‘A Unique Opportunity for Home Health Providers’: CMS Extends CJR Model

The U.S. Centers for Medicare & Medicaid Services (CMS) has extended the Comprehensive Care for Joint Replacement (CJR) payment model. That’s welcome news for home health operators, as CJR has been a key program for participating agencies since its implementation. Introduced in 2016, CJR essentially allows CMS to hand out bonuses or inflict payment penalties […]

Direct-Contracting Entities Figuring Out How to Capitalize on Competitive Advantage

A delay in the Global and Professional Direct Contracting Model by the Biden administration has put the already-accepted direct-contracting entities (DCEs) in a coveted position. New entrants are no longer being accepted for participation in the model while the Centers for Medicare & Medicaid Services (CMS) and its innovation arm review the details. That gives […]

CMS Medicare Provider Enrollment Requirements Could Drive Home Health Agencies Out of Business

Changes to the requirements for Medicare provider enrollment could have major consequences for home health providers down the line. Under provider enrollment requirements, the U.S. Centers for Medicare & Medicaid Services (CMS) has the authority to rescind providers’ Medicare enrollment if they are associated with “bad actors” and are at risk for fraud due to […]

Confirmation Delay for Next CMS Administrator Could Cause Problems for Home-Based Care Providers

It has been over three months since former Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma resigned from her post. As of Wednesday, no one has officially filled the position’s void. The Biden administration’s pick for administrator, Chiquita Brooks-LaSure, has yet to be confirmed by the Senate due to ongoing partisan disputes. For […]

Pause to Alternative Payment Models Gives Some Providers a ‘Golden Ticket,’ Leaves Others Behind

The Global and Professional Direct Contracting Model — a Center for Medicare & Medicaid Innovation (CMMI) creation — has been put on pause. The holdup is just another example of CMMI pumping the brakes on an alternative payment model in the days since the Biden administration took over the executive branch.   Broadly, the Global and […]

What Home Health Providers Need to Know About Medicare Loan Recoupment

It has been six months since the U.S. Centers for Medicare & Medicaid Services (CMS) gave home health agencies and other Medicare providers a reprieve from having to pay back advance and accelerated payment loans. But recoupment for these loans is just around the corner. To avoid future financial headaches, providers must be prepared to […]

Hospital-at-Home Holdouts: Why In-Home Acute Care Isn’t for the Faint of Heart

After making gradual inroads over the past few years, the hospital-at-home model has seemingly had its breakthrough moment. That came in November, when the U.S. Centers for Medicare & Medicaid Services (CMS) introduced its “Acute Hospital Care At Home” wavier program. The creation of CMS’s wavier — a COVID-19 relief measure — has created a […]

With Time Running Out, House Passes Medicare Sequestration Bill

Home health providers are one step closer to getting a continued suspension of Medicare sequestration payment reductions. The U.S. House of Representatives passed H.R. 1868 by a 246-175 vote on Friday. The bill, originally introduced earlier this month by House Majority Leader Steny Hoyer (D-Md.), pauses automatic spending cuts to Medicare and other programs for […]