CMS Completes Home Health Compare Overhaul, Launches New Medicare Tool

Nine months after initially floating the idea, the U.S. Centers for Medicare & Medicaid Services (CMS) has launched Care Compare, a consumer-facing database of provider quality information. The agency announced the launch on Thursday. CMS originally announced its plan to merge Home Health Compare with the seven other Compare sites in January. Agency officials said […]

Home Health Agencies Plan Ahead for Full-Blown RCD Resumption

Earlier this month, the U.S. Centers for Medicare & Medicaid Services (CMS) announced it will not immediately pursue a full-blown restart of the Review Choice Demonstration (RCD), a regulatory initiative designed to reduce improper billing in home health care. Instead, CMS outlined how it will move forward with a “phased-in approach” to RCD that gives […]

Spending on Home Health Care Down 21.6% Under PDGM

Spending on home health care services is down substantially under the Patient-Driven Grouping Model (PDGM), a recently unveiled analysis suggests. While the Bipartisan Budget Act of 2018 requires PDGM to be budget neutral, spending on home health care has actually been about 21.6% lower than projected, according to a detailed analysis from Dobson DaVanzo & […]

Confessions of a Home Health Agency Owner: ‘CMS Is Trying to Put Agencies Like Mine Out of Business’

For decades, home health agencies have learned to operate — and often thrive — in the midst of massive change. But since the start of 2019, that change has felt overwhelming for some agency owners, particularly those who run mom-and-pop businesses with razor-thin margins. Above all, perhaps, the decision by the Centers for Medicare & […]

Debunking Common PDGM Primary Diagnosis Myths

In order for home health providers to see reimbursement success, they need to be able to separate myths from facts when it comes to the Patient-Driven Groupings Model (PDGM). But one specific point of confusion has been primary diagnosis clinical groups. “There are a lot of rumors and myths floating around out there,” Robbi D. […]

More Than Half of All Home Health Agencies Have Treated COVID-19 Patients

The U.S. Centers for Medicare & Medicaid Services (CMS) officially closed its public comment window for the 2021 proposed home health payment rule on Monday. Unlike the past couple of years, the latest proposed payment rule included relatively minor changes and rate adjustments for the year ahead. In light of the mild proposal, CMS only […]

Senator Kirsten Gillibrand Pushes for Increased PPE, Telehealth Payment for In-Home Care Providers

U.S. Senator Kirsten Gillibrand (D-Ny.) is asking the Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) to ensure that in-home care providers have access to essential resources amid the coronavirus.   Throughout the public health emergency, home health and home care providers have been vocal about the challenges […]

CMS Announces New ‘Phased-In Approach’ to the Review Choice Demonstration

The U.S. Centers for Medicare & Medicaid Services (CMS) announced Friday it will not resume a full-blown resumption of the Review Choice Demonstration (RCD) for home health agencies in participating states later this month. Instead, CMS is “phasing in” RCD for agencies in North Carolina and Florida. Agencies in Illinois, Ohio and Texas will be […]

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 […]