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, […]
Home-based care providers have an unmatched view of barriers that can undermine care outcomes known as social determinants of health. Even without an immediate financial incentive, some home-based care providers are addressing these social determinants of health to remove these obstacles — and to give frontline workers a better chance to deliver the services patients need. “Home healthcare […]
Home-based care coordination platform Hera has raised $27 million in a Series A funding round led by Bain Capital Ventures, with participation from Accel and IA Ventures and angels including the chief financial officer of Mount Sinai. The company’s care coordinators – called Heroes – manage the non-clinical but often complicated work of caring for […]
At last week’s PAYER Summit, providers, policy experts and payer execs were largely aligned on what will separate successful home-based care organizations from the rest of the pack. Discussions at the event, hosted by Home Health Care News and Skilled Nursing News, included commentary on some notable changes in the payment landscape that have occurred […]
Arsen Ustayev, founder and CEO of CareChoice, has shaped his strategy around hospital referral trends and differences in state Medicaid policies. The executive, who previously founded and ran adult day care facility SarahCare, which still operates in Pennsylvania, has scaled back on certain services because of a lack of hospital system referrals – which an […]
The U.S. Department of Justice has filed a lawsuit alleging that New York’s Consumer Directed Personal Assistance Program (CDPAP) transition to a single fiscal intermediary was part of a fraud scheme that raided the state’s Medicaid program for millions of dollars. The lawsuit, filed Tuesday, alleges that the New York Department of Health selected Public […]
Home-based care veteran executive Dr. Brian Holzer has joined Freedom Senior Services as the company’s top executive after the company transitioned to new private equity ownership. Following Gemspring Capital’s acquisition of Freedom, Holzer aims to make the company an aggressive M&A player while expanding service lines and client demographics. To do so, Holzer plans to […]
Home-based care providers are feeling the squeeze from Medicare Advantage and Medicaid — and some are responding by limiting admissions for certain payers. When it comes to Medicare Advantage, providers experience a range of pains beyond just rates, including administrative burden, prior authorization delays and care denials and appeals. That’s according to a survey conducted […]
The Centers for Medicare & Medicaid Services (CMS) is moving to implement a strict new budget-neutrality requirement for Medicaid Section 1115 demonstrations. CMS announced its plans on Thursday, stating that it was providing states with early notice of its intent to implement the budget neutrality requirement. The agency plans to apply the budget neutrality standards […]
Medicaid program integrity efforts have been ramping up quickly, and last week we saw clear evidence of this trend when the Ohio Department of Medicaid (ODM) suspended payments to 49 home health providers with billing patterns that the agency deemed suspicious. This makes Ohio an early state to take cues from CMS on shifting away […]
