Home Care Visits Found Crucial to Reducing Short-Term Readmissions

Transitional care interventions, which aim to improve care transitions from hospital to home, help reduce hospital readmissions 31 to 365 days after discharge, a study in Health Affairs’ latest issue shows.  But the study’s authors found that only high-intensity interventions — including the need for home care visits — seemed to be effective in reducing […]

Home Health Providers Make Headway in Avoiding CMS Denials

Unclear filing guidelines for Centers for Medicare & Medicaid Services’ (CMS) documents are costing home health care providers billions of dollars a year, a recent report shows. Thirty-two percent of home health claims did not have the requisite or complete face-to-face encounter documentation, which resulted in $2 billion in payments that should not have been made […]

Miami Woman Gets 6 Years For $6.5 Million Home Health Fraud Scheme

The owner and operator of a Miami, Fla., home health care company was sentenced to more than six years in prison Monday for her alleged participation in a $6.5 million Medicare fraud scheme, the U.S. Department of Justice (DOJ) announced.  Cruz Sonia Collado, 64, was an owner and operator of the now-defunct home health care […]

Medicaid Readmissions Cost $77 Million Per State

In the health care industry’s quest to lower avoidable hospital readmission rates, recent findings by state Medicaid Medical Directors (MMD) now highlight the high costs — and prevalence — of Medicaid readmissions. The 30-day Medicaid readmissions rates for 19 participating states varied, but accounted for an average of 9.4% of all admissions, according to MMD […]

Home Care Fraud Allegations Call for More Internal Oversight Among Providers

Several home care fraud developments in New York, Rhode Island and Louisiana have led the National Assoication for Home Care and Hospice to recommend that providers “re-double” their internal efforts against fraud.  The association points to findings from the National Council on Medicare Home Care, a NAHC affiliate, that show Medicare fraud activity in areas […]

Ohio’s New Managed Care Plan Leaves Home Health Aides, Agencies Without Pay

Since Ohio’s new managed care plan for dual eligibles rolled out locally in July, home health workers — and their agencies — have been struggling to adjust to payment processing changes, The Columbus Dispatch reports. Before the plan, called “MyCare Ohio,” the government would process claims submitted by independent workers and home health agencies in […]

Kansas Fights Federal Labor Rule for Home Health Workers

The state of Kansas is prepared to fight against a planned federal labor rule that would affect cost of home health care services, media report. Gov. Sam Brownback’s administration says the new rule will hurt Kansans who receive home-based services that allow them to continue to live in their own homes as it would increase the […]

Little Training, Oversight Puts Home-Based Caregivers in Tough Position

Each day, thousands of home-based caregivers are put into life-and-death situations with little training and virtually no direct supervision, mainly because state payments are too low to cover additional training and oversight expenses, reports the Star Tribune. The Minneapolis-based newspaper interviewed more than two dozen personal care attendants and found that only one had received […]

GAO: CMS Lacks Reliable Data, Oversight

The U.S. Government Accountability Office (GAO) has found that the Centers for Medicare & Medicaid Services (CMS) does not have reliable data or sufficient oversight to measure and prevent duplication of postpayment claims reviews.  CMS should provide additional oversight and guidance regarding data, duplicative reviews and contractor correspondence to improve effectiveness and efficiency of postpayment […]