A federal judge has dismissed Humana’s (NYSE: HUM) lawsuit against the U.S. Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS). The company filed suit in October 2024, challenging CMS’ Medicare Advantage (MA) quality scores. Humana claimed that the agency acted “arbitrarily and capriciously” in downgrading its ratings, […]
Category: Funding
Indiana Medicaid now requires providers of attendant care and family caregiver services to directly pass a specific portion of Medicaid funds to frontline caregivers, similar to the 80/20 rule, and could inspire other states to do the same. This change, aligning with federal standards, took effect on July 1, and agencies must confirm compliance by […]
Everyone in the home-based care industry is trying to catch their breath after what appears to be a significant blow to the American health care system, including the release of the CY 2026 home health proposed payment rule by CMS on June 30 and the passage of the “One Big Beautiful Bill” (OBBB) last Friday. […]
Gather Health, which offers in-home and in-clinic primary care services, has raised $21.2 million in its latest fundraising efforts. The Quincy, Massachusetts-based company was seeking a total of $25 million, according to publicly available documents. The raise comes two years after Gather raised $16.3 million in a Series A round from investors including Khosla Ventures, […]
On Monday, I moderated a HHCN+ TALKS episode – our exclusive opportunity for HHCN+ members to hear from and engage directly with leading experts in real time. The topic was on the policy and regulatory landscape affecting the home-based care industry under the second Trump administration. Needless to say, this was a timely discussion, given […]
As the second Trump administration begins to reshape federal health care priorities, home-based care leaders are cautiously optimistic but sounding the alarm on certain key areas such as reimbursement and labor stability. Budget neutrality adjustments have been a “tragedy,” Medicaid budget cuts still loom large for patients and caregivers, Medicare Advantage (MA) plans require accountability […]
Two U.S. senators have proposed a bill to support home- and community-based services. As Congress reduces Medicaid payments, Senators Jack Reed (D-R.I.) and Ben Ray Luján (D-N.M.) reintroduced the Home and Community-Based Services (HCBS) Relief Act on June 25. This bill would allocate dedicated Medicaid funds for HCBS services for older adults, children and adults […]
Two Republican senators are urging the Centers for Medicare and Medicaid Services (CMS) to “use full authority under law” to preserve the Medicare home health agency (HHA) benefit. Senators Marsha Blackburn (R-Tennessee) and Susan Collins (R-Maine) sent a letter to CMS Administrator Dr. Mehmet Oz, expressing concerns about the future of the benefit, including payment […]
Home-based care providers face rising challenges to maintaining healthy margins in today’s reimbursement landscape. Nonetheless, precise cost reporting, disciplined payer relationships and operational efficiencies are proving to be among the strategies essential to surmounting these challenges. Leaders in the home-based care industry say these strategies are key to navigating the growing financial strain caused by […]
Axle Health, a home health care technology company, has secured $10 million in Series A funding. Venture firms F-Prime, Y Combinator, Pear VC and Lightbank led the round. Axle plans to use the funds to enhance Axle’s AI-powered scheduling and routing algorithms, develop generative AI solutions for patient engagement and expand its engineering and operations […]
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