Home Health & Hospice Week
Medicare Advantage Plans Scrimp On Care, GAO Says
Home care providers have long contended that Medicare Advantage plans aren’t approving enough home care for beneficiaries, and a new Government Accountability Office report may support that viewpoint. The GAO examined 126 MA contracts with higher disenrollment rates — above the median rate of 10.6 percent in 2014 — and found 35 contracts with “health-biased disenrollment,” the government watchdog says in a new report. The study found that beneficiaries in poor health were on average 47 percent more likely to disenroll relative to beneficiaries in better health. “Such disparities in contract disenrollment by health status may indicate that the needs of beneficiaries, particularly those in poor health, may not be adequately met,” the GAO says in its report summary. “Problems getting needed care” was chosen as the reason for disenrollment by beneficiaries surveyed almost twice as much for high-disenrollment plans versus low-disenrollment plans, says the report at www.gao.gov/products/GAO-17-393. “CMS should review data on disenrollment by health status and the reasons beneficiaries disenroll as part of the agency’s routine monitoring efforts,” the GAO recommends in the report.
Home Health & Hospice Week
- Therapy:
Follow 8 Documentation Tips To Ward Off Therapy Denials
Denials from Palmetto just keep on coming. One HHH Medicare Administrative Contractor has released results [...] - Medical Review:
Your Therapists Should Know These 11 Items Like The Back Of Their Hands
Is your therapy documentation missing any of these elements? HHH Medicare Administrative Contractor Palmetto GBA [...] - Hospice:
Weigh Carefully Decision To Reprocess Hospice Claims
The fault is CMS’s, but the work is yours. Will the work of correcting claims [...] - Fraud & Abuse:
OIG Hammers Home Health Fraud In Semiannual Report
Report revisits $3.1 million hospice settlement. Home health agencies are front and center when it [...] - Industry Note:
Bill Would Reform, Not Replace, Face-To-Face
HHA record would count, too. If you’re looking for relief from the burdensome face-to-face requirement, [...] - Industry Note:
Prevent 38157 Rejections With Some Education
Stop clogging up the Medicare claims payment system with duplicate RAPs, one HHH Medicare Administrative [...] - Industry Note:
Review Hospice Compare Preview Before It's Too Late
You’ve got until June 30 to review your Hospice Compare preview report and request review [...] - Industry Note:
Medicare Advantage Plans Scrimp On Care, GAO Says
Home care providers have long contended that Medicare Advantage plans aren’t approving enough home care [...] - Industry Note:
MCCM Nowhere Near Target Participation Number
The changes the Centers for Medicare & Medicaid Services has made to the hospice concurrent [...] - Industry Note:
Medicare Shows Its Zeal For Bundling Programs
Home care providers may have heaved a sigh of relief at the three-month delay to [...] - Industry Note:
Prepare Now For Beneficiaries' SSN-Free Medicare Cards
The April 2018 start date for use of Medicare cards with no Social Security Numbers on [...] - Industry Note:
CMS Proposes Extension For HQRP Exception Deadline
The hospice payment proposed rule for 2018 includes new duties and burdens for hospices (see [...]
