Home Health & Hospice Week
Newspaper Profile Gives Houston HHAs Bad Rap
Meanwhile, HHAs in Houston, Texas are getting a black eye in the press, thanks to a Houston Chronicle article profiling the city's high rate of Medicare spending for HHAs and those agencies' numerous survey deficiencies. The 468 agencies in the Houston area received $1.25 billion in Medicare payments in the past four years, the Chronicle points out. Some of the claims in America's fourth-largest city are the result of "fraudsters" who "bill for services not rendered," U.S. Attorney Justo Mendez told the newspaper. The paper cites HHAs that received up to 32 deficiencies but still receive Medicare dollars. HHAs rebut that they're being overly scrutinized because of fraud in the industry, with nearly every agency getting dinged for infractions that aren't that serious. Agencies singled out for newspaper scrutiny noted that they corrected all their deficiencies. Federal officials in Houston say they are investigating kickback schemes and billing for services not rendered. But "it takes CMS or Medicare to put edits in place to prevent certain types of payouts. It takes education," Elvis McBride, who supervises the FBI's Health Care Fraud Task Force in Houston, told the paper. Industry viewpoint: "I have a problem with the government not watching who is billing what," Anita Bradberry of the Texas Association of Home Care & Hospice told the Chronicle. "It's not that home health is bad. Home health is the solution to a lot of our health care problems."
Home Health & Hospice Week
- Medical Review:
Don't Let Top Denial Reasons Shoot Down Your Claims
Homebound status, lack of skilled need common reasons for denials. If you don't thoroughly understand -- [...] - OASIS:
Use Your OASIS To Pinpoint Medical Review Red Flags
Functional domain scores, diagnosis items can lead reviewers to your weak spots. One way to [...] - Tool:
Know When Your Patients Qualify For Home Care -- And When They Don't
Use this checklist from one HHH MAC to guide your eligibility assessments. Medical review from [...] - Compliance:
Hospices Serving Nursing Home Patients Brace For 2012 Scrutiny
OIG work plan for next year throws spotlight on this care setting. In a report [...] - Prospective Payment System:
Case Mix Changes Take Effect On M0090 Date
The 2.3 percent cut will hit a bit later. Don't expect to have an episode's [...] - Industry Note:
DME Bidding Areas Will Reach 100 By 2013
Bidding registration is now open. Chances are your patients' choice of durable medical equipment suppliers [...] - Industry Note:
Home Health Copay Threat Still Looms
Keep an eye peeled for developments in Washington regarding the so-called "doc fix." Industry members [...] - Industry Note:
Use New ABN Quick Glance Tool To Make ABN Calls
You've got newly revised instructions that go with the home health advance beneficiary notice (HHABN) [...] - Industry Note:
Make Hospice Discharge Code Change Jan. 1
Starting Jan. 1, you shouldn't use occurrence code 42 on your hospice claims when the [...] - Industry Note:
CMS Lifts One F2F Documentation Requirement
Ideally, you shouldn't be seeing any more claims denials when your hospitalized patient's documentation fails [...] - Industry Note:
MA Enrollees Increase
If you feel like your managed care headaches continue to grow, it's likely because Medicare [...] - Industry Note:
Home Health May Dodge Medicaid RACs' Scrutiny
The Medicaid RACs will soon make their debut. "Absent an exception, States will be required [...] - Industry Note:
Note LCD Denial Change
You'll get a little Christmas present from HHH MAC subcontractor National Government Services this month. [...] - Industry Note:
FBI Raids TX Agency
The fraud-fighting hammer appears to be dropping on an Alamo, Texas HHA. Rio Home Care [...] - Industry Note:
Newspaper Profile Gives Houston HHAs Bad Rap
Meanwhile, HHAs in Houston, Texas are getting a black eye in the press, thanks to [...]
