Push Against Competitive Bidding Goes National

A growing group of professionals with ties to the home care and medical equipment industries are uniting in their opposition to a proposal from the Centers for Medicare and Medicaid Services (CMS) to expand its competitive bidding program to new areas.  From clinicians and advocates for Medicare beneficiaries to home medical equipment providers, manufacturers, and […]

Face-to-Face Rule Burdensome to Home Health Agencies

New government rules meant to prevent inappropriate reimbursements are proving burdensome to many home health agencies who worry it will interfere with their ability to provide care to those who need it.  “The cost of caring for homebound patients is rising, and the government is trying to get a better grip on spending by requiring […]

CMS Readies Fingerprint Background Checks for Home Health Providers

The Centers for Medicare & Medicaid Services (CMS) will finally begin implementing its long-heralded fingerprint-based background checks for home health providers. As part of enhanced enrollment screening provisions contained in the Affordable Care Act, CMS announced it is beginning to phase in the implementation of fingerprinting background checks—an initiative three years in the making. The […]

Home Care Group Responds to HHS Secretary’s Resignation

Kathleen Sebelius recently announced her resignation as secretary of the Department of Health & Human Services following the end of open enrollment for—and botched rollout of—the health insurance exchanges created under the Affordable Care Act. On April 11, President Barack Obama nominated Sylvia Mathews Burwell to take over the position. Burwell is the current director of […]

OIG Finds $2 Billion in Medicare Home Health Claims Paid in Error

Federal investigators have uncovered some flaws with the Centers for Medicare & Medicaid Services’ (CMS) face-to-face rule—flaws costing $2 billion worth of erroneous home health Medicare claims, a recent report finds.  Documentation standards for face-to-face encounters did not meet Medicare requirements for 32% of home health claims, resulting in $2 billion that should not have […]

New Medicare Policies Threaten Home Health, Hospice Providers

Smaller home health and hospice providers will struggle to survive in the face of new policies and proposals that could deeply impact both industries, says Healthcare Market Resources in a market research letter that points to growth as a solution.  The home health and hospice industries are threatened by several policy efforts underway or in […]

Survey Shows CMS Competitive Bidding Program Is Not One-Size-Fits-All

Following a public commenting period from the Centers for Medicare & Medicaid Services (CMS) on Round 2 of its Competitive Bidding program for home medical equipment (HME), a recent survey shows a majority of HME providers generally reject the program’s “one-size-fits-all” approach. In efforts to simplify the submitting of public comment, VGM Group, Inc. created […]

Detroit Home Health Care Worker Sentenced for Role in $5.8 Million Fraud

On the heels of recent home health care-related fraud developments sprouting up nationwide, a new $5.8 million Medicare scheme has landed a prison sentence for an office manager of a Detroit-area home care agency. Nabila Mahbub, 28, was sentenced Wednesday by a federal judge in the Eastern District of Michigan to serve 46 months in […]

Michigan Doctor Pleads Guilty in $7 Million Home Health Scheme

A Detroit-area doctor this week pleaded guilty for her role in a home health fraud scheme that bilked Medicare out of more than $7 million.  The doctor, Adelina Herrero of Ann Arbor, Michigan, pleaded guilty to one count of conspiracy to commit health care fraud.  From April 2010 to April 2013, Herraro and others agreed […]

Congress Passes “Doc Fix” Bill, Delays Shift to ICD-10

This week, Congress passed what’s known as a “doc fix” bill, delaying not only cuts to Medicare physician payments, but also pushes back the implementation of ICD-10 coding system for one year.  The temporary “fix” delays a 24% reduction in Medicare physician reimbursement until October 2015, which initially would have taken effect March 31 as […]