DOJ Recoups $2.6 Billion from Home Health Fraud, Other Schemes in 2019

The 2019 fiscal year concluded with the Department of Justice (DOJ) bringing in $2.6 billion in recoveries involving health care fraud and false claims. Home health-related fraud was a large part of these efforts.  This marks the 10th consecutive year that the department’s civil health care fraud settlements and judgments have exceeded $2 billion. The […]

Humana, Philips Using In-Home Interventions to Tackle $17B Re-Hospitalization Problem

Insurance giant Humana Inc. (NYSE: HUM) and health technology company Royal Philips (NYSE: PHG) have teamed up to give Humana’s Medicare Advantage (MA) members 24/7 access to care via remote patient monitoring. The move reflects the continued adoption of remote patient monitoring and telehealth, especially when it comes to the MA landscape. “Payers are increasingly […]

Crisis Averted: Court Strikes Down Rate Changes Set to Compound Caregiver Shortage

Regulatory changes that threatened to compound the caregiver crisis in one state have been reversed, after a judge declared them “null and void.” The news comes more than a month after a new rate structure took effect to govern the Consumer-Directed Personal Assistance Program (CDPAP) in New York. CDPAP allows seniors and people with disabilities […]

PDGM’s Lead Author Gets Candid About Pros, Cons of Revolutionary Model

Set to take effect on Jan. 1, the Patient-Driven Groupings Model (PDGM) is as controversial as it is revolutionary. The model’s therapy changes and behavioral assumptions are two reasons why. Home health operators worry their operations and patients will suffer as a result of those modifications, among others. Even PDGM’s lead author, Lisa Grabert, acknowledges […]

Papa Exploring Medicaid, Employee Benefit Opportunities Following $10M Funding Round

Grandkids-on-demand startup Papa has raised $10 million in Series A funding, pushing the Miami-based company’s total funding raised above $13 million. The recent investment round was led by Silicon Valley-area venture capital firm Canaan, with money also coming in from Sound Ventures, Y Combinator and Pivotal Ventures, a firm created by Melinda Gates. Past big-name […]

Harvard Medical School’s David Grabowski: PDGM Is a ‘Brave New World’

The post-acute care sector is still a long ways away from the implementation of a unified payment system, but the Patient-Driven Groupings Model (PDGM) may be a step in that direction. That’s according to Harvard Medical School professor David Grabowski. As a professor in the department of health care policy, Grabowski’s work is concentrated on […]

Addus Closes on Hospice Partners of America; Ensign Group Completes Pennant Spinoff

Addus completes Hospice Partners of America deal Addus HomeCare Corporation (Nasdaq: ADUS) has completed its purchase of Hospice Partners of America. The Frisco, Texas-based at-home care company bought the multi-state hospice provider for $130 million cash — $118.4 million of which was in value and $11.6 million was in estimated tax benefits, according to a […]

Consumer-Directed Regulatory Changes Trigger Home Care Layoffs, Possible Closures

Less than three weeks in, regulatory changes in one state are already threatening to shrink the home-based care workforce there. The news comes out of New York, following Sept. 1 changes to the state’s Consumer-Directed Personal Assistance Program (CDPAP), which allows seniors and people with disabilities who receive Medicaid-certified home care to choose their own […]