Home Health & Hospice Week
HHS Moves Patient Appeals To Front Of ALJ Line
Your claims appeals may be put on hold for two years if you want an ALJ hearing, but your patients’ won’t be.
The HHS Office of Medicare Hearings and Appeals is putting providers’ requests for ALJ hearings on a two-year wait list (see Eli’s HCW, Vol. XXIII, No. 3). But "the relatively small numbers of beneficiary-initiated appeals are being immediately addressed by prioritizing their cases," OMHA says in a notice published in the Jan. 3 Federal Register. "Because they are among our nation’s most vulnerable populations, OMHA is committed to being as responsive as possible to the Medicare beneficiary community, regardless of the challenges presented by the significant increase in the number of requests being filed," OMHA Chief Judge Nancy Griswold told the Washington Post. "Beneficiary appeals continue to be assigned as quickly as OMHA can process them, and processing times for beneficiary appeals are expected to decrease."
Traditional Medicare appeals have in-creased due to factors including the increase in the number of beneficiaries. There are also more ap-peals caused by Recovery Audit Contractor (RAC) review and Part D drug coverage. These increases have maxed out OMHA’s resources, the office says. From 2010 to 2013, OMHA’s caseload grew by nearly 185 percent while the office’s resources stayed the same.
Home Health & Hospice Week
- Audits:
RACs Launch New Home Care Reviews This Month
Medical necessity, long stays top Recovery Audit Contractors’ new hit lists. Home health agencies’ heavy [...] - Diagnosis Coding:
Use 3 Coding Questions To Bolster Medical Necessity
Beware of recycling diagnoses for recertifications. RACs and other Medicare contractors are zeroing in on [...] - Medical Review:
Get Up To Speed On These RAC FAQs
Undergoing one RAC audit doesn’t mean you won’t get hit with another for the same [...] - Therapy:
High Therapy May Land You On MAC's Radar
Check these claims to make sure you can back up your patients’ therapy visits and [...] - Reimbursement:
MedPAC Finalizes Rate Cut Recommendations For Home Health, Hospice
Influential advisory body continues its pressure to implement a home health copay. Your uphill battle [...] - Industry Note:
LUPA Hold Throws Agencies For A Loop
Hold may affect more than LUPA claims. A new claims system glitch is slowing home [...] - Industry Note:
Therapy Cap Exception Process Expires In 2 Months
For home care providers furnishing Part B therapy in the home, you’ve got a bit [...] - Industry Note:
New Education Tool Explains F2F To Physicians
CMS is offering you a helping hand to get docs on board with face-to-face encounter [...] - Industry Note:
HHS Moves Patient Appeals To Front Of ALJ Line
Your claims appeals may be put on hold for two years if you want an [...] - Industry Note:
Rogue Employee Causes Major HIPAA Violation
If you don’t have a good handle on what your employees are up to with [...] - Industry Note:
Joint Commission Revises Home Care Requirements
Home health agencies accredited by The Joint Commission will see revised requirements effective next month. [...] - Industry Note:
CMS Podcast Helps Docs With Hospice Billing Basics
You can help out physicians who refer hospice patients to your organization by pointing them [...] - Industry Note:
HHAs Open While Hospice Downsizes
Growth and change continue in the home health and hospice markets. In North Carolina: BAYADA [...] - Industry Note:
2 Veteran Consulting Firms Join Forces
Two industry veterans in home care consulting have joined forces. Simione Healthcare Consultants, founded in [...]
