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Home Health & Hospice Week

Reimbursement:
Don’t Let Diagnosis Hold Up RAPs In New Year
Prepare for dummy HIPPS and diagnosis codes — and different procedures for each. Starti... Read more
Compliance:
Can You Require Your Staff To Get The COVID Vaccine?
Tip: Prepare for legal questions from both staff and patients. Home health and hospice ... Read more
Hospice:
New Visits In Last Days Of Life Measure Starts Jan. 1
New Visits In Last Days Of Life Measure Starts Jan. 1 If you have questions about the new... Read more
Cares Act:
Consider These Steps For Your PPP Loan In Light Of New IRS Guidance
Take action now if you're not expecting Paycheck Protection Program loan forgiveness. So... Read more
Fraud & Abuse:
Authorities Focus On Medicaid Home Care Fraud
Medicaid agency owners seem to be in an egregious fraud competition. New York Medicaid ... Read more
Industry Notes:
As COVID-19 Vaccinations Begin, So Do Billing And Coding Of Them
Medicare disseminates vaccination specifics. The path to COVID-19 vaccination is paved w... Read more
Industry Notes:
Beware Claims Processing Glitch That Is Recoding Later Periods As Early Under PDGM
Beware of PDGM overpayments that you'll have to repay later — or underpayments you'll mi... Read more
Industry Notes:
Ball Starts Rolling For Second Year Of VBID Hospice Carve-In
Hospices are bracing for the first year hospice services will be included in Medicare Adva... Read more
Industry Notes:
Home Infusion Therapy Billing Will Work Differently Next Year — Prepare Now
Time is running out enroll to become a HIT provider under the new benefit that begins Jan.... Read more
Industry Notes:
Whistleblowers Rake In 6-Figure Award In Texas Fraud Settlement
A sham medical director arrangement is at the center of a Texas home health fraud case. T... Read more
Reimbursement:
MedPAC Sharpens Knife For HH Pay Cut
Profit margin figures seal agencies' fate with commission. Despite the significant hit t... Read more
Know Your Facts:
HH Spending, HHA Numbers, And Volume Are All Down
HHA profit margin in 15% range for fifth year in a row. Despite the fact that key indica... Read more
Hospice:
MedPAC Pushes Rate Freeze, 20% Cap Reduction — Again
Cap cut would equal a 3% rate cut, staffer says. Hospices' average profit margin is dow... Read more
COVID-19:
Provider Relief Fund Clarification Brings Good News For Hospices
Feb. 15 reporting deadline is fast approaching. Back in September, the Department of H... Read more
Mergers & Acquisitions:
Traditions Health Expands With Acquisition Of Multi-State Provider
Hospice deals dominate M&A landscape. A Texas-based chain is continuing its rapid ... Read more
Industry Notes:
Biden Names Potential New HHS Secretary
CMS Administrator not yet nominated. The changeover of presidential administrations is s... Read more
Industry Notes:
OIG Doubles Down On Whistleblower Lawsuits
The Department of Health and Human Services is beefing up its presence related to whistleb... Read more
Industry Notes:
Review Hospice Abuse, Neglect Reporting Requirements With This Tool
The fraud and abuse spotlight continues to shine on hospices in the wake of two scathing H... Read more
Industry Notes:
Can Legislation Stave Off Sequestration's Return On Jan. 1?
Will Congress give you a lump of coal or a present in your stocking regarding sequestratio... Read more
Industry Notes:
Major National Chain Considers Spin-Off, Sale, More
Keep an eye on Encompass Health Corp. The company formerly known as HealthSouth “is expl... Read more
Industry Notes:
Warn Patients Of These COVID Scams
As COVID-19 cases once again surge, so do fraud scams related to the disease. Warn your pa... Read more
Industry Notes:
HHA, Execs Excluded After Breaching Corporate Integrity Agreement
A recent exclusion is another sign to take a Corporate Integrity Agreement with the HHS Of... Read more
Compliance:
Home Health Improper Payment Rate Down To 9.3%
Insufficient documentation continues to plague HH claims. Not all the details are out a... Read more
COVID-19:
Medicare Expands Hospital At Home Program As COVID Surge Swamps Hospitals
Make sure you understand the differences between the home health benefit and the hospital ... Read more
Fraud & Abuse:
CIA Violation Racks Up $1.3 Million in Penalties For HHA
OIG Semiannual Report works through the naughty list. ‘Tis the season for the OIG to pi... Read more
Audits:
Miami HHA Owes $730,000, OIG Audit Charges
One-third of determinations reversed after rebuttal. A for-profit Miami home health agen... Read more
Hospice:
OIG Admits It Got Nearly Half The Claims Determinations Wrong In Compassus Audit
Plus: OIG pats itself on the back for hospital pay proration for early discharges to hosp... Read more
Policy:
Home Care Aides Need First COVID Vaccinations Too, Home Care Groups Urge
Newly approved priority guidelines lack many details. All eyes were on a Centers for D... Read more
Industry Notes:
Stark Law Reform Eases Some Self-Referral, Kickback Restrictions
Giving free tech to referral sources may be OK, one HHS example says. Home health is sti... Read more
Industry Notes:
Click On This For Medicare Advantage Carve-In Info
Medicare wants to make sure hospices are getting all the info about the new Medicare ... Read more
Industry Notes:
Beef Up HH Benefit, Study Urges
If insurers including Medicare really want to get the most bang for their buck out of the ... Read more
Industry Notes:
Sham Med Director Pay, Bonuses Feature In HH Fraud Settlement
A Sarasota, Florida home health agency and its top executives have agreed to pay $5.8 mill... Read more
Industry Notes:
MACs Unite To Train On Addendum
If you're struggling with the new hospice election addendum, the MACs are offering some he... Read more
Patient-Driven Groupings Model:
Don’t Let No-Pay RAPs Sink You In 2021
Prediction: Reimbursement shortfall will lead to more agency sales, closures. If you'r... Read more
Reimbursement:
Prepare For No-Pay RAP Success With These 12 Tips
Focus on the 3 items required in the new RAP. The reimbursement seas are going to get ch... Read more
Finance:
Don’t Miss These No-Pay RAP Clarifications
Bad news: Outlier, LUPA payments are affected. A few no-pay RAP details revealed in the ... Read more
Hospice:
Get Ready To Be Judged On Drug Claims
New PEPPER target area to debut in the spring. Hospices will have one more metric to wor... Read more
Compliance:
Beware Speaker Fees For Your Referring Docs After OIG Fraud Alert
Paying referral sources for speaking at in-services will land you under increased scrutiny... Read more
Industry Notes:
Medicare Home Health Improper Payment Rate Falls Again
Exactly how far still unclear. Home health agencies are looking less and less like the b... Read more
Industry Notes:
Get New Coverage And Payment Info On COVID-19 Vaccine, Treatment
The ramp-up to COVID-19 vaccination continues, and a new treatment option is now covered. ... Read more
Industry Notes:
Federal Judge: States Can Collect HH Union Dues
A San Francisco federal judge has sided with the California Attorney General in a lawsuit ... Read more
Industry Notes:
Compare Change Nearly Complete
Say goodbye to Home Health Compare and Hospice Compare next month. But all of their conte... Read more
Industry Notes:
MA Plans To Reach Out To Hospices
Watch your snail mail for information about the Medicare Advantage hospice carve-in. Medi... Read more
Industry Notes:
Benefit Manual Updated For New Hospice Election Requirements
The Medicare Benefit Policy Manual now reflects the addition of the new hospice election s... Read more
Industry Notes:
HIT Enrollment Underway
The enrollment requirements for suppliers of services under the new home infusion therapy ... Read more
Industry Notes:
Appeals Won't Help Your RCD Stats
Dec. 1 starts a new Review Choice Demonstration cycle for home health agencies in Illinois... Read more
Reimbursement:
Still No Direct Pay For HHAs’ Telehealth Visits
HHAs should redouble efforts to furnish virtual visits — and report data on them accurat... Read more
Regulations:
Burdensome Telehealth Requirement On Plan Of Care Dropped
Audio-only visits count, feds confirm. Home health agencies may not have gotten what th... Read more
Compliance:
Keep Compliance In Mind When Furnishing Visits Via Telecommunications Tech
Accessibility is required under the law, CoPs. Take to heart some CMS comments about prov... Read more
Policy:
Crystal Ball Shows Favorable Conditions Under Biden Administration
Heavier regulations may be on deck, however. One thing 2020 has driven home is that the... Read more
Quality:
Medicare Freezes HH, Hospice Compare Sites For A Year
Your data won't be public, but it will be available to you. Hopefully your latest Compar... Read more
Mergers & Acquisitions:
Hospices Chains Keep Growing
Hospice execs talked ramped-up M&A in latest earnings calls. Acquisitions aren't the... Read more
Industry Notes:
Review This Summary Of 2021 Pay Changes
Plus: Claims processing system to change. You can take a look at the rundown of Patient-... Read more
Industry Notes:
Prepare For 2021 Rates
Check your iQIES folder to determine whether you met your Home Health Quality Reporting Pr... Read more
Industry Notes:
No Election Means No NOTR
The Medicare Claims Processing Manual has caught up to current hospice billing with a new ... Read more
Industry Notes:
Medicare Deductibles, Premiums Rise
Count Medicare deductibles and premiums among the costs rising in 2021. “The Medicare... Read more
Industry Notes:
Look For HOPE Analysis Next Spring
Hospice Outcomes & Patient Evaluation (HOPE) assessment tool testing appears to still ... Read more
Industry Notes:
HH Fraudster Gets 5 Years
Just because it's not Medicare fraud doesn't mean it won't carry a big penalty. In Memphi... Read more
Industry Notes:
HH Employee Faces Kickback Charges
A Texas home health employee and medical marketing business owner are facing kickback and ... Read more
Industry Notes:
HH Owner Convicted Of Tax Evasion
A Wisconsin federal judge has sentenced Medicaid home health agency owner Latoya N. Joseph... Read more
Industry Notes:
Bayada, Baptist Health Form Joint Venture In Florida
Moorestown, New Jersey-based BAYADA Home Health Care is forming a joint venture with Bapti... Read more
Patient-Driven Groupings Model:
Medicare Scales Back Your 2021 Pay Increase
About $150 million less will make it into HHAs' coffers than proposed. The scores of com... Read more
Reimbursement:
Brace For Late RAP Penalties To Start In January As Proposed
RAP-related closures are on the horizon, state trade group warns. If you aren't at peak ... Read more
Payment:
LUPA, Add-On Concerns Brushed Off In Final Rule
Agencies will continue to lose 2.5% per year on outliers. Ranging from big issues like... Read more
Regulations:
2021 HH Final Rule Hits On OASIS, NPPs, and VBP
Plus: CMS will allow home infusion therapy back billing in the new year. In a year of tu... Read more
Fraud & Abuse:
OIG Backs Off Denied Claims After Audited HHAs Contest Them
But millions in overpayments are still alleged. A federal watchdog agency is up to its... Read more
Industry Notes:
Review Choice Demo Phase-In Period Keeps Rolling Until Jan. 1
CMS continues to hold off on 25% payment reduction. Home health agencies in Florida and N... Read more
Industry Notes:
Consult New Guidance, Education Session For VBID Hospice Carve-In That Hits In Less Than 2 Months
As the Value-Based Insurance Design model testing hospice's inclusion in Medicare Advantag... Read more
Industry Notes:
Celebrate Home Health and Hospice Month, Aide Week
Take the time this month to celebrate your agency, your staff, and your patients with Home... Read more
Industry Notes:
New Toolkit From CMS Aims To Help States Keep Patients In The Home, Community Setting
Some new tools from the feds aim to help benefi­ciaries stay in their homes. The Centers... Read more
Industry Notes:
HH, Hospice Billing For COVID Vaccine Should Work The Same As For Flu, Pneumococcal Vaccinations
A new CMS interim final rule that hasn't been published yet is laying out the policies and... Read more
Reimbursement:
Where Will 2021 Rates Land In Final Rule?
Commenters want the behavioral cut gone. In a few short weeks or even days, home health ... Read more
Patient-Driven Groupings Model:
LUPAs, Outliers Require Changes Under PDGM
HHAs are losing 2.5% of payments per year. It's not only the behavioral adjustment cut re... Read more
Mergers and Acquisitions:
Hospices Change Hands In Spate Of Recent Deals
Plus: Nursing recruitment issues shut down only hospice in rural county. As temperatures... Read more
Labor Law:
FLSA Home Care Rule Causes Multiple Problems, GAO Report Finds
Companionship exemption elimination brings unintended consequences. Back in 2015, the ... Read more
Industry Notes:
Hospice Concurrent Care Demo Saves Medicare Money
MCCM keeps trucking. For the third year, the Medicare Care Choices Model has shown provi... Read more
Industry Notes:
MACs, FAQs Enlighten Providers On Accelerated Payment Recoupment
Providers still grappling with paying back accelerated and advanced payments (AAPs) from M... Read more
Industry Notes:
CMS Cranks Up Education For VBID Hospice Carve-In
Do you want to find out more about the Medicare Advantage hospice carve-in that may be hit... Read more
Industry Notes:
LUPA Claims Glitches Will Remain Until Next July, MAC Says
It's going to be a while until some LUPA-related claims processing problems get fixed. Pr... Read more
Industry Notes:
Be Sure All Your Diagnosis Codes Are Switched Over As Of Oct. 1
Beware of yet another way 2020 is a unique year — this time for diagnosis coding purpose... Read more
Industry Notes:
Check Out Raised AIC Rates
Among the rates rising in 2021 are the ones that qualify you for certain legal reviews. ... Read more
Industry Notes:
NY Hospice Lands In OIG Hot Seat
Providers that don't want to enter into a Corporate Integrity Agreement with the OIG ... Read more
Industry Notes:
Massachusetts Agency, Owners Settle Fraud Charges For $3.1 Million
A Massachusetts home care company and its owners will pay $3.1 million to resolve allegati... Read more
Industry Notes:
Agency On COVID Outbreak List
More COVID spread means more chances for home care agencies to experience an outbreak — ... Read more
REIMBURSEMENT:
Accelerated Payment Relief Hits The Books
Follow 4 steps to success under new AAP repayment terms. Home health and hospice provid... Read more
COVID-19:
Here’s How Accelerated Pay Recoupment Will Work Under New Rules
Plus: Consult Frequently Asked Questions for more repayment details. Providers got good n... Read more
FINANCE:
Beware These 5 Pitfalls Under New HHA Cost report
Know the difference between telehealth and telecommunications for cost reporting purposes.... Read more
EMERGENCY PREPAREDNESS:
Don’t Skip Your EP Testing Before Double-Checking Documentation
Watch out: Your next exercise of choice may come sooner than you think. A new memo to Med... Read more
PAYMENT PROTECTION PROGRAM:
Simpler Form For PPP Reporting Provides Welcome Relief
Form applies to companies with loans of $50K or less. The Small Business Administration h... Read more
INDUSTRY NOTES:
Lawmakers Side With Home Health Agencies On PDGM
Collins goes to bat for HHAs. As the countdown to the 2021 final rule for home health p... Read more
INDUSTRY NOTES:
New Hospice Item Set Manual Includes Draft Instructions For 2021
Make sure you're not late in prepping for Hospice Item Set changes scheduled for Jan. 1. ... Read more
INDUSTRY NOTES:
Get The Scoop On Submitting Multiple Cost Reports In New MCReF System Later This Month
Don't let the new Medicare Cost Report e-Filing (MCReF) system scare you out of being effi... Read more
INDUSTRY NOTES:
Are You On Medicare's 'Successful Hospices' List?
Your potential referral sources and patients — not to mention competitors — can easily... Read more
INDUSTRY NOTES:
COVID Outbreak At Inpatient Hospice Draws Press Attention
One Hawaii hospice is getting the sort of press no provider wants. Six patients and “se... Read more
Finance:
It’s Official: New Cost Report Requirements Retroactive To January 2020
Tip: You must separate Medicare, Medicaid, and ‘Other' data. Here's where managed care f... Read more
Provider Relief Fund:
Round 3 Of Provider Relief Funding Offers ‘Add-Ons’ to Previous Recipients
Feds set to release another $20 billion to beleaguered providers. Home health and hospic... Read more
COVID-19:
Rapid Response Tests On Their Way To HHAs, Hospices
Beware of overreliance on the tool. The Department of Health and Human Services is foll... Read more
Reimbursement:
New Rules Smooth Out No-Pay RAP Wrinkles
HHAs should catch a break on RAPs timely filed, then canceled. No home health agency is ... Read more
Industry Notes:
Long Stays, GIP Are MAC’s Newest Review Targets
Hospices' reprieve didn't last long. One HHH Medicare Administrative Contractor has final... Read more
Industry Notes:
Feds Put Extra Funding Into Keeping Beneficiaries At Home
CMS is putting its money where its mouth is when it comes to keeping patients out of the n... Read more
Industry Notes:
Hospice Carve-In Areas Mapped Out
To find out whether you may get swept into the program testing hospice as a part of Medica... Read more
Industry Notes:
Renewed PHE Means Renewed Regulatory Flexibilities
To no one's surprise, Health and Human Services Secretary Alex Azar has renewed the public... Read more
Industry Notes:
Don't Let Hospice Election Statement, Addendum Haunt You
It's past Oct. 1, and ghosts and goblins aren't all that's scary this month. Your hospice ... Read more
Industry Notes:
Dump PDGM Behavior Cut, Rep Urges
The home health industry isn't giving up its fight to make Patient-Driven Groupings Model ... Read more
Industry Notes:
Epic Fraud Takedown Charges More Than 100 Docs, Nurses, Clinicians
If you think enforcement agencies have been taking it easy during the pandemic, think agai... Read more
Industry Notes:
CA Last In HH PEPPER Downloads
Are your competitors perusing their PEPPER benchmarking reports to improve and optimize th... Read more
Industry Notes:
Whistleblower Sues Over Kickbacks, Ineligible Patients
A Kansas hospice is facing whistleblower charges that it kept ineligible patients on servi... Read more
Industry Notes:
Warning: Cyberattacks Skyrocket
You're not paranoid — your electronic systems are under greater threat than ever before.... Read more
Provider Relief Fund:
Big PRF Reporting Change May Mean You Have To Pay Back Funds
Where do you fall under HHS' newly issued guidance? You may not know what you think you k... Read more
Finance:
Take These 4 Steps To Get Ready For PRF Reporting
Watch out: Quickly growing agencies may be harmed by definition change. Now that the off... Read more
Mergers & Acquisitions:
M&A Activity Continues Full Steam Ahead
Deals involving hospice and/or Texas prove popular in latest round. As market pressures p... Read more
Fraud & Abuse:
OIG Slaps HHA With $1 Million Overpayment Assessment
Ambulation distance figures prominently in audit findings. The HHS Office of Inspector Ge... Read more
COVID-19:
Keep An Eye On Accelerated Payment Relief
Extended deadline, lower interest rates are under consideration. If you have been wond... Read more
Industry Notes:
Hospice Assessment Tool To Debut Soon
20 hospices will alpha test the long-in-the-works HOPE tool. Medicare is one step closer... Read more
Industry Notes:
Watch Out For FFCRA-Exempt Intake Staff, Case Managers, Attorneys Caution
If you're still wrestling with which of your staff are exempt from extended FFCRA leave af... Read more
Industry Notes:
Nursing Homes Must Have Reasonable Cause To Limit Visits, CMS Says
A new memo updating visitation guidelines for nursing homes may make it easier to see your... Read more
Industry Notes:
New Therapy Asst G Codes On Deck
Are you ready to use the new billing codes for home health therapist assistants starting n... Read more
Industry Notes:
Anticipate Quarterly Update Hold
It's not some new reimbursement catastrophe if your claims don't process at the beginning ... Read more
Industry Notes:
CMS Offers Reg Relief In Oregon
Providers in Oregon are receiving regulatory relief due to the wildfires. On Sept. 16, HHS... Read more
Industry Notes:
Double Check Your Wage Index Code
A move to help ease provider burden with the new wage index designations will also complic... Read more
Industry Notes:
Hospices Need COVID-19 Test Help
If you're having trouble securing COVID-19 testing for your employees, you're not alone. ... Read more
Labor Law:
Aides Are In, Billers Are Out For FFCRA Exemptions, New Rule Indicates
DOL replaces rule provisions that federal court invalidated. Trying to figure out whic... Read more
Compliance:
Dig Deeper In New FFCRA Rule From DOL
Pay attention to new rule's provision on leave related to hybrid school schedules. A new... Read more
Hospice:
Hospices Get Good News On Addendum Penalties, But Questions And Concerns Remain
Wait for written guidance, legal expert cautions. CMS has taken some of the pressure off... Read more
Quality:
Measure On Hospice Visits In Last Days To Undergo Significant Revision
Only RN and MSW visits will count toward claims-based measure. A Hospice Quality Reporti... Read more
Enforcement:
OSHA Cites Health Care Providers For COVID-19 Violations
DOL is examining PPE, respiratory protections, and more. Mind your COVID-19 employee pro... Read more
Industry Notes:
CHART Model Aims To Relieve Rural Hardships
Watch for a rural ACO coming to an area near you. More than 130 rural hospitals have clo... Read more
Industry Notes:
CMS Urges Medicaid Programs To Adopt Value-Based Care With New Guidance Document
Value-based care will gain importance if new recommendations get picked up by the states. ... Read more
Industry Notes:
MedPAC Acknowledges COVID-19-Sparked Volume Nosedive For Home Health, Inpatient Rehab
The steep decline in home health services when the COVID-19 pandemic began isn't going unn... Read more
Industry Notes:
Medicaid Hospice Rates For 2021 Released In New Transmittal
Check out Medicaid's fiscal year 2021 hospice payment rates in a three-page memo at www.me... Read more
Industry Notes:
Check Out Myth-Busting Information On HIPAA And Encryption
Check your assumptions about HIPAA compliance and encryption. Many providers think electr... Read more
Compliance:
Take A Close Look At Your Medical Director Practices
Florida HHA settles medical director-related kickback charges for $300K. With so many req... Read more
Fraud & Abuse:
Billers, Coders, And More Face The Fraud & Abuse Music
Saying you just followed orders won't protect you from individual liability. It's not jus... Read more
Labor Law:
You May Not Be Stuck With The IRS Mileage Rate
New DOL opinion letter gives employers leeway on transportation reimbursement. Right wh... Read more
Quality:
Care Compare Launches For Cross-Setting Quality Data Access
New site is tailored to mobile devices. COVID-19 might have delayed the revamp of Medica... Read more
Industry Notes:
Overpayments Based On Extrapolation May Get Harder To Appeal
Standardized guidance is in Program Integrity Manual. The OIG wants CMS to tighten up ... Read more
Industry Notes:
How HHS Issues Guidance May Change
There are a few days left to give federal officials your feedback on how they should issue... Read more
Industry Notes:
Review Your Quality Reporting Requirements So You Won't Lose Out
Brush up on the Home Health Quality Reporting Program basics with a new training course at... Read more
Industry Notes:
HHS Declares Retroactive Public Health Emergency For California Wildfires
Much like with Hurricane Laura, Centers for Medicare & Medicaid Services officials are... Read more
Industry Notes:
Medicare Reconfigures LCDs
See the more than 100 diagnosis codes added to the upcoming updates to the Local Coverage ... Read more
Industry Notes:
Boost Your PPE Profile With Patients
Home care and hospice providers wishing to build public confidence in their COVID-19 safet... Read more
Industry Notes:
ProPublica Buts Hospices On Hot Seat
Are you ready for your practices regarding COVID-19 patients to go under public scrutiny? ... Read more
Industry Notes:
$1.5 Million Federal Grant Aims To Boost Aide IT
A $1.5 million federal grant may eventually make life, and work, easier for some of your e... Read more
Industry Notes:
Rapid COVID Tests Are Coming To Home Health
The majority of the 150 million rapid response coronavirus tests the federal government is... Read more
Patient-Driven Groupings Model:
PDGM Behavioral Adjustment Is Way Off, New Study Charges
LUPAs are sky high and coding remains mostly unchanged, claims show. If you feel like yo... Read more
Hospice:
Beware Pitfalls Hiding In New Hospice Addendum Requirement
Return to ‘normalcy' means onset of a new regulatory burden. Hospices that are already ... Read more
Reimbursement:
Beware Penalty For Missing/Late/ Invalid Addendums
The beneficiary's entire stay could be at risk. Just how much is at stake when hospices ... Read more
Compliance:
Follow 10 Pointers To Master Addendum Before It Tanks Your Claims
You should finalize your forms and P&Ps this week, expert advises. To avoid complia... Read more
Labor Law:
If In-Person School Is An Option, You Don’t Have To Grant FFCRA Paid Leave
If In-Person School Is An Option, You Don't Have To Grant FFCRA Paid Leave But there is ... Read more
Industry Notes:
Here’s How To Respond To Postpay ADRs
MACs offer helpful hints. After a five-month break from medical review, you may be rus... Read more
Industry Notes:
Medicare Requires COVID-19 Testing In Nursing Homes —Including Your Staff
While many hospice and home health agencies that serve patients residing in nursing homes ... Read more
Industry Notes:
CMS Responds To Hurricane Laura
Public Health Emergency waivers in Texas and Louisiana for Hurricane Laura don't look much... Read more
Industry Notes:
Medicare Reconfigures Local Coverage Decisions
You can check out updates to the local coverage billing and coding articles for Hospi... Read more
Industry Notes:
MACs To Check This Cost Report List
Check out new items in Medicare's “Cost Report Acceptability Checklist” that could kic... Read more
Industry Notes:
Medicare Transmittal Includes 2021 Hospice Rates
The 2021 hospice payment rates have officially hit the books. Consult CR 11876 at www.cms.... Read more
Industry Notes:
Business Associate HIPAA Breach Affects You Too
It doesn't have to be your agency directly that suffers a ransomware attack, to have to br... Read more
Industry Notes:
Hospices Make Buys In 2 Southeast States
The busy hospice mergers and acquisitions market continues to hum. In Georgia: Alleo Heal... Read more
Review Choice Demonstration:
Review Choice Demo Implementation Slows With New Phase In
HHAs already under RCD also get a breather with lifting of 25% payment penalty. HHAs in... Read more
Medical Review:
Follow These 5 Tips To Ace RCD Review
Which of these trouble spots puts your agency's claims most at risk? Knowing every single... Read more
Surveys and Certification:
Watch For These 5 Survey Hot Spots
Critical: Do your policies actually reflect your practices? With resources spread paper ... Read more
Finance:
Feds Give Providers 2 More Weeks To Score COVID Relief Funding
Plus: Don't let accelerated payment interest sneak up on you. Home care providers have a... Read more
Diagnosis Coding:
2021 ICD-10 Coding Update Addresses COVID-19
Check out an entirely new section on coding guidelines for the novel coronavirus. There'... Read more
Industry Notes:
Near-LUPAs, GIP, Long Stays Are First Up On Reviewers’ Hit Lists
MACs reveal new medical review topics. Medical review resumption is proceeding, despite ... Read more
Industry Notes:
New Study, Mayor's Campaign Highlight Aide Difficulties
The plight of home care aides in the pandemic is getting more attention. For example: A s... Read more
Industry Notes:
Here's When You Can Use Televisit HIS Data — And When You Can't
Keep your Hospice Item Set data collection rules straight before surveyors hit your doorst... Read more
Industry Notes:
Provider Relief Funds May Complicate Sales
If you're considering a buy or sale for your Medicare agency, you might want to look at th... Read more
Industry Notes:
Don't Count On Cost Report Deadlines Moving Again
Medicare seems to be holding firm to its cost report filing deadline for year-end fiscal y... Read more
Industry Notes:
Put Your Peepers On Your New PEPPER Report
There's still time to sign up for training on the newest home health agency PEPPER benchma... Read more
Industry Notes:
Hospice Access Horror Story Featured In Florida
The topic of hospices being able to access patients in facilities continues to draw attent... Read more
Surveys and Certification:
Routine Surveys Are Back — And You Could Be Next On The List
Will home care providers face the same punishing scrutiny as nursing homes? The feds s... Read more
Compliance:
IJ Revisits, Complaint Surveys Top New Survey Priority List
Recert surveys are at the bottom of the list. While a provider is never sure exactly whe... Read more
Medical Review:
HHAs Pull Out All The Stops To Head Off RCD In FL, NC
PHE and RCD don't mix, members of congress tell CMS. Medicare officials are in the proce... Read more
Fraud & Abuse:
HHA Audited By OIG Pushes Back Based On Homebound Criteria
Newest report piles on the pressure. A government watchdog agency wants a San Diego home... Read more
Industry Notes:
New Home Infusion Therapy Billing Details Revealed
Pay rate will be higher for initial visit. The new home infusion therapy services benefi... Read more
Industry Notes:
Don't Miss Out On Another Go-Round For PRF Applications
Home care providers that haven't accessed Provider Relief Funds yet still have a chance. ... Read more
Industry Notes:
MAC Divulges More Medical Review Resumption Specifics
Medicare is cranking up its medical review machine for all providers, and more details are... Read more
Industry Notes:
Gain Insights On HOPE Assessment Tool Development With New Abt Report
If you want to keep tabs on how the Hospice Outcomes and Patient Evaluation hospice assess... Read more
Industry Notes:
Employers Oppose Executive Order On Social Security Payroll Tax Relief
President Trump's Aug. 8 executive order deferring certain payroll taxes may not help empl... Read more
Industry Notes:
Begin Your Hospice Quality Reporting Program Educational Journey With New Resource
If you're looking for a Hospice Quality Reporting Program rundown, Medicare now has one. ... Read more
Industry Notes:
New York Hospice Settles GIP, CHC Upcoding Charges For $5.2 Million
Higher-level care continues to be a flash point for hospice fraud investigations. Metropo... Read more
Industry Notes:
NJ, IL Hospices Are Latest To Shed 'Hospice' Name
More hospices are rebranding away from the “hospice” name. In New Jersey: Samaritan H... Read more
Industry Notes:
Multi-State Chains Make Hospice Acquisitions In 3 States
Hospice deals continue to rack up. In Texas: Home health and hospice provider Traditions... Read more
Finance:
Q2 Earnings Show Recovery Is In Full Swing
Many chains are back to normal LUPA levels, they say. If your revenues were down last q... Read more
Reimbursement:
Company Leaders Say The Future Is Bright For The Rest of 2020
Home health and hospice providers are compensating for decreased institutional referrals. ... Read more
COVID-19:
7 Strategies Public Companies Used To Counteract COVID
Consider one chain's approach to therapist pay restructuring. Home care providers need... Read more
Compliance:
Weigh Your FFRCA Choices Carefully In Wake Of NY Court Decision
Ruling may affect any furloughed employees. Home care providers that have relied on the ... Read more
Fraud & Abuse:
OIG Scrutinizes Home Health In 3 New Reports
Watchdog agency pushes for HHA surety bonds — again. Home health agencies just can't s... Read more
Industry Notes:
Facebook Memes Lead To Hospice CEO's Resignation
Hospice draws the wrong kind of attention. Make sure your staff, including top execs, kn... Read more
Industry Notes:
Take The Opportunity To Learn More About MCReF Tracking And Other Features
Bone up on the Medicare cost report system's new tracking feature via a recording or trans... Read more
Industry Notes:
CMS Bumps ABN Deadline Again Due To COVID-19
You have an extra four months to start using the updated Advance Beneficiary Notice form. ... Read more
Industry Notes:
Medicare Care Compare Website Appears Still On Hold, But Provider Data Catalog Is Rescheduled For Late Summer
Watch for changes to how Medicare will share its publicly reported information. The Center... Read more
Industry Notes:
Medicare Adds Osteoporosis Drugs To List For Home Health Billing
Home health agencies that bill for osteoporosis drugs for Medicare beneficiaries should co... Read more
Industry Notes:
Tarheel State County HHA Prepares To Go On The Block
Another North Carolina County is making plans to sell its home health agency. In an Aug. 1... Read more
Fraud & Abuse:
OIG Hits HHAs Hard On Near-LUPA Episodes
Medicare overpaid HHAs $192 million for episodes slightly exceeding LUPA thresholds. LUP... Read more
Hospice:
Addendum Requirement Continues To Barrel Toward Hospices This Fall
Hospices have less than 2 months until implementation. Hospices hoping to get some brea... Read more
Reimbursement:
Hospice Final Rule Reduces Pay Update Slightly
Big swings for wage index areas may batter already struggling hospices. A minor reducti... Read more
Regulations:
Hospice Final Rule Seems To Give Thumbs Up To Electronic Signatures
More good news: Contractors can't trigger the condition for payment, only patients. Th... Read more
Industry Notes:
Calculate Your PPP Loan Forgiveness With New Clarifications
Owners of multiple businesses can decide how to allocate their compensation. If you're... Read more
Industry Notes:
NY Federal Court Decision Creates Potential Labor Law Risk.
A Department of Labor frequently asked question set from March may not be the final answer... Read more
Industry Notes:
No-Pay RAPs And Related Penalties Loom On The Horizon
If you'd been hoping the penalty for late or no RAPs would go away for next year, no such ... Read more
Industry Notes:
Hospices' PEPPER Reports Have Arrived And HHAs' Are Nearly Here
Now that providers' pandemic-related break from PEPPER reports is over, it's time for home... Read more
Industry Notes:
CMS Touts Telehealth Expansion
Telehealth expansion is on Medicare's to-do list, but it may not touch home care providers... Read more
Industry Notes:
PHE Gets Another Extension
The Department of Health and Human Services Secretary has officially extended the COVID-19... Read more
Industry Notes:
Take A Look At Corrected Reports
If you've looked at your Provider Preview Reports and/or the Quality of Patient Care Star ... Read more
Industry Notes:
Find Out How to Track Cost Reports
Bone up on the cost report system's new tracking feature via a recording or transcript at ... Read more
Industry Notes:
3 Indicted In $12M HH Scheme
A Michigan couple faces fraud and tax evasion charges in connection with a $12 million hom... Read more
Industry Notes:
Authorities Continue To Focus On Medicaid Fraud — This Time In FL
Authorities have arrested a Florida Medicaid home and community-based services agency owne... Read more
Provider Relief Fund:
Feds Lower Loan Amount Threshold For PRF Reporting
Detailed reporting requirements out next month. If one thing is constant about coronavi... Read more
Medical Review:
CMS Forges Ahead With Medical Review Resumption
Expect COVID waiver-related reviews, attorneys warn. It's not only Review Choice Demonstr... Read more
Compliance:
Keep Telehealth Rules In Mind As Claims Review Gears Up
Get the facts on ‘good faith' principles. With medical review roaring back next month, ... Read more
Budget:
Biden Focuses On Home Care In $775 Billion Health Plan
‘Caregiving squeeze' could be helped by more funding, unions for workers. Buckle up fo... Read more
HIPAA:
Make Sure Your Telehealth HIPAA Bases Are Covered
Medical review discretion is coming to an end, but HIPAA discretion goes on. You'd bet... Read more
Mergers and Acquisitions:
2 Chains Get Bigger
Midwest hospice chain contemplates selling. Alleo Health System, formerly known as the H... Read more
Industry Notes:
HH, Hospice Fraud Get The Spotlight In OIG-DOJ Fraud Report
HHA owners get 15-year sentences. The enforcement hammer keeps hitting home care fraud... Read more
Industry Notes:
Medicaid PRF Application Extended To Aug. 3
If you'd still like to apply for Provider Relief Funds in the program's Medicaid distribut... Read more
Industry Notes:
2021 Rates Are On The Line In HQRP Letter
Check your CASPER folder to see whether you'll be getting reduced reimbursement rates in 2... Read more
Industry Notes:
Meet Your New Quality Measure, The Hospice Care Index
Tune into an Aug. 5 Medicare forum to find out about a potential new quality measure you'l... Read more
Industry Notes:
Check Your Rates Against Your Peers' — Before Reviewers Do
Looking for benchmarking data? Try this free source. The Alliance for Home Health Quality... Read more
Industry Notes:
Don't Skip This HART Software Update
An update to the free Hospice Item Set HART software is now available. You can download th... Read more
Industry Notes:
4-Year Hospice Stays And 2-Week GIP Stays Tip Off The Feds To Fraud
Hope Hospice in Fort Meyers, Florida, will pay $3.2 million to resolve allegations that it... Read more
Review Choice Demonstration:
CMS Prepares To Restart Review Choice Demo Engine
Florida, North Carolina agencies will start Aug. 31. For home health agencies in Review C... Read more
Therapy:
Warning From MAC May Signal Big Drop In Therapy Utilization
The pandemic isn't distracting Medicare from your therapy utilization. You'd better be ... Read more
Compliance:
Take These Steps To Survive Therapy Scrutiny
Know your own data to assess your risk. The solution for quality and payment problems u... Read more
Reimbursement:
One County To See 33% Wage Index Increase In 2021
Where does your area fall in the wage index reshuffle? The 5 percent cap on wage index de... Read more
COVID-19:
Surprise Legislation Extends PPP Loan Application Window
Denied applicants get a second chance. You still have time to apply for Payment Protect... Read more
Industry Notes:
OIG Puts Telehealth Under The Microscope
The major expansion of telehealth services provided to Medicare beneficiaries is about to ... Read more
Industry Notes:
Trump Administration Pushes For More Dialysis At Home
Medicare has proposed some End State Renal Disease Prospective Payment System changes that... Read more
Industry Notes:
HH PEPPER Benchmarking Reports Due Next Month
The indefinite postponement of PEPPER bench­marking reports is now definite. The release ... Read more
Industry Notes:
Resolution Of C5467 Returned Claims Requires Action On Your Part, MAC Instructs
If you've been sitting on claims that returned in error for Reason Code C5467, it's time t... Read more
Industry Notes:
Telecommunications Waiver Still Applies To Hospice Item Set, CMS Clarifies In New Tool
Having trouble keeping straight which COVID-19 waiver flexibilities are still in effe... Read more
Patient-Driven Groupings Model:
HHAs To See Largest Rate Increase In More Than A Decade — But It Could Be Higher
Productivity adjustment chips away at inflation update. A calm home health annual payment... Read more
Reimbursement:
Watch Out For Wage Index Wallop
Mid Atlantic agencies win, New England agencies lose under new OMB system. Are you ready ... Read more
Payment:
Rural Add-On Is Going, Going, Almost Gone
Activate your plans for dealing with reduced reimbursement in rural regions. Home health ... Read more
Regulations:
Proposed Rule's Telehealth Changes Don't Measure Up To Home Health Agencies' Wish Lists
Direct reimbursement for telehealth visits is not in the rule. The future of home care te... Read more
Conditions of Participation:
Check Out The Newly Proposed CoP Language On Telehealth
Don't miss any new requirements. If the telehealth proposal in the home health 2021 propo... Read more
OASIS:
New HHAs Get A Slight Break In Proposed Rule
Plus: Rule lays out home infusion therapy details, misses OT certification opportunity. N... Read more
Industry Notes:
Providers Get More Breathing Room On Cost Reports
Blanket extension means it's automatic. Medicare has pushed cost report deadlines once a... Read more
Industry Notes:
Costs Are Up And Admissions Are Down
Costs are up and admissions are down under COVID-19, a new industry survey shows. “The ... Read more
Industry Notes:
Medicare Extends MCCM Concurrent Care Demo
Medicare's concurrent care demonstration project will get another year. The Centers for M... Read more
Industry Notes:
VA Ups HH Referrals, GAO Report Says
HHAs are receiving more Veterans Administration referrals due to COVID-19. So says a new r... Read more
Industry Notes:
Gear Up For Quality Data Reporting Resumption
You might still be in the middle of a pandemic, but your quality reporting duties are abou... Read more
Industry Notes:
Pick Back Up Where You Left Off With MAC's Advice
All may not be as you left it when you left your office weeks, or months, ago. One MAC is ... Read more
Industry Notes:
HH Employees Plead Guilty, Get Probation, Home Detention, Restitution
Two home health billers have been sentenced in the ongoing Moriarty Consultants Medicaid f... Read more
Industry Notes:
Texas-Based Hospice Chain Makes Buys, Plans Growth
A Texas-based hospice chain is setting its sights outside of the state. “We have done... Read more
Industry Notes:
OIG Tells MCFU To Prosecute More
If you operate in a state that hasn't seen a lot of activity from its Medicaid Fraud Contr... Read more
Regulations:
CMS Makes Bigger Commitment To Cutting Red Tape
Making COVID-19 waivers permanent would be a start, expert says. Medicare is saying all t... Read more
Finance:
Providers Are Off The Reporting Hook For CARES Act Provider Relief Funds — For Now
Uncertainty over reporting duties continues. If you missed the Department of Health and H... Read more
Funding:
Consult Further Provider Relief Fund Clarifications
Be sure you pay back any funds that don't go to qualifying expenses. You may feel more co... Read more
COVID-19:
Consider This Funding Route
You may qualify for Main Street lending if you have PPP loans, but not Provider Relief Fun... Read more
Know Your Facts:
Home Health Captures 11.4% Of COVID-19 Discharges
Hospice receives 5.3%, newly released data shows. New Medicare beneficiary data may help ... Read more
Industry Notes:
OIG Examines UPIC Review
Plus: Feds plan nationwide audits on advanced care planning. A federal watchdog agency wa... Read more
Industry Notes:
Sales Rep Sues Publicly Traded Hospice Chain
Coronavirus-related lawsuits from employees are underway. For example: A San Mateo, Calif... Read more
Industry Notes:
Learn About This New DDE Home Health Screen
Expect some changes to DDE screens starting July 6, including a new home health screen. "... Read more
Industry Notes:
Beta Testing On Latest HH Grouper Update About To Start
While many things have changed, one thing remains the same — an update to Home Health Gr... Read more
Industry Notes:
Use Updated ABN Form In August
Mark your calendar: You need to start using an updated ABN form by Aug. 31. The Advance B... Read more
Industry Notes:
Hospital At Home Cancer Program Cuts Readmissions 58%
If you're looking to partner with hospitals for hospital-at-home programs, results from on... Read more
Industry Notes:
HH Employment Isn't Rebounding From COVID-19 Fall
Home health employment fell 7 percent from February to April, says Kaiser Family Foundatio... Read more
Industry Notes:
Consult New Hospice Terminal Prognosis Tools From MAC
Two new guidance documents may help you document and defend your hospice claims. HHH Medi... Read more
Industry Notes:
Review Medicare Appeals Ladder
Be sure you know the five levels of the Medicare appeals process. Before you can request a... Read more
Compliance:
Medicare Finalizes Lift Of Nondiscrimination Duties
Notices and taglines are going away. How a new federal nondiscrimination rule treats tran... Read more
COVID-19:
No Access? No Stay, Frequently Asked Question Set Says
When do telehealth visits factor in? Hospices may have to discharge patients living in a... Read more
Hospice:
COVID-19 Testing May Test Your Facility Access
Nursing homes can ban who they want. If you have a showdown over who will test your staff... Read more
Fraud & Abuse:
OIG Cracks Down On Medicaid Fraud
MFCUs recover more than $6 for every $1 spent on enforcement activities. Sometimes Medica... Read more
Reimbursement:
MAC Spells Out Denial Reasons For Accelerated Payments
Warning: A ‘no' to accelerated payments could signal a fraud investigation is in the wor... Read more
Health Information Technology:
Be Sure You're Not Health Info Blocking Under New Rule
Providers get extra breathing room on deadline. Don't let new requirements for health dat... Read more
Industry Notes:
NPPs Can Bill For Home Health, MACs Confirm
But only if their states allow it. Home health agencies that have felt leery about using... Read more
Industry Notes:
Provider Relief Fund Reporting Forms Due Soon, HHS Official Pledges
The deadline for the first Provider Relief Fund reporting is coming up quick on July 10, b... Read more
Industry Notes:
Hospice VBID Effective Date Clarification Issued
Effective dates for the Medicare Advantage hospice carve-in are clearer after an update fr... Read more
Industry Notes:
EEOC Releases Crucial Guidance On COVID-19 Work Scenarios
Firm up your knowledge of how COVID-19 and employment law intersect with new guidance from... Read more
Industry Notes:
Sequence Matters For NOTR Submissions
A new Medicare transmittal may clear up some of your lingering questions about hospice Not... Read more
Industry Notes:
CMS Offers New Training Course On HH Benefit Basics
If you want to learn more about how consolidated billing, therapy services, and physician ... Read more
COVID-19:
New PPP Law Provides More Flexibility
Bonus and hazard pay count toward 60% payroll target, interim final rule clarifies. Anot... Read more
Legislation:
PPP Borrowers Narrowly Avoid Forgiveness Cliff
Legality of the change is still fuzzy, but providers will take it. The feds might not be... Read more
Medicaid:
Medicaid Providers To Finally See Some CARES Act Help
Can you abide by the two conditions? Medicaid home care providers left out of Provider Re... Read more
Review Choice Demonstration:
Yep: RCD 'Pause' Will End With 100% Postpay Review
But review schedule will consider burden, CMS says. Home health agencies hoping for a re... Read more
Compliance:
OIG, HH Chain Duke It Out Over Audited Claims
Ten denied claims lead to $2.1M overpayment. The latest improper payment rate for fee-fo... Read more
Industry Note:
Consider These New Survey Priorities
Routine surveys are back on deck. Back in March, CMS Administrator Seema Verma announced... Read more
Industry Note:
HOPE Tool Alpha Testing Still On Schedule For Fall
COVID-19 isn't derailing the development of Medicare's Hospice Outcomes & Patient... Read more
Industry Note:
Couple Uses Home Health Medicaid Fraud Proceeds For Jet, Jewelry And More
Two Medicaid fraud cases focus on home health services. Case #1: Married couple Latisha H... Read more
Industry Note:
Hospice Video Could Increase Benefit Access, Study Says
There may be a way to educate potential hospice patients about the benefit, even though ph... Read more
Industry Note:
If OCR Investigator Calls, Don't Take Their Word For It
Watch out for yet another scam to swipe your patients' private info. An individual posing ... Read more
COVID-19:
Provider Relief Fund Requirements Get More Specific
But where's the reporting form? There's no excuse for not keeping careful records of you... Read more
Mergers & Acquisitions:
Pandemic Funding Contributes To M&A Slowdown
Buyers expect to scoop up struggling agencies later. COVID-19 has throttled back mergers... Read more
Finance:
When Will The M&A Market Rebound?
Multiple factors will affect an agency's trajectory. Predicting what will happen in a ye... Read more
Medical Review:
Why The RCD 'Pause' Doesn't Provide Much Relief
Warning: 100% post-pay review waits on the other side of the pause. In its first respons... Read more
Fraud & Abuse:
OIG Highlights Home Health, Hospice Fraud
HHA owner fugitive is apprehended at the border. Home health may not get mentioned in th... Read more
Industry Note:
Hospices Get More Medicare Advantage Carve-In Clues
You'll still bill your MAC — at least sometimes. There's not a lot of time between now... Read more
Industry Note:
How Well Do You Understand Billing Disaster Codes?
Get updated instructions on when to use the CR and DR disaster billing codes in a new Medi... Read more
Industry Note:
Review Your Latest Hospice Quality Data
It's time to check out your next Hospice HIS provider preview reports and Hospice CAHPS pr... Read more
Industry Note:
What's In A Name? Too Much Confusion, For These Medicare Systems
Medicare is clearing up some naming confusion across its Identity & Access (I&A) M... Read more
Industry Note:
Amedisys Closes Blockbuster AseraCare Deal
Amedisys Inc. has closed on its acquisition of Homecare Preferred Choice Inc. doing busine... Read more
Industry Note:
Midwest Hospice Co. Opens And Acquires
Private equity-backed St. Croix Hospice is adding new branches quickly. The Oakdale, Minne... Read more
Industry Note:
Texas-Based Hospice Chain Makes Multiple Buys
Traditions Health LLC, a hospice and home health provider in Texas, California, and Arizon... Read more
Industry Note:
Equity Firm Launches Post-Acute Platform With Virginia Acquisition
And a new private equity firm has entered the home health space. London, U.K.-based Bridge... Read more
COVID-19:
Learn 5 COVID Coping Lessons
Take a page from publicly traded chains' playbooks. In their latest earnings reports and ... Read more
Finance:
CARES Act Flexibilities Boost Bottom Lines
Some provisions are helping now, some will help later. It's not only the funding and tax... Read more
Finance:
When Should You Apply For PPP Loan Forgiveness?
Keep loan documentation for 6 years, the Small Business Administration instructs. Now th... Read more
Industry Note:
Providers Get Some Breathing Room On Provider Relief Fund Acceptance
Make use of the 45-day extension. Home care providers trying to decide whether they shou... Read more
Industry Note:
RCD Resumption Date Still In Question
According to a May 27 update, North Carolina providers have so far opted to go entirely wi... Read more
Industry Note:
More TPE After Round 3 Codified In PI Manual
Some Targeted Probe and Educate practices have finally been put into print, thanks to a ne... Read more
Industry Note:
Hospice Bottom Lines Are Bottoming Out
Telehealth is helpful, but isn't the answer to hospices' COVID-19-related problems, indica... Read more
Industry Note:
Home Care Reduces Heart Attack Readmissions
A new study presented at the May 15 American Heart Association Quality of Care & Outco... Read more
Quality:
Where Is HH Value-Based Purchasing Headed?
Nationwide adoption of the demonstration could be in the cards. If you didn't have time ... Read more
Industry Note:
Tap CMS Training On GG OASIS Items
Don't neglect training for OASIS ac­curacy, since OASIS items drive both your payment and... Read more
Industry Note:
OSHA Clarifies COVID-19 Work-Relatedness
Check out new enforcement guidance the Occupational Safety and Health Adminis­tration rel... Read more
Industry Note:
OIG Piles On Work Plan Topics, Including Provider Relief Fund Audits
If you think a slowdown in federal com­pliance oversight is in store under the pandemic, ... Read more
Industry Note:
Hospitals Consolidate Home Health Agencies
Four Indiana hospitals are joining forces to furnish home care. Margaret Mary Health ... Read more
Industry Note:
HHS Offers Podcasts
You can keep on top of the Department of Health and Human Services' regulatory, policy, an... Read more
COVID-19:
Clarifications May Help With PPP Loan Forgiveness
Watch out: Change in FTE calculations may hurt. Long-awaited details about how borrowers ... Read more
Finance:
Public Companies Review Q1 In 'Year Of Disruption'
PPE, lower volume cost chains millions. 2020 was already expected to throw home health ... Read more
Reimbursement:
Check Out How COVID-19 Hit Companies' Bottom Lines
Chains managed to stay in the black. In addition to discussing operational and financial... Read more
Compliance:
Encompass Hands Back Provider Relief Funds
‘We know it's not free money,' CEO says. If you're wondering whether you should pocket... Read more
Hospice:
DEA Telehealth Limitation Holds Back Hospice Care
Nix visual requirement, industry experts urge Medicare. Hospices hoping to see flexibili... Read more
Industry Note:
Home Care Aide Faces Criminal Charges After Infecting Client
Client's death led to endangerment charges. A cautionary tale for making sure your staff... Read more
Industry Note:
iQIES MBI Glitch Means You Need To Resubmit Affected Claims
News flash: Not all OASIS matching problems concerning iQIES are due to user error. The p... Read more
Industry Note:
CMS Hands Down More State Waivers
Regulatory flexibility keeps coming. At press time, the Centers for Medicare & Medicai... Read more
Industry Note:
Doc Settles HH Kickback Charges For $450K
A Houston-area physician has paid $450,000 to settle allegations that he falsely signed ho... Read more
Industry Note:
RCD Results Letters Go Electronic
Don't watch the snail mailbox for your Review Choice Demonstration results. “Providers w... Read more
Industry Note:
Regional Chain Buys Arizona Hospices
The Pennant Group Inc. has acquired two affiliated hospice agencies in Arizona, it says in... Read more
Industry Note:
Nonprofit Hospice Support Organizations Join Forces
Two organizations supporting nonprofit hospices and palliative care providers have joined ... Read more
Reimbursement:
LUPAs Are Throwing HHAs For A Loop Under COVID-19
Will rising LUPA rates bring agency closures? Home health agencies knew they'd be grappl... Read more
COVID-19:
Some Surprising Factors Contribute To Spiking LUPAs
Patient refusals and staff shortages top the list. Although an increase in LUPA rates wa... Read more
PDGM:
10 Tips To Fight Needless LUPAs
Pointer: Document your efforts to persuade patients to allow visits. If home health agen... Read more
Education:
School Patients On Your Infection Control Processes
Plus: Remind them home care can keep them out of the hospital, nursing home. Missed visi... Read more
Regulations:
HH Therapists Gain More Freedom In New Waiver
OTs achieve long sought after goal. Medicare officials have knocked down another wall to... Read more
Hospice:
Inpatient Hospice Waivers Added
Hand sanitizer, fire drills, and more addressed. Medicare is lifting more burdens from i... Read more
Finance:
PPP Distribution Schedule Doesn't Leave You Off The Hook
Provider Relief Fund cert details reassure. Many questions continue to swirl about the C... Read more
Industry Note:
New Therapy G Codes On Deck
Codes address maintenance therapy. Get familiar with two new therapy assistant G codes f... Read more
Industry Note:
Take A Peek At Who Received CARES Act Provider Relief Funds — And Just How Much They Got
You can satisfy your curiosity about who in your neighborhood is borrowing CARES Act Provi... Read more
OASIS:
OASIS-E Delayed Until At Least 2022
Hoped-for relief comes through well ahead of time. A big training burden is now off your ... Read more
COVID-19:
CMS Clears The Way For NPP Home Health Orders, Certs
But watch out for state barriers. If you've erred on the side of caution by not acceptin... Read more
Regulations:
Newest Batch Of Waivers Address Aide Duties, QAPI
Pay attention to the makeups you'll need to do when the PHE lifts. Medicare is trying to... Read more
Quality:
VBP Reporting Will Follow QRP Requirements
2020 data won't be good for VBP decision-making. In addition to OASIS-E and NPPs, the ne... Read more
Tax Law:
IRS Knocks Down PPP Tax Benefit
Surprise IRS guidance makes grants less favorable. The complications of COVID-19 funding ... Read more
Finance:
HHS Signals Good News For Provider Relief Fund Payments
Take spending documentation duties seriously. Providers should soon receive official wor... Read more
Cost Reports:
Should You Wait On Cost Report Filing?
Don't automatically opt for later deadline. Deadline relief from the Medicare program is... Read more
Industry Note:
Hospital Outpatient Dept. May Block Your HH Episode
New codes bound to impact reimbursement. It's not just other home health or hospice agen... Read more
Industry Note:
COVID-19 Survey: LUPAs Have Doubled For Majority Of HHAs
COVID-19 is hitting home health agencies hard, indicates a new survey with 1,119 agencies ... Read more
Industry Note:
CMS To SNFs: Let Hospice, HH Workers In
Home health and hospice workers struggling to gain access to patients in skilled nursing f... Read more
Industry Note:
Multi-Factor Authentication On Hold For PECOS, NPPES, And I&A
One administrative task is off your plate, at least for now.“In an effort to reduce prov... Read more
COVID-19:
Keep On Top Of Rapid COVID-19 Funding Changes
Already complex coronavirus funding gets even more confusing by the day. If you're just g... Read more
Finance:
Watch Out: Provider Relief Fund Takebacks May Loom
Second-wave COVID-19 funding leaves home, hospice care all wet. The unveiling of the seco... Read more
Reimbursement:
Accelerated Pay Off The Table
Keep up with CMS' funding course correction. The lesson to be learned from COVID-19 fund... Read more
Budget:
More Relief Funding Goes To Rural, High-Impact Areas
Home care misses out in announced CARES Act funding, but more relief targets may await. ... Read more
Strategy:
Which Funding Source Is Right For You?
Beware the CARES Act conditions. With new COVID-19 funding available via the replenished... Read more
Compliance:
Struggle To Access Patients In Facilities Continues
CMS can't do much for non-Medicare facilities. Home care providers are facing a wide arr... Read more
Fraud & Abuse:
OIG Says You Can Provide Staff To SNFs For Free
Be careful: You must meet the requirements for COVID-19 impact. If you're looking for a ... Read more
Hospice:
Prevent Drug Diversion With GAO's Recommendations
Consider having patients, caregivers sign drug forms? While COVID-19 is taking up hospic... Read more
Industry Note:
Amedisys To Fork Over $235 Million For Aseracare
Chain's hospice locations will grow to 190 in 35 states. National chain Amedisys Inc. is... Read more
Industry Note:
Beware Recoding Glitch Under PDGM
One more set of mysterious claims adjustments under PDGM is now explained. Problem: “Me... Read more
Industry Note:
Will FQHCs Encroach On HHA Territory?
COVID-19 may make for strange bed-fellows. For example, Federally Qualified Health Centers... Read more
Industry Note:
Billing Boosts In Effect
Don't forget some of the billing help you're getting during the novel coronavirus pandemic... Read more
Industry Note:
Texas Chain Grows With Hospice Buy
Amedisys isn't the only company building its hospice presence in Texas. Choice Homeca... Read more
COVID-19:
Make A Judgement Call On NPP Orders
CMS document says NPP orders are OK, but where are the regs? Medicare has provided home ... Read more
Compliance:
Untangle F2F Guidance For Telehealth, NPPs
Watch out: Make sure physician encounters include both audio and visual components. With ... Read more
OASIS:
HHAs, Hospices Need More To Fight COVID-19
From lifting OASIS matching edits to prioritizing in-home workers for PPE, help is falling... Read more
Hospice:
Rule Reveals More Hospice Election Addendum Details
Check out Medicare's new model forms. Hospices would love for Medicare to put off the new... Read more
Regulations:
Model Forms Have These Problems
Do the forms need both related and unrelated diagnoses listed? In conjunction with its 20... Read more
COVID-19:
PPE For Home Care Workers Grabs Headlines Nationwide
Franchisor launches website to help home care agencies procure PPE. Home health, privat... Read more
Industry Note:
Ohio HHAs Can Enter RCD Choices For Next Phase
Cycle 1 ended March 30. Medicare still has the Review Choice Demonstration on “pause”... Read more
Industry Note:
Find Out How Much Medicare Will Pay MA Plans For Hospice
Hospices can get some clues about reimbursement for the Medicare Advantage carve-in, but n... Read more
Industry Note:
CDC Revises Return To Work Guidance — Again
If you're trying to nail down your policies and procedures for staff returning to work aft... Read more
Industry Note:
MAC Offers New PDGM Tool
For agencies continuing to struggle with mastering the Patient-Driven Groupings Model at t... Read more
Industry Note:
TPE Resumption Date Remains Cloudy
If you're wondering when Targeted Probe & Educate medical review will resume, you're n... Read more
Industry Note:
Hospital-Based Agency Undergoes Change
A home health agency formerly owned by multiple hospitals in Ohio has changed its name. H... Read more
COVID-19:
Keep 3 COVID-19 Funding Sources Straight
Critical: Know which ones require repayment, and which ones don't. Home health and hospi... Read more
Finance:
Watch Out For Hidden Strings In 'No Strings Attached' Relief
Recording and reporting requirements under CARES Act money are significant. The feds' qu... Read more
Compliance:
Follow These 8 Tips To Boost Your Financial Health With New Funding Programs
Don't forget the crucial last step to keep your CARES Act relief money. Whether you're ... Read more
Reimbursement:
Here's How New Relief Fund Payments Work
If you haven't seen a payment yet, it may still be on its way. Many home health and hosp... Read more
Hospice:
Should CMS Delay Election Statement Addendum Again?
Medicare proposes 2.6% hospice pay increase. At 19 pages, the newest hospice payment up... Read more
Regulations:
CMS Grants More Waivers For COVID-19
OT, nurses, aides affected. Home health and hospice agencies are getting a bit more regu... Read more
Industry Note:
CMS Nails Down Waiver Dates For Quality Data Reporting
Waiver extends through end of June — not Sept. The Centers for Medicare & Medicaid... Read more
Industry Note:
Advise Your Patients To Be On The Lookout For New COVID-19 Scams From Fraudsters
Keep tabs on how the HHS Office of Inspector General is dealing with COVID-19 issues on it... Read more
Legislation:
NPPs Can Order Home Health Permanently
Plus: CARES Act lifts 2% sequestration reduction. The COVID-19 pandemic is terrible on ma... Read more
Telehealth:
Home Health Telehealth Doesn't Go Far Enough
Agencies need direct payment for telehealth visits. Home health agencies are grateful tha... Read more
Eligibility:
Looser Homebound Definition Aims To Increase HH Access
Docs must certify medical contraindications. Medicare is allowing home health agencies to... Read more
Medical Review:
HHAs, Hospices Get Medical Review Reprieve Amid COVID-19
RCD is paused. The medical world under the novel coronavirus contains many things provide... Read more
Regulations:
OASIS Extensions Among List of HH Relief Measures
Warning: Don't confuse initial assessment with start of care. Home health agencies need m... Read more
Reimbursement:
Accelerated Payments May Cure PDGM Billing Woes — For Now
This is not free money, industry veteran stresses. If you've been worrying about how to... Read more
Accelerated Payments:
Follow 5 Steps For Accelerated Payment Applications
The sooner you submit an application, the faster your payment will come, experts predict.... Read more
Finance:
SBA Ramps Up CARES Act Loans
Apply for a PPP loan before the funds are all gone. If accelerated payments aren't a good... Read more
Hospice:
Medicare Liberalizes Telehealth For Hospice
RHC telehealth visits must be on the plan of care. Hospices feeling left out of Medicare'... Read more
Regulations:
Hospice Waivers Lighten Regulatory Load
Areas from volunteers to aide supervision affected. In addition to telehealth-related reg... Read more
Labor Law:
Home Care Providers Are Exempt From Expanded Sick, FMLA Leave
FFCRA still may apply to some workers, though. Home health and hospice providers have bee... Read more
Industry Note:
Grouper Update Includes COVID-19 Diagnosis Code
Vaping code is in there too. The home health Patient-Driven Groupings Model grouper will ... Read more
Industry Note:
Most States Are Using Emergency Waivers
The vast majority of states, 41 at press time, now have Section 1135 waivers approved to ... Read more
Industry Note:
Labs Get HH Code
You can pass on new billing information to your clinical diagnostic lab partners for COVID... Read more
Industry Note:
Use Electronic Appeals
Snail mail appeals will slow your decisions even more than normal under the coronavirus. Q... Read more
COVID-19:
Medicare Allows F2F Via Expanded Telehealth Visits
FaceTime, Skype are OK for F2F encounters now. Home health agencies and hospices are unde... Read more
Regulations:
Feds Give Home Care A Break On Surveys, Cost Reports, More
Plus: Enrollment liberalization may help access. Home health and hospice agencies have a... Read more
Operations:
Operations PPE, Staffing Top Home Care Concerns In Face Of COVID-19
Warning: Sick, FMLA leave legislative changes could pack a wallop. The problems the 2019... Read more
Emergencies:
Follow These Steps To Tackle COVID-19 Trouble Spots Head On
Will your QA staff step in to fill direct care spots? Home care providers are all in the... Read more
OASIS:
Reserve Time For OASIS-E In Your Schedule
Keep an eye out for a possible delay. It may be hard to look past the current pandemic, ... Read more
Industry Note:
Next Home Health Compare Refresh Date Bumped To October
The next refresh won't be until October. Medicare has pushed off its next Home Health Co... Read more
Industry Note:
Review Your Hospice Item Set, CAHPS Data Preview Reports Before It's Too Late
In contrast to HHAs, hospices have until April 13 to review their preview reports for thei... Read more
Industry Note:
No Joke: CDC Makes 'Unprecedented' Move To Activate New COVID-19 Diagnosis Code April 1
If you are treating patients for COVID-19, there's a new diagnosis code to use as of April... Read more
Industry Note:
PACE Organizations Can Use Telehealth Too, New CMS Guidance Says
PACE Organizations are the latest provider group to get COVID-19 guidance from CMS. A thre... Read more
Emergency Preparedness:
HHAs, Hospices Brace For COVID-19 Impact
Staff shortage looms on the horizon. Home health and hospice agencies that aren't anywh... Read more
Compliance:
Medicare's HH, Hospice COVID-19 Guidance Takes Away 1 Worry
CMS: Nursing homes should admit hospice staff. Providers have a big job ahead of them t... Read more
Tools:
Use These 4 Indicators To Screen Patients For COVID-19
Beware: COVID-19 signs can be confused with the ordinary flu. Medicare is offering a hel... Read more
Regulations:
Follow This Guidance To Decide Which Staff Can't Work
Even staff without symptoms may be affected. Not sure how to determine who should come t... Read more
Review Choice Demonstration:
Texas HHAs Start RCD Mostly With Pre-Pay Review
Where are RCD's affirmation rates? Texas home health agencies did a little better than ... Read more
Industry News:
TPE Focuses On Hospice Topics
MAC zeroes in on site of service for RHC. Medical reviewers seem to have plenty of hospi... Read more
Industry News:
Program Integrity Manual Update Heads Off Double Recoveries
A new Medicare Program Integrity Manual update should reduce potential double whammies on ... Read more
Industry News:
Contact Your MAC With This Info If OASIS Matching Denials Continue To Bedevil Your Correct Files
Medicare has resolved nearly all the problems listed on its iQIES known issues list at htt... Read more
Industry News:
Prosecutors Zero In On Hospice Kickbacks
Aggressive marketing goals are partly to blame for a hospice's $1.75 million fraud settlem... Read more
Industry News:
CMS To Clarify MA Hospice Carve-In Details
If you want to learn more about the Value-Based Insurance Design (VBID) Model's hospice ca... Read more
Reimbursement:
Watch Out: New Cost Report Requirement May Lead To Lower Pay Rates
Don't be surprised at how CMS and MedPAC use your hourly wage data. You'd better take you... Read more
Payment:
Take 3 Steps To Stave Off Rate Reductions Based On Cost Reports
Don't expect major — or any — changes. You can mitigate or maybe even prevent rebala... Read more
Finance:
Retroactive Cost Report Changes May Leave HHAs Scrambling
Cost report year for some will be almost over by the time the new form and instructions ar... Read more
Enrollment:
Look Out for Enrollment Threat Hiding In Plain Sight
New requirements will cut billions in Medicare spending. With PDGM, RCD, payment level ... Read more
Medical Review:
MAC Discrepancies Continue In TPE Denial Rates
Face-to-face continues to be a killer. Round 3 of the Targeted Probe and Educate medical... Read more
Industry News:
Beware CMS 'Helping' You
Agency frames iQIES transition and adding PoC requirements as ways they are helping HHAs. ... Read more
Industry News:
Get A First Look At Medicare Advantage Hospice Payment Rates
Medicare has shared more details about payment for the Medicare Advantage hospice carve-in... Read more
Industry News:
Enrollment Picks Up The PACE In California
PACE enrollment in California continues to grow. “Enrollment in the Program of All-incl... Read more
Industry News:
Consult Updated Medicare Resource For Hospice Item Set Details
Brush up on Hospice Item Set deadlines with a revised fact sheet from Medicare. Reminder:... Read more
Industry News:
Hospital, Freestanding Hospice Plan Inpatient Facilities
Hospice facilities continue to open across the nation. In Ohio: Aultman Alliance Communit... Read more
Industry News:
Nonprofit Hospice Buys Assisted Living Facility
In Minnesota, Prairie Home Hospice & Community Care in Marshall has signed an agreemen... Read more
Patient-Driven Groupings Model:
OASIS Matching Problems Dog PDGM Claims
Refer matching errors with 2020 ‘From' dates to your MACs. As more and more final clai... Read more
Assessment:
Hospices Get Ready To Put HOPE To The Test
Plus: New Hospice Compare data is up. Hospices planning to field test the new Medicare a... Read more
Hospice:
As You Submit Cap Reports, Keep Wary Eye On The Future
Don't forget you can have a reopening based on your reopening. On the eve of Medicare's ... Read more
Emergency Preparedness:
Focus On These Common EP Trouble Spots
Don't neglect the after-action review. The recent lightening of providers' emergency pre... Read more
Reimbursement:
Know How To Use DR Condition Code
Disaster billing code no longer discretionary, Medicare points out. Don't ignore the bil... Read more
Industry Note:
Texas, Illinois Top CERT Error Rates In Jurisdiction M
Face-to-face continues to be a challenge. One of the states with the highest payment err... Read more
Industry Note:
Go Back To Handwashing Basics
With the CDC banging the drum about the coronavirus threat, now may be a good time to use ... Read more
Industry Note:
ICU Discharges Need More HH Therapy, Yale Researchers Say
Ironically, a new study encourages more home health therapy visits for patients discharged... Read more
Industry Note:
VA Plans To Use More Home Care
The Veterans Administration will increasingly look to home care to serve veterans' long-te... Read more
Industry Note:
The More Billing Changes, The More Billing Mistakes Stay The Same
While home health agencies' reimbursement framework may have changed drastically on Jan.1 ... Read more
Industry Note:
CMS Chokes Off RAP Cash Flow
Medicare appears to be eliminating RAPs for as many home health agencies as it can as quic... Read more
Industry Note:
Get More Appeals Demo Info
Want to learn more about the Qualified Independent Contractor (QIC) Telephone Discussion a... Read more
Industry Note:
Joint Replacement Bundling Demo To Go 3 More Years
If you were looking forward to the end of the Comprehensive Care for Joint Replacement (CJ... Read more
Patient-Driven Groupings Model:
Follow These 12 Tips For PDGM Success
Your PDGM training has only just begun. You might feel like your world has been turned u... Read more
Diagnosis Coding:
Sidestep PDGM Diagnosis Coding Pitfalls With Updated Processes
Make sure your staff know how to query physicians for coding specifics. An inaccurate di... Read more
Reimbursement:
Rein In Unnecessary LUPAs Or Risk Your Bottom Line
Pointer: Consider how visit management affects outcomes. To ensure adequate reimbursemen... Read more
Finance:
Make No Mistake, PDGM Is Closing Agency Doors
PDGM to create a buyers' market. It's still early days for the Patient-Driven Groupings ... Read more
Fraud & Abuse:
HH, Hospice Kickbacks Feature In Latest Fraud Cases
One former owner draws 5-year prison term. You don't have to be the mastermind of a home... Read more
Industry Note:
HHH MAC Moves Up Self-Reported Hospice Cap Schedule
Sequestration will figure into your cap liability sooner. With hospices' cap self-report... Read more
Industry Note:
U.S. Senators Urge CMS To Lay Off Indiscriminate Home Health Cuts
U.S. Senators have home health agencies' backs when it comes to PDGM and other detrimental... Read more
Industry Note:
Private Equity-Backed Hospice Chain Makes Acquisition
Hospice Care of South Carolina in Spartanburg has acquired Agape Hospice for an undisclose... Read more
Industry Note:
VNA Branches Out Into Hospice After Operating More Than A Century
Brockton Visiting Nurse Association in Massachusetts is expanding its hospice program, it ... Read more
Industry Note:
Oklahoma HH, Hospice Agencies Merge
Accentra Home Healthcare in Oklahoma has merged with Hometown Home Health and Sooner Hospi... Read more
Patient-Driven Groupings Model:
These Top Problems Menace HHAs Under PDGM
Wake up to revenue changes before it's too late. If you feel like you're facing a pletho... Read more
Documentation:
HHAs Grapple With Admission Source Details
What counts as institutional — and what doesn't? One of the many new items that influe... Read more
Therapy:
You've Been Warned: CMS Signals A Therapy Crackdown
What does your utilization data say about you? Home health agencies struggling to stay a... Read more
Compliance:
Follow These Steps To Manage Therapy Under PDGM
You aren't stuck with your therapy utilization. A new warning against cutting therapy vi... Read more
Industry Note:
Trump Budget Pushes PAC PPS
Hospice cuts for SNF RHC rates also proposed. While politicians argue over what the defi... Read more
Industry Note:
Lawmakers Propose Hospice Legislation In Wake Of Critical OIG Reports
A bill that would increase hospice survey frequency is working its way through Congress. T... Read more
Industry Note:
CMS Tells Surveyors To Put New Emphasis On Infection Control In Light Of Coronavirus Threat
Home care providers should always comply with infection control practices, but the emergen... Read more
Industry Note:
Get Hospice Item Data Set Basics In New Webinar From Medicare
You can now sign up for a March 3 webinar reviewing Hospice Item Set (HIS) Data Submission... Read more
Industry Note:
Texas HHA Coughs Up Nearly $60K In Settlement With OIG
A new settlement with the HHS Office of Inspector General may remind providers of why chec... Read more
Industry Note:
HH Grouper Loads New Vaping Diagnosis Code
The Home Health Grouper will accept a new diagnosis code related to vaping starting April ... Read more
PDGM:
How Does Primary Diagnosis Affect OASIS Referral Date Under PDGM?
A new OASIS Q&A tries to tackle that issue, but questions remain. The importance of o... Read more
OASIS:
Look For iQIES Workarounds Here
Open issues outnumber resolved ones so far. Home health agencies frustrated by being in t... Read more
Emergency Preparedness:
Don't Overlook These Time-Saving Emergency Preparedness Changes
You can scale back testing, review time frames. Are you making the most of Emergency Prep... Read more
Compliance:
Use Loosened EP Requirements Wisely
Update whenever you experience an emergency event, no matter what the regs say. While a r... Read more
Quality:
Prepare For Major Compare Website Revamp
CMS needs to fix Compare problems, despite the format, reps say. How potential referral s... Read more
Industry Note:
HHVBP Saves Medicare Money
But it also increases ER use. If you are wondering whether Medicare will take Home Health... Read more
Industry Note:
MAC Fixes Glitch
If some of your claims are being adjusted but have maintained the same payment rate, they ... Read more
Industry Note:
Do Your Homework When MBIs Reject
Do you have a claim rejecting due to an incorrect MBI? Then you need to do a little resear... Read more
Industry Note:
Your RCD Results Are Now At Your Fingertips
Home health agencies under the Review Choice Demonstration now have a new tool to help the... Read more
Industry Note:
Review Upcoming SPADE Requirements In New Web Education Sessions
You can learn about upcoming changes to Post-Acute Care Quality Reporting Programs, includ... Read more
Industry Note:
MAC Pauses TPE Edit To Target More Carefully
Hospices served by one HHH Medicare Administrative Contractor are getting a break from som... Read more
Industry Note:
New Medicare Fact Sheet Educates On Reporting Hospice Abuse, Neglect
Reports of abuse and neglect of hospice patients may increase following Medicare's issuanc... Read more
Industry Note:
Mega-Merger Off For 2 HH Companies
Aveanna Healthcare's acquisition of Maxim Healthcare Services' home health division is off... Read more
Review Choice Demonstration:
Overwhelming Majority Of Texas HHAs Are Opting For RCD Pre-Claim Review
More than a third of Texas agencies have entered their RCD choice so far. Pre-Claim Revi... Read more
Medical Review:
Know Your Affirmation From Your Approval Rate
Approval rates are tougher. Under the Review Choice Demonstration, choosing the Pre-Clai... Read more
Demonstration Projects:
New Year Has Brought New RCD Developments
Here's how results calculation works. Some Illinois agencies were placed in the wrong re... Read more
Reimbursement:
iQIES Problems Persist
Keep a record of your failed OASIS submission attempts, NAHC advises. While it's still t... Read more
OASIS:
Change How You Answer M2420 Effective Immediately
Response 2 now applies only to Medicare home health skilled services. Add another OASIS ... Read more
Industry Note:
OIG To Eye IRF Discharges To Home Health
Will examination lead to drop in IRF referrals? Another home health-related topic has la... Read more
Industry Note:
MedPAC Wants Cuts
As expected, the Medicare Payment Advisory Commission has finalized its recommen­dations ... Read more
Industry Note:
Beware This Hospice Billing Trap
Do you know how to bill for a day when a patient changes hospice care levels on that day? ... Read more
Industry Note:
CMS Quality Conference Is Next Month
If you'd like to join in the Centers for Medicare & Medicaid Services' quality improve... Read more
Industry Note:
CMS Bungles Some MBIs
Medicare's conversion to using MBIs rather than HICNs has been pretty smooth, but hasn't g... Read more
Industry Note:
MAC To Docs: Get Your HH Coding Together
Do you need help getting your referring physicians to provide the documentation necessary ... Read more
Industry Note:
Include IDG Support
Don't leave out Interdisciplinary Group documentation when you respond to a hospice medica... Read more
Industry Note:
Hospice Notifies Families About HIPAA Breach
Instead of electronic files, it's hard copy paper files that have led Hospice of Anchorage... Read more
Industry Note:
Hospice Adds To Name
Another hospice is tweaking its name to indicate its wide array of services. Last fall, Ca... Read more
Industry Note:
Hospice Builds Facility
Nonprofit hospice provider Pathways plans to build a 12-patient inpatient hospice facility... Read more
Industry Note:
Supervisor Pleads Guilty
A home health supervisor has pleaded guilty to Medicaid fraud in the ongoing Moriarty Cons... Read more
Industry Note:
NPR Criticizes Hospice
Mainstream media is taking another swipe at hospice. “Patients Want To Die At Home, But ... Read more
Review Choice Demonstration:
Upload RCD Documentation Only Once For 2 Billing Periods
Warning: Separate submission will mean duplicate documentation process. The Review Choic... Read more
Reimbursement:
Illinois HHAs Bail Out Of RCD Post-Pay Review In Droves
About 25 percent of the nation's agencies will eventually be under RCD. If you're one of... Read more
Patient-Driven Groupings Model:
iQIES Problems Stall HHAs' PDGM Engine
OASIS submission difficulties are putting home health reimbursement in jeopardy. Another... Read more
Oversight:
Use AI Knowledge To Understand How You're Being Targeted For Review
Knowing the basics is the first step. Artificial intelligence continues to dominate the ... Read more
Make The Most Of Your Eli's Home Care Week Subscription
You have more than 15 years' worth of information on a multitude of home health and hospic... Read more
Industry News:
More Home Care Discharges Saved Medicare Money
Shifting hospital discharges from facilities to home care helped shave $17 million off Med... Read more
Industry News:
Death Doesn't Stop MBI Lookup
You can still look up a patient's MBI, even if that patient has expired. So says HHH Medic... Read more
Industry News:
Beware This Top Claims Denial Cause
If the reason for a patient's General Inpatient (GIP) stay is not related to the patient's... Read more
Industry News:
What Comes After TPE Round 3?
If you fail three rounds of Targeted Probe & Educate review, the Centers for Medicare ... Read more
Industry News:
New Year, New Therapy Cap Amount
The threshold formerly known as the outpatient therapy cap has increased for this year. R... Read more
Industry News:
Check Out These Updated Hospice Education Tools
Medicare has updated two of its hospice education tools. Access the revised 12-page Hospic... Read more
Industry News:
Health System-Owned Chain Sells
Nonprofit Advanced Home Care has agreed to sell the its home health, specialty pharmacy, a... Read more
Industry News:
5-State Hospice Chain Expands Again
St. Croix Hospice has opened a location in Grand Rapids, Minnesota, the Oakdale, Minnesota... Read more
Industry News:
Health System Sells HH, Hospice Units For $350K
Graham Regional Medical Center has agreed to sell its home health and hospice department t... Read more
Industry News:
Stark Law Charges Leveled In Chicago
A physician and his home health agency-owning siblings are facing fraud charges not often ... Read more
Industry News:
Heed This Encryption Cautionary Tale
If you're unsure whether you should spend the time, resources, and effort encrypting your ... Read more
OASIS:
iQIES Glitches Compromise HHAs' Billing, CoP Compliance
Providers frustrated with lack of transparency. It will be another week or two before ma... Read more
PDGM:
PDGM RAPs Should Pay Soon — Just Not Very Much
HIPPS codes are the sticking point. The unusual payment hold on RAPs should let up withi... Read more
Regulations:
Texas HHAs March Toward RCD Implementation
Alert: Check out 10 new RCD Q&As on PDGM. With hundreds of more HHAs going under the ... Read more
Regulations:
Stay Abreast Of VBID Developments
Plus: HOPE tool, HIS benchmark addressed in forum. Medicare is pushing its Medicare Adva... Read more
Hospice:
Cap Reporting Deadline Slides To March
Tip: Gather your PS&R info as quickly as you can. The hospice cap self-reporting dea... Read more
Mergers & Acquisitions:
Hospice Deals Dominate Year End
Chains focus on hospice development. Home care and hospice companies didn't take a holid... Read more
Industry Note:
Blue Button 2.0 Bug Put PHI At Risk
BB2.0 apps were sharing beneficiaries' info. A coding bug in Medicare's Blue Button 2.0 ... Read more
Industry Note:
MAC Targets These Topics In Latest Medical Review
If you feel like hospice medical review is stepping up in intensity, you may be right. HHH... Read more
Industry Note:
Boost PDGM Billing With These Aids
If the timing of PDGM billing is tripping you up, some new tools from one HHH Medicare Adm... Read more
Industry Note:
Get Ready For These New Quality Measures
New quality measures are on the horizon — some closer and some farther away. Closer mea... Read more
Industry Note:
Survey Changes Take Aim At Subjectivity
Get ready for new survey procedures this year. Guidance the Centers for Medicare & Med... Read more
Industry Note:
Peruse HIT Details
If the details of Medicare's new Home Infusion Therapy benefit are still fuzzy, a recently... Read more
Industry Note:
Appeals Demo Available
Would information on why Medicare is denying your claims help you improve in the future? I... Read more
Industry Note:
MA = Lower Quality
More information about the Direct Contracting payment model is coming up. Reminder: Unde... Read more
Industry Note:
Mind Disclosable Events
Even with everything else on your plate in 2020, you can't afford to slack off on recordin... Read more
Industry Note:
Check F2F Documentation For This Must
Don't overlook a common reason for claims denials, especially with cash flow so critical u... Read more
Industry Note:
Providers Go Beyond Hospice — As Do Their Names
More hospices are continuing the trend of changing their names to reflect a broader range ... Read more
Fraud & Abuse:
HH Payment Error Rate Continues To Plummet
Hospice error rate falls, too. Medicare has just handed home health agencies ammunition ... Read more
Audits:
OIG Wants Hospital-Based HHA To Pay Back $680K
Don't ignore any ‘credible information' on potential overpayments, the feds warn. If y... Read more
Medical Review:
OIG Docks Nonprofit HHA For These Patients
Watch out: Refusing therapy may make your patient ineligible for home care at all, recent ... Read more
Hospice:
New MA Hospice Carve-In Fails To Allay Industry Fears
Will managed care plans diminish hospice services? Hospices are getting a first look at ... Read more
HIPAA:
New Year Should Bring New HIPAA Emphasis
Follow these 7 pointers to get into good HIPAA shape this year. If you want to avoid fin... Read more
Industry Note:
Check Out Latest RCD-PDGM Clarification
Update confirms doubling of RCD workload. Home health agencies in Review Choice Demonstr... Read more
Industry Note:
Explore MA Options That May Loosen Requirements
You can find out more about Medicare's Direct Contracting Model in two upcoming educationa... Read more
Industry Note:
Preview Window Closes Soon
Don't miss an advance look at your new Home Health Compare data. Home health agencies can ... Read more
Industry Note:
Hospice Assessment Tool Gets Closer To Implementation
If you've applied to “alpha test” Medi- care's new Hospice Outcomes & Patient Eval... Read more
Industry Note:
Give CMS Your Tips On Lightening Supervision
Medicare wants your two cents on lifting regulatory burden related to supervision. “In ... Read more
Industry Note:
Avoid Exclusion Crises With New Tutorial
Don't lose your rightful reimbursement by accidentally hiring an individual excluded from ... Read more
Industry Note:
Consult Hospice 1-Pager
Review the basics of Medicare's Hospice Comprehensive Assessment Measure with a recently p... Read more
Industry Note:
Have You Completed This QIO Requirement?
Don't let more time slip by without completing the Memorandum of Agreement with your Benef... Read more
Industry Note:
Check This Checklist
Making sure your claims are adequately documented is more important than ever before under... Read more
Industry Note:
Boost Doc Education With New CMS Video
Whether you're trying to educate your own staff, or the providers and their staff who refe... Read more
Industry Note:
Hospice Head Pleads Guilty
A New Orleans hospice administrator has pleaded guilty to falsifying records in connection... Read more
Industry Note:
HH Fraud Funds Cosmetic Procedures In FL
A vast Medicare fraud conspiracy in South Florida has resulted in lengthy prison sentences... Read more
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