OIG: Medicare Overpaid $267M for Hospital In-Patient Claims with Post-Acute Transfers to Home Health Services

Hospitals improperly coding for post-discharge services contribute to hundreds of millions of dollars in Medicare overpayments. And the majority of incorrect payments are often related to home health services. That’s according to a new audit report from the Department of Health and Human Services (HHS) Office of Inspector General (OIG). The purpose of the OIG […]

OIG: CMS Could Have Saved $192M with Stronger LUPA Oversight

Federal watchdogs are once again setting their sights on perceived improper billing practices by home health agencies. In an audit report published last week, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) found that stronger oversight of Low Utilization Payment Adjustments (LUPAs) in home health care could have saved […]

‘An Absolute Travesty’: Home Health Advocates Make Last-Ditch Effort to Delay Review Choice Demonstration

When the U.S. Centers for Medicare & Medicaid Services (CMS) announced that the Review Choice Demonstration (RCD) would resume for participating states in August, home-based care providers and advocates were up in arms over the decision.  But as the resumption date approaches, industry advocates are making a last-ditch effort to get CMS’s attention and persuade […]

Emergency Responders, In-Home Care Providers Seek Collaboration — Not Competition

As hospitals continue to experience overcapacity challenges due to the COVID-19 emergency, 911 ambulance crews and community paramedics have found themselves treating more patients at home. Historically, ambulance crews and community paramedics — both of which operate in the emergency medical services (EMS) space — have always provided some degree of care in the home […]

Tale of Two Home Health Providers: ‘Value-Based Care Gap’ Growing Wider

Earlier in June, the Trump administration and the U.S. Centers for Medicare & Medicaid Services (CMS) touted a “renewed national commitment to value-based care.” But for that renewed commitment to take off in the home health care space, government officials need to act fast, industry insiders caution. There’s a widening value-based care gap between larger […]

CMS Appoints New Chief Medical Officer

The U.S. Centers for Medicare & Medicaid Services (CMS) announced a number of new leadership appointments on Tuesday. The agency’s leadership shakeup includes naming a new chief medical officer, a role that had been vacant since Dr. Kate Goodrich joined Humana Inc. (NYSE: HUM) in March. Dr. Lee Fleisher will take over as CMS’s CMO […]