Home Health & Hospice Week

Outlier payments, nursing home-hospice interactions could raise red flags. If you receive more outlier payments than average, you may soon be in the hot seat. The HHS Office of Inspector General advises the Centers for Medicare & Medicaid Services to "review home health providers that exhibit aberrant outlier payment patterns," according to the OIG's new Compendium of Unimplemented Recommendations. That's despite CMS putting a 10 percent cap on HHA outlier payments last year. "CMS reported that its Miami Field Office implemented a new Fraud Prevention and Early Abatement approach to home health care that focused on performing data analysis and beneficiary interviews for those highly suspect new home health providers," the report says. Meanwhile: Expect a proposed rule this fall that "will require unannounced and extended surveys of HHAs, and the imposition of sanctions when HHAs are found to be out of compliance with the Federal standards," the report says. [...]