Home Health & Hospice Week
Stark Law Fate Uncertain, CMS Administrator Indicates
Will a decades-long prohibition on physician referrals and ownership get the ax? Home care and other medical care providers have lived with Stark Law restrictions since the 1990s, but don't assume they will last forever. American Hospital Association President and CEO Rick Pollack had Centers for Medicare & Medicaid Services Administrator Seema Verma on an AHA town hall webcast in late January, where they discussed regulations in health care and moving toward a value-based payment system. During the webcast, Verma acknowledged what hospitals and other healthcare entities consider challenges with Stark Law regulations, according to an AHA news release. "I think the Stark Law was developed a long time ago, and given where we're going in terms of modernizing [Medicare] and the payment systems we are now operating under ... we need to bring along some of those regulations," Verma said. Verma added that Congress might have to act to provide full relief from the Stark Law, according to the AHA. In the meantime, of course, providers still must abide by Stark Law regulations. Parts of the Stark Law were enacted in 1989, but in its current form, home health services, durable medical equipment, physical therapy services, parenteral and enteral nutrition, equipment, and supplies, and more are considered designated health services. Reminder: According to CMS's website on Physician Self-Referral, the Stark Law: 1. Prohibits a physician from making referrals for certain designated health services (DHS) payable by Medicare to an entity with which he or she (or an immediate family member) has a financial relationship (ownership, investment, or compensation), unless an exception applies. 2. Prohibits the entity from presenting or causing to be presented claims to Medicare (or billing another individual, entity, or third-party payer) for those referred services. 3. Establishes a number of specific exceptions and grants the Secretary the authority to create regulatory exceptions for financial relationships that do not pose a risk of program or patient abuse. Note: Watch the AHA webcast at http://windrosemedia.com/windstream/aha/011718/.
Home Health & Hospice Week
- OASIS:
Submit Your OASIS-D Suggestions Before It's Too Late
Comment early and often. If you think Medicare needs to change some things about the [...] - Managed Care:
Watch For Business Opportunities As Medicare Allows MA Plans To Cover Aide Services
Key: Help show that aide services will 'reduce avoidable emergency and healthcare utilization.' Exactly how [...] - Regulations:
Stark Law Fate Uncertain, CMS Administrator Indicates
Will a decades-long prohibition on physician referrals and ownership get the ax? Home care and [...] - Medical Review:
Pay Attention To Midstream TPE Education
Improving your billing rate in the middle of a Targeted Probe & Educate round could [...] - Diagnosis Coding:
Stop Using ICD-9 As A Coding Crutch
Remember, you won't get any more GEMs. Question: I often find myself coding ICD-9 in [...] - Industry Note:
MACs Get Marching Orders To Reprocess Rural Add-On Claims
Remember: This is the last year of a full add on under BBA 18. As [...] - Industry Note:
Share These Recert Estimate Tips With Your Docs
Are you risking denials with records that include an insufficient physician recertification estimate - or [...] - Industry Note:
Half Of Docs Spend Less Than A Minute Reviewing 485
A new study by Johns Hopkins University researchers underscores what many home care providers have [...] - Industry Note:
View HIS Coding, HQRP Training At Your Leisure
Help for hospices is now available from Medicare in a number of new educational offerings. [...] - Industry Note:
New Quality Measure Aims To ID Problem Discharges
Now's your chance to comment on a new quality measure Medicare is readying to address [...] - Make The Most Of Your Eli's Home Care Week Subscription
You have 15 years' worth of information on a multitude of home health topics at [...] - Industry Note:
Double-Check Who Is Signing Your Cost Reports
Some newly announced changes for home health agency cost reports may alter how you submit [...] - Industry Note:
Massive Merger Of LHC, Almost Family Complete
Two publicly traded chains, LHC Group Inc. and Almost Family Inc., have completed their merger. [...] - Industry Note:
Private Duty Chain Addus Makes Major Acquisition
Private duty chain Addus HomeCare Corp. has purchased the assets of Arcadia Home Care & [...] - Industry Note:
Updated Hospice PEPPER Reports Out Soon
Get ready for an update to the free benchmarks Medicare provides you through the PEPPER [...]
