CMS Proposes Rules to Improve Data Sharing Between Health Care Providers, Insurers

The Centers for Medicare & Medicaid Services (CMS) is taking further steps to cure lack of interoperability within the health care system, an issue that has long plagued the home health industry. On Monday, CMS released proposed rules that require many providers and insurers to adopt a secure, standard format for electronic patient data by […]

CMS Lifts Moratoria on Home Health After 5 Years

The long-standing moratoria on new Medicare home health agencies is no longer in effect anywhere in the U.S. The Centers for Medicare & Medicaid Services (CMS) allowed the temporary ban to expire on Jan. 30, a move that will likely improve patient access to home-based care in related markets, experts say. CMS initially implemented a […]

CMS Outlines Further Expansion of Medicare Advantage Benefits for In-Home Services, the Chronically Ill

The Centers for Medicare & Medicaid Services (CMS) is proposing to further expand Medicare Advantage (MA) flexibilities for certain in-home services and supports for chronically ill Americans starting in 2020, the agency announced Wednesday. The move is in line with CMS’ larger goals of broadening the scope of the MA program, which has quickly grown […]

Court Ruling Goes Against Pro-Home Health Provider Medicare Recoupment Trend

A recent court ruling against a home health care company could mean trouble for providers struggling financially as a result of Medicare recoupment, at least one legal expert believes.   Currently, home health care providers that are overpaid for Medicare services are not required to repay the Centers for Medicare & Medicaid Services (CMS) while […]

How Home Health Agencies Can Prepare for, Fight PDGM

When it takes effect next year, the Patient-Driven Groupings Model (PDGM) from the Centers for Medicare & Medicaid Services (CMS) is expected to revolutionize home health agency operations and double billing efforts. As the biggest payment overhaul in years, it’s crucial for providers to spend 2019 preparing for — and fighting certain aspects of — […]

NAHC’s Dombi: Threat of Payment Cuts Can’t Be Ignored

It’s been a hectic time since Bill Dombi officially took over as president of the National Association for Home Care & Hospice (NAHC) about 11 months ago. Perhaps more than anything, though, it’s been a period punctuated by the introduction of the Patient-Driven Groupings Model (PDGM), the biggest payment overhaul the home health industry has […]

Hospice Leaders Applaud MA Carve-In Approach — But Also Voice Concerns

Hospice leaders are, for the most part, encouraged by the move to explore a Medicare Advantage (MA) carve-in for hospice through an expanded demonstration. But several questions remain, they caution, with the bulk of them focusing on whether the hospice benefit could somehow be diluted or lessened. The Centers for Medicare & Medicaid Services (CMS) […]

[Updated] CMS to Test Hospice Carve-In Under Medicare Advantage

The Medicare Advantage (MA) carve-in that many industry insiders pegged as “inevitable” has finally arrived. The Centers for Medicare & Medicaid Innovation (CMMI) on Friday morning announced it is expanding the MA Value-Based Insurance Design (VBID) model, using VBID to test out several wide-ranging updates to MA offerings, including a hospice carve-in set to take […]

CMS Announces ACO Overhaul, Enhances Telehealth Options

CMS has released new rules overhauling Medicare’s accountable care organizations (ACO) program. Called “Pathways to Success,” the new policies shorten risk-free periods and offer more regulatory flexibility, including for providing telehealth to people in their homes, among other changes. In recent years, home health companies have become more involved in ACOs, seeing it as an […]