? A recent case where a hospital paid ha... 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... Read more
Industry Note:
Learn About Your Free Hospice Benchmarks
Newest version of PEPPER report should arrive in a few weeks. Find out more about the ... Read more
Industry Note:
CMS Beating The Clock On Payment Shift
When the Centers for Medicare & Medicaid Services announced last year that it intend... Read more
Industry Note:
Accrediting Body Launches New Palliative Care Certification
Home care or other health care providers that furnish palliative care in the home, but t... Read more
Industry Note:
Hospital Shuts Down Home Health Division
Another hospital is closing its home care division under tight margins. Columbia Memoria... Read more
Industry Note:
Compassus Buy Extends Service Area To 30 States
Genesis HealthCare plans to sell the majority of its home health and hospice operations ... Read more
Industry Note:
Texas-Based Company Makes Dallas Acquisition
Post-acute healthcare company Life-Care Holdings plans to acquire Haven Home Health for ... Read more
Industry Note:
State, County Shed Home Health Programs
Government-run HHAs continue to become more scarce. Example: Six parties have submitte... Read more
Industry Note:
Florida-Based Hospice Provider Files Bankruptcy To Sell
One hospice chain is facing the painful legacy of a whistleblower lawsuit. Jacksonville,... Read more
Medical Review:
Large Portion Of P&E Denials Due To ADR Non-Response
Do agencies think F2F review is hopeless? The ongoing Probe & Educate medical revi... Read more
Reimbursement:
Beat Non-Response Denials With These 8 Tips
Biller-clinician cooperation is key to success. Don’t let failure to respond to ... Read more
Value-Based Purchasing:
HHAs Bear Brunt Of VBP Information Dissemination
Only one-third of VBP agencies have signed up for data reporting website. Add one more... Read more
Regulations:
Assess Your OASIS Compliance Before It Cuts Your Pay Rates
Plus: Here’s why you’ve been waiting so long on the free Pricer software. ... Read more
Reimbursement:
More Payment Errors Mar Hospice Reform
The timing of one fix will withhold some SIA payments until this summer. Medicare has ... Read more
Hospice:
CMS Clears Up Confusion About Post-Mortem Hospice Visits
Plus: Sequestration is not going anywhere. Your CAHPS and HIS reporting stats are abou... Read more
Industry Note:
Alleged Fraudster Jacques Roy Finally Stands Trial
HHA owners to testify in high-profile home care fraud trial in Texas. Brace for the ho... Read more
Industry Note:
Wait A While Longer For E0149 Glitch Resolution
If you thought the E0419 billing glitch was resolved, think again. Then: Last month, H... Read more
Industry Note:
Give CMS Your 2 Cents On Home Health Prior Auth Demo
Does requiring prior authorization for Medicare home care services seem like a bad idea?... Read more
Industry Note:
Deadline For Hospice Cap Reporting Is Almost Here
Don’t miss the March 31 deadline to calculate and self-report your hospice aggrega... Read more
Industry Note:
HHA Owner Pays $1.75M To Settle Fraud Charges
Sham medical directorships are at the heart of a $1.75 million fraud settlement in Flori... Read more
Industry Note:
Learn More About The IMPACT Act From CMS
The IMPACT Act is is already affecting your data collection and quality reporting, and w... Read more
Medical Review:
MACs Deny 92% Of Claims Under F2F Probe $ Educate
One MAC’s rate is a staggering 97 percent. Your reimbursement may be doomed unde... Read more
Regulations:
Make Sure Your Doc's F2F Note Hits These 5 Elements
Know what you can help with, and what you can’t. Under the new face-to-face docu... Read more
Face-To-Face:
Unfair F2F Requirement Tortures HHAs
HHAs can’t control physicians’ documentation. Home health agencies face a ... Read more
Face-To-Face:
Don't Hold Your Breath For F2F Changes
F2F poised to run HHAs out of business. If you think absurdly high denial rates for th... Read more
Compliance:
Use These 12 Pointers To Increase Your F2F Chances
Warning: Just receiving the physician’s documentation isn’t enough. If you... Read more
Education:
Bone Up On F2F With These Resources
Confusion abounds about the face-to-face physician encounter for home health patients. U... Read more
Industry Note:
New PEPPER Reports Zero In On Discharges, GIP
Diagnosis coding and CHC also highlighted. You may be putting yourself on reviewers&rs... Read more
Industry Note:
CMS Finalizes Face-To-Face Rule For Medicaid
Get ready for Medicaid’s face-to-face physician encounter requirement to hit this ... Read more
Industry Note:
Disregard Contract Staff When Reporting This VBP Measure
HHAs in the nine Value-Based Purchasing states are getting a small break on new measures... Read more
Industry Note:
Chain Makes Hospice Buy
National home care chain LHC Group has acquired the assets of Heartlite Hospice, a subsi... Read more
Industry Note:
CDC Issues Guidance On Home Health, Hospice Emergency Planning
Want a boost to your emergency planning? You can consult a new resource from the Centers... Read more
Industry Note:
MAC Lends Helping Hand For Hospice Overlap Disputes
If patient overlap disputes with other hospices, hospitals or SNFs are plaguing your hos... Read more
Enforcement:
Medicare Flexes Fraud-Fighting Muscle
New tools to detect and curb fraud on deck. What your patients have to say about your ... Read more
Enrollment:
Medicare To Toughen Up Enrollment Procedures
Ramifications from Dr. Jacques Roy case seen in proposed rule. The home care and hospi... Read more
Face-To-Face:
Probe & Educate Review Racks Up Shocking Denial Levels
Compliance is out of HHAs’ hands, industry leader insists. With all the difficul... Read more
Fraud & Abuse:
HHA Holds Off Medicare Termination With Bankruptcy Court Ruling -- For Now
Plus: Agency owners aren’t the only convicts in Medicare fraud cases. One of Ind... Read more
Strategy:
Ambulance Companies Make Forays Into Home Care
How will new trend affect traditional home health agencies, hospices? Are home health ... Read more
Industry Note:
Joint Replacement Bundling May Boost Home Care Spending
New study shows BCPI bundling increases home health spending. The forthcoming Comprehe... Read more
Industry Note:
Star Ratings Can Vary Widely For Clinical Versus Patient Satisfaction Measures
If you are confused about your star ratings, you aren’t alone. Patients are also u... Read more
Industry Note:
Don't Let Sequester Confusion Lull You Into False Sense Of Hospice Cap Security
Don’t breathe a final sigh of relief if you don’t owe an overpayment when yo... Read more
Industry Note:
Some Claims Suspensions Are OK, MAC Says
Don’t get worried if you see a suspended claim in FISS, HHH Medicare Administrativ... Read more
Industry Note:
Medicare Denies 800 HHA And Ambulance Enrollments In Last 4 Years
The Centers for Medicare & Medicaid Services touts home health “savings”... Read more
Industry Note:
Study Warns Of Setting Transitions For Hospice Patients
Add one more indicator to your hospice quality list. Care transitions after hospice admi... Read more
Payment:
Use These 10 Tips To Prepare For Hospital-PAC Bundling
Joint replacement demo will limit post-acute care networks, experts warn. The new Comp... Read more
Compliance:
Physician Staff Can Make Post-Discharge Visits To Non-Homebound Patients Under CJR, But HHAs Can't
Home care expertise goes to waste in final joint replacement bundling methodology. The... Read more
Regulations:
Joint Replacement Spending Leads To Its Guinea Pig Status
HHAs won’t always be the right fit for CJR patients. Why is Medicare focusing it... Read more
HIPAA:
Are You Ready For 2016's HIPAA Audits?
Add HIPAA readiness to your to-do list. As expected, HIPAA audits will continue this y... Read more
Industry Note:
Access The Same Fraud- Identifying Data CMS Uses
Your location could land you in the hot seat. Want to know if you may be next on the l... Read more
Industry Note:
Just 2 Out Of 5 Dinged Claims Send You To Repeat Face-To-Face Medical Review
Don’t jump the gun in requesting one-onone education based on your face-to-face-fo... Read more
Human Resources:
Use 2 Quick Pointers To Boost Employee Morale
Don’t forget the importance of praise. Looking for a low-cost way to motivate yo... Read more
Industry Note:
Routine Home Care Overpayments Dog New Hospice Reimbursement
Hospice payment reform has given rise to another payment glitch — and this one cou... Read more
Industry Note:
Speak Your Mind About Quality Of Care Star Ratings
You may still be getting used to the Quality of Patient Care Star Ratings that Home Heal... Read more
Industry Note:
Appeal Hospice Cap Inclusion Of Sequestration, Lawyer Urges
You’ve got about a month left to calculate and report your hospice cap and any rel... 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... Read more
Industry Note:
Billing Glitch Resolved
A stubborn billing glitch is finally resolved. Medicare contractors tried multiple times... Read more
Industry Note:
Hospice Owner Pleads Guilty To GIP-Related Fraud
The founder of now-shuttered Passages Hospice in Lisle, Ill., had pleaded guilty to Medi... Read more
Industry Note:
HHA-Based Hospice Cost Report Changes Released
Big hospice changes are now finalized for home health agency-based cost reports. CMS has... Read more
Payment:
Joint Replacement Bundling Demo Set To Change Home Health Landscape
Quality, costs will matter more than ever. If you think you can shrug off Medicare&rsq... Read more
Know Your Facts:
Educate Yourself On Joint Replacement Bundling Demo
Take note: Hospice services are included. Get to know the new hospital payment model t... Read more
Regulations:
HHAs Disappointed In CJR Final Rule
VBP agencies are still included. While the Comprehensive Care for Joint Replacement (C... Read more
Hospice:
CMS: Joint Replacements Related To Hospice Services
What’s related and what’s not? Over provider protest, the Centers for Medi... Read more
Hospice:
Hospice Access Threatened
The Comprehensive Care for Joint Replacement (CJR) model gives rise to another concern a... Read more
Compliance:
Home Care Providers Find Relief In 60-Day Overpayment Rule
Caps and outliers won’t trip you up. Cap- and PIP-related concerns for home heal... Read more
Reimbursement:
CMS Specifies Overpayment Identification For 60-Day Rule
Plus: Lookback period loosens up. While it’s tempting to regard the new 60- day... Read more
Industry Note:
Learn This New Code For Billing Without Skilled Visits
CMS aims to minimize review. Usually home health episodes must contain a skilled visit... Read more
Industry Note:
CMS Wants Experts For Improving Medicare Post-Acute Care Transformation (IMPACT) Act Panel
If you’d like to have a say in how Medicare implements the Improving Medicare Post... Read more
Reimbursement:
CMS Proposes 5-State Prior Authorization Demonstration For Home Health
Don’t be surprised to see the program expand quickly. Expect to wait weeks for M... Read more
Fraud & Abuse:
CMS Should Use More Effective Fraud Prevention, Critics Say
Prior auth won’t slow down home care fraudsters, experts contend. The whole reas... Read more
Budget:
HHA Pay Cuts, Copays Feature In President's 2017 Budget
Are bundling, nationwide VBP inevitable? You may be just getting used to payment chang... Read more
Hospice:
Obama Budget Proposal Calls For Hospice Cuts
Hospice-specific market basket needed, according to proposal. In an unwelcome switch f... Read more
Budget:
Keep An Eye On These Proposed Budget Items
Appeals changes in the works. Not all of the provisions in the Obama administration&rs... Read more
Industry Note:
Skilled Visits Vary At End Of Hospice, JAMA Study Says
Industry takes another popular press beating. Day of the week, service setting, locati... Read more
Industry Note:
Massachusetts Investigates Its Medicaid Program HHAs
An 82 percent increase in Medicaid home health spending over two years has caused one st... Read more
HIPAA:
OCR Stresses Home Health Compliance In Lincare HIPAA Breach Case
Oxygen provider pays 6-figure HIPAA Civil Money Penalty. If you thumb your nose at HIP... Read more
Industry Note:
Kindred Acquires Florida, South Carolina Providers
Kindred Healthcare Inc. is expending its home care and hospice presence after buying Gen... Read more
Industry Note:
Dallas-Based Regional Chain Makes Texas Buy
Regional chain Jordan Health Services has acquired Cooper Home Health in Cooper, Texas, ... Read more
Industry Note:
California Health System Makes Investment In Private Duty Home Care
A California health system is getting into the private duty home care business. Irvine, ... Read more
Industry Note:
Warning: HIPAA Requirements Don't Expire When The Patient Does
Don’t fall into HIPAA non-compliance due to a common myth. If a patient passes awa... Read more
Quality:
HHAs Fare Better Under Newest Star Rating Category
Be aware that your star rating may easily change next time. Many more home health agen... Read more
Data:
These 5 Measures May Make Or Break Your Marketing Efforts
18 HHCAHPS questions determine your star rating. To some potential patients, patient s... Read more
Data:
Keep Up With These 9 Quality Measures
Review the measures contributing to the other star rating. New Patient Survey measures... Read more
Value-Based Purchasing:
CMS Keeps HH VBP Cards Close To The Vest
A month in, VBP questions abound. If you’re a home health agency in one of the n... 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... Read more
Hospice:
QIES Blackout Leaves Hospices Worried About Compliance
Double-check your HIS submissions. Plan ahead to avoid missing your 30-day Hospice Ite... Read more
HIPAA:
Keep Yourself In Compliance When Adopting New Technology
Don’t neglect a risk analysis. If you allow employees to use web-based document ... Read more
HIPAA:
Train Your Staff & Know What They're Doing
Would you pass the test of interviewing 15 randomly selected staffers on HIPAA? In its... Read more
Industry Note:
F2F Pressures Mount On HHAs
CMS finalizes Medicaid F2F rule. If you got passed over in MAC’s initial face-to... Read more
Industry Note:
Hospices See SIA Pay Errors Related To CHC
Major payment system changes rarely take effect smoothly, and hospice payment reform is ... Read more
Industry Note:
G-Code-Related Claims Glitch Continues
You can identify the claims delayed by a G-code related claims glitch by spotting two re... Read more
Industry Note:
Hospital Sheds HHA In Face Of 'Significant' Losses
Mt. Graham Regional Medical Center in Safford, Ariz., is shuttering its home health agen... Read more
Industry Note:
Home Care M&A Picks Up The Pace
Mergers & acquisitions activity in the home care market has picked up after a declin... Read more
Industry Note:
CMS Extends HHA Moratoria In Fraud Hot Spots
It’s no surprise that the Centers for Medicare & Medicaid Services is once aga... Read more
Hospice:
MedPAC Finalizes Rate Freeze Recommendation For Hospice
Advisory body to Congress casts suspicion on for-profits, nursing homes. As legislator... Read more
Know Your Facts:
Hospice Live Discharge Rates Decreased In 2014
Profit margins are also down, but that didn’t stop MedPAC from recommending a rate... Read more
Hospice:
MedPAC Plans Increased Scrutiny Of Nursing Home Patients Receiving Hospice
Advisory body to Congress will circle back to this hot-button issue later this year. T... Read more
Fraud & Abuse:
4 Home Care Fraud Cases Feature Physician Involvement
Texas HHA exec receives 10-year sentence. Physicians furnishing a large volume of home... Read more
Labor Law:
Does Your Employee Confidentiality Policy Violate The NLRA?
Lesson: Consider HIPAA and NLRA when structuring policies. Even if your employee&rsquo... Read more
Labor Law:
Tailor Your HIPAA Policies To NLRA Compliance
As shown by a recent Administrative Law Judge decision, health care providers need to ma... Read more
Industry Note:
Ready, Set, Go For 2015 Hospice Cap Reporting
Don’t leave it until the last minute. You should run the necessary reports to ca... Read more
Industry Note:
Take A Break From HIS, OASIS Data Reporting During QIES Blackout
Make plans now to avoid data reporting penalties caused by a QIES shut-out in March. &... Read more
Industry Note:
Hospice, Home Care Providers Go Above And Beyond During Snowzilla
Extreme weather events like the blizzard that socked the East and Mid-Atlantic Coast pre... Read more
Industry Note:
Counties Close Their HHAs, Hospices
Shrinking margins are leading to more home care closures. Example #1: Logan County, Oh... Read more
Industry Note:
Federal Jury Finds Miami HHA Owner/Manager Guilty Of Medicare Fraud
The man who managed Willsand Home Health Agency Inc. and owned JEM Home Health Care and ... Read more
Budget:
MedPAC Finalizes Recommendation For No HHA Pay Increase Next Year
Drop in home health spending shouldn’t deter rate cut, advisory body says. You m... Read more
Know Your Facts:
Home Health Stats Drop In Most Categories In 2014
But MedPAC still recommends no pay increase next year. Take a look at the statistics t... Read more
Budget:
What Is Marginal Profit?
Get to know the new term that’s helping policymakers decide your fate. “Ma... Read more
Budget:
MedPAC Wants Therapy Out Of PPS Equation
Commission won’t let copay issue drop. In addition to a rate freeze, the Medicar... Read more
Hospice:
Hospice Pay Reform In Full Swing
Watch your hospice claims carefully this month. You may just be getting used to the ne... Read more
Managed Care:
MCO Drops HHAs After Decades Of Service
Pittsburgh-based managed care organization Highmark recently cut eight home health agenc... Read more
Durable Medical Equipment:
Prior Authorization For DME Raises Concerns
Lower limb prosthetics could suffer unfair targeting by new regulation. Obtaining cert... Read more
Durable Medical Equipment:
Beware 3 Flaws In DMEPOS Prior Authorization Rule
Watch out: A PA green light doesn’t guarantee claim payment. DME suppliers and t... Read more
Reimbursement:
HHA Claims Face Returns Due To New Nursing G-Codes
Plus: CBSA issues kick out claims. A New Year often means a new batch of claims headac... Read more
Industry Note:
ACOs Are On The Rise
You can’t ignore this trend. The Centers for Medicare & Medicaid Services be... Read more
Industry Note:
Use YouTube For IMPACT Act Education
Learn more about the law that is already affecting your OASIS and quality programs with ... Read more
Industry Note:
Don't Forget Application Fee For Revalidations
The Medicare enrollment application fee for providers has gone up a mere $1 to $554 as o... Read more
Face-To-Face:
CMS Issues Revised F2F Form As Confusion Reigns
MAC calls out agencies for not including physician records in ADR responses. Medicare ... Read more
Compliance:
New F2F Form Makes Slight Improvements
Agencies can fight off denials by using form in an unexpected way. Check out the newes... Read more
Medical Review:
Hold Off On Responding To F2F ADRs Under P&E
Add another wrinkle to the already confusing Probe & Educate mandate. The burden o... Read more
Hospice:
Hospice Claims Under Fire For Terminal Prognosis
Warning: Dementia patients at high risk. Hospice claims are subject to more scrutiny e... Read more
Medical Review:
Document Decline With These 5 Steps
How often are you taking measurements? You can bulletproof your hospice patients&rsquo... Read more
Hospice:
Consider These Measurement Tools To Bolster Data
Stock your toolbox to protect your claims. Your longer-stay patients’ records wi... Read more
Industry Note:
CMS Unveils HIS Submission Calculation
A chunk of your pay rides on it. If you’re not sure what counts — and what... Read more
Industry Note:
Pass On Newly Clarified Rules For Advance Care Planning Codes To Your Referring Physicians
You can help your referring physicians figure out how to obtain additional reimbursement... Read more
Industry Note:
Tune In To Forthcoming CMS Call On IMPACT Act
The IMPACT Act is already changing OASIS with the proposal of OASIS-C2 for January 2017.... Read more
Industry Note:
Publicly Traded Chain Diversifies With Big Non-Medicare Buy
Chain Almost Family Inc. has acquired Natick, Mass.-based Long Term Solutions Inc., a la... Read more
Industry Note:
Company That Bought Gentiva Settles Therapy Fraud Charges For 6 Figures
One of the nation’s largest home health services providers has settled therapy-rel... Read more
Industry Note:
Medicare Adds Future Hospice G-Codes
You may just be getting used to the new G-codes for nursing services, but other new hosp... Read more
OASIS:
OASIS-C2 Will Contain Weight Opt Out
Plan your training schedule for 2016. Home health agencies who want to prepare for the... Read more
Value-Based Purchasing:
First VBP Q&A Contains Some Surprises
Participants get timeline for benchmarks. Home health agencies anxious to figure out h... Read more
Value-Based Purchasing:
Early Birds Must Hold Off On VBP
No quarterly performance reports for non-VBP agencies. Home health agencies in the nin... Read more
Utilization:
CMS Home Health Data Spotlights Highest Users
Bulletproof your 1CGK claims. Wondering where Medicare is going to put its resources f... Read more
Fraud & Abuse:
Home Care Fraud Enforcement Heats Up
HHA owner receives 6-year sentence, must repay millions. While you were busy wrapping ... Read more
Hospice:
ZPIC Probe Leads To 7-Figure False Claims Settlement
Plus: Hospice physicians indicted in California scheme. If you think the worst you&rsq... Read more
Human Resources:
Make Your Meetings Matter
Lead a meeting like a pro. Whether you’ve been supervising for years or are new ... Read more
Industry Note:
Review Your Star Rating Before It's Too Late
Check your CASPER folder. You’ve only got a few weeks to put the kibosh on your ... Read more
Industry Note:
Why You Should Prioritize Claim Adjustments For Hospice Drugs
If hospices fail to submit claims adjustments that don’t affect their reimbursemen... Read more
Industry Note:
Watch For Therapy-Related Recoupments In Coming Weeks
Watch for potential recoupments related to a therapy downcoding problem coming soon. P... Read more
Industry Note:
MAC To Reverse ZPIC Denials Made In Error
A ZPIC edit has led to erroneous denials, but HHH MAC Palmetto GBA will fix them with ma... Read more
Industry Note:
New Face-To-Face Code Solves Hospice Billing Problems
A new face-to-face-related billing code could ease your hospice billing headaches when t... Read more
HIPAA:
Consider Remote Disabling, Wiping As HIPAA Compliance Tools
Learn the differences. Question: Clinicians in our organization often use mobile devic... Read more
OASIS:
CMS Issues OASIS-C2 For January 2017 Implementation
Start your preparation now for the revamped assessment tool, expert urges. Home health... Read more
Assessment:
Check Out 3 New Items Coming In OASIS-C2
Promised opt-out for weight doesn’t appear in new form. Just as you’re set... Read more
Education:
CMS Tweaks Lookback Period, Formatting In OASIS-C2
Many items renumbered. In its new OASIS-C2 tool released Dec. 22, the Centers for Medi... Read more
OASIS:
Medication, Wound Items See OASIS-C2 Changes
Put ‘worsening’ on top of your training list. If you’ve been focusin... Read more
Medical Review:
Improper Pay Rate Spikes To Staggering 59% For HHAs
HHS insists F2F changes will help. Historically high profit margins aren’t the o... Read more
HIPAA:
OIG Calls For More HIPAA Enforcement
Watch for agency to get more aggressive, experts caution. As if you didn’t have ... Read more
Human Resources:
Pay Attention To Your Micromessages
Eliminate your unconscious negativity with these dos and don’ts. You could be de... Read more
Industry Note:
MedPAC To Call For Another HHA Pay Cut In 2017
Influential advisory body to Congress also calls for more rebasing. Soon, MedPAC won&r... Read more
Industry Note:
Your HIPAA P&P Could Avert A Costly Facebook-Sparked Payout
Will you be on the hook if one of your employees posts PHI on Facebook? It depends on yo... Read more
Industry Note:
Prior Authorization Procedure Finalized For DME
CMS has finalized a rule requiring prior authorizations for certain durable medical equi... Read more
Industry Note:
OIG Calls For Medicare Contractors To Get Tougher On Hospice Fraud
The HHS Office of Inspector General is keeping hospice fraud on its radar. “In t... Read more
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