How Personal Care In Acute Care Settings Could Become Popularized, Benefiting Patients And Providers

In March, the U.S. Centers for Medicare & Medicaid Services (CMS) approved a request from one state to allow more personal care service delivery within acute care facilities. Though not yet widespread, the amendment could open doors for providers and patients needing personal care in alternative settings in the future.  One change to a Medicaid […]

CMS’ Daniel Tsai Stands Behind ‘80-20’ Provision, Medicaid Access Rule In Congressional Hearing

A senior Centers for Medicare & Medicaid Services (CMS) official stood behind the “80-20 rule” — which has drawn major pushback from the home-based care industry — during a congressional hearing Tuesday. Last week, the “Ensuring Access to Medicaid Services” rule was finalized. The impetus behind the rule is to strengthen access to home- and […]

Congresswoman Kat Cammack Introduces Legislation To Block 80-20 Rule

One policymaker is attempting to put a halt to the 80-20 rule. At the start of the week, the “Ensuring Access to Medicaid Services” rule was finalized. The 80-20 provision is, arguably, the most controversial component of the Medicaid rule. In summary, the provision calls for 80% of Medicaid payments for home- and community-based services […]

OIG Targets Home Health Improper Payments, EVV, Consumer-Directed Programs in Ongoing Watchdog Initiatives 

In past years, Medicare-certified home health agencies and Medicaid personal care services providers have been big focus areas for government watchdogs. While there’s still plenty of oversight, the spotlight on home health and personal care providers appears to have dimmed somewhat. Instead of focusing on home health and personal care, watchdogs are increasingly targeting hospices, […]

Report: Medicaid Payment Variability Hinders Access To Home- and Community-Based Services

Medicaid payment rates for home- and community-based services (HCBS) vary drastically across states, causing workforce instability and access challenges for services. That’s according to a recent report from the Medicaid and CHIP Payment and Access Commission (MACPAC). MACPAC makes recommendations to Congress, the U.S. Department of Health and Human Services (HHS) and states on issues […]

Inside Home-Based Care Provider Strategies For Surviving Under The Looming 80-20 Rule

After the release of the proposed “80-20 rule” last year for home- and community-based services (HCBS), providers had plenty of time to digest. Now, they’re formulating their plans of action ahead of the proposal’s potential finalization. Broadly, the U.S. Centers for Medicare & Medicaid Services’ (CMS) proposed rule had several components, but the most controversial […]