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 […]
Public Partnerships LLC (PPL) is seeking dismissal of the Department of Justice’s (DOJ) lawsuit over its administration of New York’s Consumer Directed Personal Assistant Program (CDPAP), calling the case “an act of gross overreach” fueled by political motivations. The DOJ alleged PPL engaged in fraud when acting as New York’s sole fiscal intermediary for CDPAP, […]
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 […]
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 […]
A federal judge has preliminarily approved a $162 million class action settlement to approximately 200,000 home care workers over alleged payroll and benefits violations after New York transitioned its Medicaid-funded Consumer Directed Personal Assistance Program (CDPAP) to a single fiscal intermediary. News of the proposed settlement comes weeks after the U.S. Department of Justice (DOJ) […]
The 2027 Medicare home health proposed payment rule dropped yesterday, and it was a surprising one. The home health industry has become accustomed to years of proposed cuts – but this one featured an aggregate rate increase. In the last two proposed rules, CMS floated aggregate cuts of 6.4% and 1.7%, making the 2027 proposal […]
Home health leaders and stakeholders have largely responded to the Centers for Medicare and Medicaid Services’ (CMS) moratorium on home health enrollment with concerns about a broad-brush approach to program integrity – as well as the length of the moratorium. CMS announced the moratorium as a six-month freeze on home health and hospice, but specified […]
The Centers for Medicare and Medicaid (CMS) has experimented with pre-claim review processes — and new research suggests that this Medicare program can be highly effective, but only in certain states. Medicare pre-claim reviews for home health services cut spending in Illinois by 13% and reduced an estimated $1.2 billion in traditional Medicare home health […]
