Indiana has instituted a six-month provider certification and enrollment moratorium on some home- and community-based services waiver providers after gaining approval from the Centers for Medicare & Medicaid Services (CMS). The moratorium goes into effect on Aug. 1, 2026, and is designed to mitigate fraud, waste and abuse, according to Indiana Health Coverage Programs (IHCP). […]
When I started covering home-based care, I did not anticipate that the industry would become a flashpoint in partisan politics, beyond familiar debates about reimbursement rates and the finer points of regulations. So, I’ve been surprised — and disturbed — by developments this year. The latest came this week: the U.S. Centers for Medicare & […]
On Tuesday, the U.S. Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) announced that the agencies deferred over $1 billion in Medicaid payments for certain high-risk Medicaid claims in two states, including home-based services. HHS and CMS deferred $867.5 million in federal Medicaid payments to California and […]
Medicare-certified home health agency supply continued to grow in 2024, but much of that expansion was concentrated in California — particularly Los Angeles County, an area previously identified by the California state auditor as a major hotspot for hospice fraud, waste and abuse — according to the Medicare Payment Advisory Commission (MedPAC). California, and Los […]
The Centers for Medicare and Medicaid Services (CMS) has issued updated survey guidance on home health agencies’ acceptance-to-service policies, a new standard under the Home Health Agency Conditions of Participation that took effect in Jan. 2025. The agency issued the guidance to home health agencies in a Wednesday memo, clarifying requirements to develop, implement and […]
On Tuesday, the Centers for Medicare & Medicaid Services (CMS) proposed shifts to Medicare’s Shared Savings Program (MSSP), accountable care organizations (ACOs) and physician payment structure with the broad goal of propelling a shift toward value-based care. The proposed changes, which include allowing ACOs with approved applications to decrease or cut beneficiary out-of-pocket costs for […]
The Centers for Medicare & Medicaid Services’ (CMS) six-month moratorium on new Medicare home health enrollments limits one pathway for providers to scale, but operators can still expand organically and through M&A. Growth-minded operators can increase census, improve workforce availability, acquire other businesses and forge joint ventures, home health industry insiders said during a recent […]
At the beginning of every year, Home Health Care News issues a list of the trends we believe will define the industry. Often, these predictions seem almost inevitable early in the year, only for events to unfold that completely change the trajectory of a specific trend before the frost melts from the trees. Other predictions […]
The Centers for Medicare & Medicaid Services’ (CMS) proposed home health payment rule for CY2027 is a mixed bag for providers and industry insiders, offering a long-awaited raise alongside the sting of unresolved retroactive cuts. Experts told Home Health Care News that while the proposed aggregate payment increase of 2.4% could suggest that CMS’ home […]
UnitedHealth Group’s (NYSE: UNH) in-home health program, HouseCalls, coincided with up to 5% fewer inpatient stays and 4% fewer emergency room visits for older adults with conditions such as diabetes and hypertension in the year after their visit, according to a Tuesday announcement. In the announcement, the healthcare giant shared initial results of an external […]
