Democratic lawmakers are expressing concern over President-elect Donald Trump’s choice of Dr. Mehmet Oz to head the U.S. Centers for Medicare and Medicaid Services (CMS). Specifically, lawmakers are focused on Oz’s advocacy for the elimination of traditional Medicare, and what they call his “deep financial ties” to private health insurers. In a recent letter — […]
Category: CMS
On Nov. 1, the Centers for Medicare & Medicaid Services (CMS) issued the final home health payment rule for 2025, updating Medicare policies and rates for home health agencies. But while the payment-related information grabbed headlines, there are plenty of other changes to home health care within the rule that providers should be paying attention […]
With the passage of the most recent home health final rule, providers are reminded that clawbacks are still hanging over their heads. Broadly, temporary cuts, or clawbacks, are an attempt from the U.S. Centers for Medicare & Medicaid Services (CMS) to recover perceived overpayments from home health providers in relation to the shift to PDGM. […]
The Medicaid program could face significant challenges under the Trump administration, according to Dan Tsai, the deputy administrator and director of the Center for Medicaid and Children’s Health Insurance Program (CHIP) Services. He expressed these concerns during a leadership update call from the Center for Medicare & Medicaid Services (CMS) on Wednesday. “Medicaid is so […]
With the 2025 home health final payment rule came the admission-to-service policy — an update to the Medicare Conditions of Participation. In many ways, experts consider it a formalization of measures home health providers are already taking. Broadly, the policy has two parts. The first part requires home health providers to develop, implement and maintain […]
Formerly U.S. Medical Management, the home-based care company HarmonyCare raised $200 million in June. On Wednesday, it touted its success in the Accountable Care Organization (ACO) “REACH” Model, the successor to the The Global and Professional Direct Contracting Models (GPDC). Put forth by the Centers for Medicare & Medicaid Services (CMS), ACO REACH gives private […]
Donald Trump will take over the presidency again in January. There will be many implications for home-based care providers, and details from Trump’s first presidency will help project those. In the weeks leading up to the Nov. 5 election, Trump and Kamala Harris battled over home-based care. Specifically, Harris suggested a personal home care benefit […]
The U.S. Centers for Medicare & Medicaid Services (CMS) released its CY 2025 home health final payment rule Friday. It comes with an estimated aggregate increase to 2025 home health payments of 0.5%, or $85 million, compared to 2024 aggregate payments. But another permanent cut will be implemented in the new year. “CMS estimates that […]
Medicare Advantage (MA) companies receive higher risk-adjusted payments from the Centers for Medicare & Medicaid Services (CMS) for sicker enrollees. This helps ensure that plans receive sufficient payments to cover increased care costs and that enrollees have access to plans. However, a new report states that taxpayers are footing the bill for billions of dollars […]
The U.S. health care system is banking on home- and community-based services (HCBS) to help keep seniors and individuals with disabilities at home and away from more costly brick-and-mortar facilities. But for now, incongruent rates mean disparate access to those services state by state. The Centers for Medicare & Medicaid Services (CMS) released the Medicaid […]
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