Home Health Spending Rate Projected to Surpass All Other Care Categories

Roughly $108.8 billion is projected to be spent on home health care in the United States in 2019, according to a newly released analysis from the Centers for Medicare & Medicaid Services (CMS) Office of the Actuary. U.S. expenditures on home health care are projected to hit $186.8 billion by 2027. An aging population, a […]

LHC Group CEO Urges Congress to Support PDGM-Altering Bill

LHC Group (Nasdaq: LHCG) Chairman and CEO Keith Myers is again calling on Congress to pass legislation refining the assumption-based payment adjustments currently outlined under the Patient-Driven Groupings Model (PDGM). The co-founder of the Lafayette, Louisiana-based company recently penned an article in The Hill emploring legislators to pass S. 433, a new bipartisan bill that […]

CMS Moves Step Closer to Required EVV Survey

Federal health care policymakers have taken another step toward rolling out a required nationwide electronic visit verification (EVV) survey. The 21st Century Cures Act originally required home care providers and state agencies to begin adopting EVV systems by Jan. 1, 2019. EVV requirements are meant to reduce instances of fraud and abuse in the delivery […]

Senate Lawmakers Introduce New Legislation Urging Evidence-Based PDGM Changes

Newly introduced bipartisan legislation in the U.S. Senate is targeting the widely opposed behavioral adjustments set to hit home health agencies next year under the Patient-Driven Groupings Model (PDGM). If passed, the legislation would require the Centers for Medicare & Medicaid Services (CMS) to base Medicare reimbursement rates on observed evidence and data, instead of […]

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The long-standing moratoria on new Medicare home health agencies is no longer in effect anywhere in the U.S. The Centers for Medicare & Medicaid Services (CMS) allowed the temporary ban to expire on Jan. 30, a move that will likely improve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