CMS Issues Second Wave of Home Health Moratoria

Following in the footsteps of its initial home health moratorium last year, the Centers for Medicare & Medicaid Services (CMS) will now bar new agencies from enrolling in four additional U.S. metros.  CMS today announced a new temporary moratoria on the enrollment of home health agencies in Fort Lauderdale, Detroit, Dallas and Houston, as well […]

Texas Home Health Operator Indicted on Medicare Fraud, Bank Structuring Charges

Despite federal efforts to curb Medicare fraud among home health operators, a home health agency owner and operator and director of nursing were arrested this week in Richmond, Texas for their alleged roles in a recent Medicare fraud scheme.  According to the Department of Justice, the participants conspired to structure bank withdrawals.  Stella Maduka, of […]

CMS Updates Home Health Medicare Benefit Policy Manual

The Centers for Medicare and Medicaid Services has announced it is updating some of its Medicare policy manuals pursuant to a recent settlement in Jimmo vs. Sebelius.  CMS is providing manual updates to clarify Skilled Nursing Facility (SNF), Inpatient Rehabilitation Facility (IRF), Home Health (HH), and Outpatient (OPT) coverage requirements pursuant to the settlement of the case, the […]

Home Health Spending Growth Outpaced SNF, CCRCs in 2012

Home health spending outpaced that of skilled nursing facilities and continuing care retirement communities in 2012 due to changes in Medicare reimbursements, says the Centers for Medicare & Medicaid Services (CMS).  Healthcare spending for freestanding skilled nursing facilities and CCRCs increased slightly to $151 billion in 2012, representing a deceleration in spending growth from the previous year, according to the […]

Home Health Alliance: Medicare Cuts Make for an Unhappy New Year

Upcoming payment changes to the Home Health Prospective Payment System under the Affordable Care Act have made the start to the new year unhappy, according to a home health alliance that’s urging the Obama Administration to prevent or reverse the planned cuts.  A final rule released the Friday before Thanksgiving cuts Medicare home health payments […]

Home Health Spending Tops $77 Billion Despite Low National Growth

The home health industry experienced billion dollar growth in 2012, despite low national health spending overall, according to a recent report from the Centers for Medicare & Medicaid Services (CMS). While national health spending slowed for the fourth consecutive year at an annual rate of 3.7% in 2012, home health spending growth accelerated 5.1% to […]

CMS Moves Closer to Fingerprint Background Checks in Home Health

Three years following a final rule that will allow for fingerprinting of workers—a measure targeting Medicare fraud—the Centers for Medicare and Medicaid Services is finally making plans to contract with a company to conduct the background checks, according to a Modern Healthcare report. The fingerprint screening is one of several mechanisms now allowed by the […]

CMS Data Show Hospital Readmissions Fell 18% in 2013

The Affordable Care Act appears to be having an impact on lowering the number of costly hospital readmissions, as reforms under the law have helped drive down the 30-day readmission rate by as much as 18% in 2013, according to data released this week by the Centers for Medicare & Medicaid Services (CMS).  During the […]

Miami Home Health Fraudsters Sentenced for $8 Million Scheme

Two former owners of a home health care company in Miami, Florida were sentenced this week for their roles in a health care fraud scheme that bilked the federal government out of $8 million in Medicare dollars. The former owners of Flores Home Health Care Inc., Miguel Jiminez and Marina Sanchez Pajon, were sentenced to […]

CMS Redefines ‘Homebound’ for Medicare-Eligible Services

The Center for Medicare & Medicaid Services (CMS) has released a clarified definition of ‘homebound’ regarding eligibility for Medicare-reimbursable services. Individuals can be considered “confined to the home,” or homebound, if they meet two criteria that more closely align the Benefit Policy Manual to the Social Security Act’s definition, says CMS. The first criteria requires […]