Dual-Eligible Medicare Advantage Beneficiaries Have Greatest Social Determinants of Health Needs

Addressing social determinants of health is especially important for Medicare Advantage (MA) beneficiaries, as they are increasingly affected by a lack of services targeting those needs, which include access to and quality of housing, food and transportation, among other socio-economic factors. That’s according to a recent report from Avalere Health, a Washington, D.C.-based health care […]

States Sue Trump Administration Over Home Care Worker Union Dues

At least five states are suing the Trump administration over a recently finalized rule they say would prevent home health workers paid by Medicaid from having their union dues automatically removed from their paychecks, according to Reuters. States involved in the lawsuit include California, Washington, Connecticut, Massachusetts and Oregon. The states claim the rule weakens […]

[Updated] Industry Insiders: Don’t Overlook CMS’s Dual-Eligibles Directive

*Editor’s note (4/30/2019): This story has been updated to include comments from Hometeam CEO Randy Klein. Home-based care providers continue to show their support for the Centers for Medicare & Medicaid Services’ (CMS) move to better coordinate care for Americans who qualify for both Medicare and Medicaid. CMS first announced plans to expand coverage options […]

Addus Exec: CMS’s Dual-Eligibles Move Encouraging for In-Home Care Providers

The Centers for Medicare & Medicaid Services (CMS) announced plans Wednesday to expand coverage options for Americans who qualify for both Medicare and Medicaid, giving states the freedom to develop their own programs for dual-eligible beneficiaries. While the directive doesn’t outline specific opportunities for home-based care providers, the move is still encouraging for the industry, […]

House Lawmakers Pass Short-Term Money Follows the Person Extension

A program that allows Medicaid users — including seniors — to seamlessly transition back home after a nursing home or institutional care stay could receive a short-term $20 million funding boost. The House recently passed the Medicaid Services Investment and Accountability Act, which provides an extra $20 million in funding for the Money Follows the […]

CMS Made $3.2 Billion in Improper Home Health Payments in 2018

Despite increased oversight efforts, improper payments under Medicare and Medicaid are costing the federal government billions of dollars, a new report from the watchdog arm of Congress has found. And home health providers appear to be the root of the problem. In fiscal year 2018, improper Medicare fee-for-service (FFS) payments totaled $31.6 billion for all […]