How to Handle a Home Health Audit, According to a CMS Auditor

If you operate a home health agency, Laura Long and her colleagues are probably the last people you want to hear from. Long is the Medicare operations lead at AdvanceMed, one of five unified program integrity contractors (UPICs) nationwide hired by the Centers for Medicare & Medicaid Services (CMS) to audit and investigation home health […]

Home Health Providers Lag Behind Skilled Nursing Facilities in Preventing Re-Hospitalizations

While home health care is often touted as a cost-effective way to reduce readmissions, skilled nursing facilities (SNFs) — though more expensive — might be better at keeping patients out of the hospital post-discharge. That’s according to a new article published in JAMA Internal Medicine, which shows readmission rates for patients discharged to home health […]

Trump Administration Calls for Medicaid Overhaul, $846 Billion in Medicare Cuts

The Trump administration on Monday released its proposed budget for fiscal year 2020, calling for government-wide domestic spending cuts of 5%, a site-neutral payment system for health care providers and a major Medicaid overhaul. The proposed budget — unlikely to make it past a democrat-controlled House of Representatives — also seeks to curb Medicare spending […]

Paul Ryan: ‘Fee-For-Service Doesn’t work,’ MA the Future of Medicare

As if home care agencies needed any more encouragement to dive into the Medicare Advantage (MA) world, they got some last week — courtesy of a well-known Capitol Hill veteran. Home care providers have been positioning their businesses to appeal to potential MA players since April 2018, when Centers for Medicare & Medicaid Services (CMS) […]

LHC Group CEO Urges Congress to Support PDGM-Altering Bill

LHC Group (Nasdaq: LHCG) Chairman and CEO Keith Myers is again calling on Congress to pass legislation refining the assumption-based payment adjustments currently outlined under the Patient-Driven Groupings Model (PDGM). The co-founder of the Lafayette, Louisiana-based company recently penned an article in The Hill emploring legislators to pass S. 433, a new bipartisan bill that […]

CMS Proposes Rules to Improve Data Sharing Between Health Care Providers, Insurers

The Centers for Medicare & Medicaid Services (CMS) is taking further steps to cure lack of interoperability within the health care system, an issue that has long plagued the home health industry. On Monday, CMS released proposed rules that require many providers and insurers to adopt a secure, standard format for electronic patient data by […]

Court Ruling Goes Against Pro-Home Health Provider Medicare Recoupment Trend

A recent court ruling against a home health care company could mean trouble for providers struggling financially as a result of Medicare recoupment, at least one legal expert believes.   Currently, home health care providers that are overpaid for Medicare services are not required to repay the Centers for Medicare & Medicaid Services (CMS) while […]

CBO: 2019 Will Be Tipping Point for Federal Spending Tied to Older Adults

The aging population of the United States and the rising cost of health care will likely cause federal spending to skyrocket over the next decade — with a noticeable spike surfacing even sooner than previously anticipated. Federal spending on programs that provide services for adults age 65 or older — Medicare and Social Security, namely […]

How Home Health Agencies Can Prepare for, Fight PDGM

When it takes effect next year, the Patient-Driven Groupings Model (PDGM) from the Centers for Medicare & Medicaid Services (CMS) is expected to revolutionize home health agency operations and double billing efforts. As the biggest payment overhaul in years, it’s crucial for providers to spend 2019 preparing for — and fighting certain aspects of — […]

Shifting ACO Rules Create Uncertainty for Home Health Agencies

Home health agencies are still unsure what a recent overhaul of Medicare’s accountable care organization (ACO) program means for them. They will be affected, experts say, but how and to what extent remains unclear. Called “Pathways to Success,” the new policies for ACOs were announced by the Centers for Medicare & Medicaid Services (CMS) about […]