Editor’s Picks: Pre-Claim Delays and Woes

It’s been a big week for the home health Pre-Claim Review Demonstration. The poorly-received program made several Home Health Care News headlines, first with its delayed start in Florida, and then due to home health providers still calling for the program’s total suspension everywhere. Meanwhile, the Department of Health and Human Services Office of Inspector General (OIG) bestowed the largest-ever corporate integrity agreement (CIA) penalty against Kindred Healthcare, Inc. (NYSE: KND), and home health organizations are working overtime to push legislation in Washington D.C.

Here’s a recap of this week’s most-read news stories on HHCN:

Most Read

Pre-Claim Review Delayed Ahead of Florida Start Date—Amid reports that the rollout of the Pre-Claim Review Demonstration in Illinois led to a “complete mess,” the Centers for Medicare & Medicaid Services (CMS) will delay the start date in Florida by at least 30 days, the agency has announced. The decision comes as industry groups, home health care companies and two U.S. Senators have spoken out against the demonstration.

OIG Smacks Kindred with Largest-Ever Penalty of Its Kind—The country’s largest provider of post-acute care, Louisville-based Kindred Healthcare, Inc., has paid a penalty of nearly $3.1 million after failing to comply with a corporate integrity agreement (CIA) it signed with the federal government. The penalty came after Kindred failed to correct improper billing practices in the fourth year of the five-year agreement.

Agencies Remain ‘Desperate’ Over Pre-Claim Despite Delayed Rollout—Having won a victory in their fight against the pre-claim review demonstration, home health providers and advocacy groups are calling for it to be suspended totally—while continuing to decry it as a historically bad program that threatens to drive a large number of agencies out of business. “I was sweating bullets until the moment [I learned of the delay],” a home health provider told HHCN at Tuesday’s Homecare Homebase summit in Chicago. “How can you decide to delay in Florida because it’s not working, but still keep Illinois involved?” a different attendee asked.

‘Full-Court Press’ Underway to Get Home Health Bills Passed—A “full-court press” is on to push forward home health legislation in Washington D.C., to better enable home health care businesses to provide care and meet compliance requirements. The National Association for Home Care & Hospice (NAHC) is one group heavily involved at the forefront of the press.

Weekend Read

My sister made her end-of-life wishes clear. Then dementia took hold—Before she was diagnosed with frontotemporal dementia at age 56, Deborah had expressed her end-of-life wishes to her family—and had made it clear she wanted to age at home through the end of her life. Then, when the dementia changed her personality, her family had to figure out what Deborah “was really feeling, what she really wanted, in her altered state.” They ended up moving her into a memory care community, where Deborah seemed truly happy, high-fiving staff and dancing with a male caregiver. “Was the quality of her life what she had imagined as acceptable?” the author, Deborah’s sister, asks in this STAT article. “No. Did those of us who knew her best think she was remarkably well-adjusted and content? Yes.”

Written by Mary Kate Nelson