Home Health & Hospice Week

CMS also discusses new OASIS form, PPS rate cuts, and more at industry conference. Expect medical review scrutiny in some new areas, the Centers for Medicare & Medicaid Services revealed at a recent industry conference. Current problems Medicare medical reviewers are finding include old standbys, with homebound documentation first and foremost. About 43 percent of home health claim denials are for homebound reasons, noted CMS's Latesha Walker at the National Association for Home Care & Hospice's March on Washington conference March 26. Other problems are medical necessity; failure to have a plan of care or physician signature for the POC; and a lack of documentation to support the services billed (for example, therapy visit frequency missing from the POC), Walker said. But medical reviewers will be focusing on two new areas, Walker said. They will examine episodes that barely exceed the low utilization payment adjustment (LUPA) threshold of five visits. [...]