Obama Budget to Curb DME Medicaid Reimbursement

The Obama Administration’s all-ecompassing 2015 Budget includes provisions that aims to limit Medicaid reimbursement for durable medical equipment (DME) in efforts to reduce federal spending in the coming year and beyond.  One of the main provisions included in the 2015 Budget details using Medicare bid rates under the DME Competitive Bidding Program for Medicaid reimbursement, […]

DOJ Announces $4.3 Billion Record Year for Health Care Fraud Busts

Last year was a record year for cracking down on health care fraud, with $4.3 billion in recovery from fraud busts nationwide. The Department of Justice and the Department of Health and Human Services announced last week the record performance for the year, as well as a total for $19.2 billion over the last five.  […]

Home Health Study Highlights Who Medicare Cuts Will Impact

New analyses on home health beneficiaries highlights suggests older women and minorities will be disproportionately impacted from cuts to Medicare reimbursements stemming from the Affordable Care Act. A majority of home health beneficiaries and caregivers are women, and Medicare home health beneficiaries are among the most vulnerable of all Medicare beneficiaries, finds analysis completed by […]

CMS Seeks Comment on New Competitive Bidding Round for DME

The Centers for Medicare and Medicaid Services is seeking public comment in the process of moving toward national implementation of its competitive bidding system for durable medical equipment.  CMS has been rolling out the program—currently operating in 100 areas across the U.S.—gradually. It  and has been met with strong opposition from home health care providers […]

CMS Changes Rules on Vaccines for Hospice Patients

The Centers for Medicare & Medicaid Services (CMS) recently emphasized policy enforcement on reimbursement windows for respite care and changed its policy on what kinds of care providers can give vaccines to hospice patients. Respite care, when in-home caregivers are essentially given a short break from their duty, can only be billed to Medicare in […]

Bipartisan Letter Wants to Delay Home Health Rebasing Rule

A bipartisan letter from several House Representatives is calling for the postponement and re-evaluation of a rebasing rule that will cut home health payments by 14% over the next three years. Representatives Ralph Hall (R-TX), Tom Price (R-GA), David McKinley (R-WV) and Doris Matsui (D-CA) sent a letter earlier this week to House Speaker John […]

Home Health Groups Applaud Latest Wave of CMS Moratoria

Both local and national home health care trade associations have voiced their approval of the recent announcement from the Centers for Medicare & Medicaid Services (CMS) that prevents the enrollment of new providers in the Medicare program for select cities.  Last week, CMS announced its temporary moratoria on the enrollment of new home health agencies. […]

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 […]