Editor’s Picks: Pre-Claim Affirmation Rate Tops 90% in Illinois

New year, new us! While we stayed busy sticking to our New Year’s resolutions—for now, anyway—we were sure to keep our readers up to date on the latest home health care and home care news. Readers wanted to know where seniors are looking to retire and why, as well as some of the top home health Medicare schemes as observed by one assistant U.S. attorney.

There was some good news for Illinois home health care providers taking part in the Pre-Claim Review Demonstration (PCRD). The affirmation rate for pre-claim requests, including partial and fully affirmed pre-claim requests, ticked up to 90.8% in the 22nd week of the program, which ended Dec. 31, 2016, according to the Centers for Medicare & Medicaid Services (CMS). The affirmation rate has seen a dramatic increase since the start of the program, which began in Illinois in August 2016. PCRD is expected to begin in Florida beginning April 1, 2017.

Here in the newsroom, the story of a Virginia Beach doctor who captures intimate moments between caregivers and patients in photographs caught our eye.


We’re also keeping our eye on the incoming Trump administration, as Republicans noted they aim to get a bill to repeal Obamacare to President Trump’s desk ASAP.

Most Read

These Are The Top 10 State For Retirement—The majority of older Americans wish to age in place, but aside from living near family and friends, they are also looking at other factors to choose where they want to live as they age. The best states for retirement were found based on life expectancy, tax friendliness ranking, violent crime per 100,000, the cost of living index and health care costs, according to a recent study from MoneySavingPro.com.


U.S. Attorney: Common Home Health Schemes ’Turn System Upside Down’—Home health care agency owners would be the first to say the industry is seeing an onslaught of new regulations. However, there may be good reason for it—the industry is rife with improper and fraudulent payments, according to the Centers for Medicare & Medicaid Services (CMS).

BrightStar CEO: Major Tech, Workforce Investments Sharpen Competitive Edge—For Chicago-based home care provider BrightStar Care, 2016 was a milestone year after it opened its 300th franchise location. Home Health Care News caught up with CEO Shelly Sun to hear about the company’s plans for growth in 2017, technology investments and top challenges and concerns across the industry.

Around the Web

Doctors Who Always Noticed Caregivers Photographs Them in Retirement—Dr. Michael Geller of Virginia Beach always noticed caregivers waiting with patients he was examining, sensing their behind-the-scenes work, The Virginian-Pilot writes. After observing caregivers and their intimate moments with patients, he picked up a camera to capture them.

Transforming Health Care Delivery through the CMS Innovation Center: Better Care, Healthier People and Smarter Spending—The CMS Innovation Center prepared its third annual report to Congress, summarizing the progress and outcomes of its numerous initiatives over the last year.

Amy’s Adds

Conservatives Want to Cut Medicaid. If They Were Serious About Creating Jobs, They’d Expand It.—An election cycle that made manufacturing jobs part of the national rhetoric may be missing the mark, according to writer Livia Gershon. Instead of focusing on manufacturing, government should keep their eye on and invest in one of the most in-demand jobs right now—home care.

Written by Amy Baxter

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