What ‘Significant’ AseraCare Ruling Means for Home Health Providers

A recent hospice-related court ruling may impact how federal watchdogs and whistleblowers go after home health agencies moving forward. Last month, the U.S. Court of Appeals for the Eleventh Circuit issued its long-anticipated decision in United States vs. AseraCare, a winding legal battle involving false claims allegations dating back to 2008. Hospice companies, other Medicare-reimbursed […]

New Trump Order Seeks Rate Equality Between Advantage Plans, Fee-for-Service Medicare

President Donald Trump signed a new executive order Thursday designed to bolster and expand Medicare Advantage (MA), the private Medicare insurance program for seniors that currently covers roughly 22 million individuals. While the executive order is relatively wide-ranging in scope, one major detail should immediately win the attention of home health providers. In the order, […]

CMS Pauses RCD in Two States Ahead of PDGM — But Moves Ahead in Texas

Good news for home health providers in North Carolina and Florida: The Centers for Medicare & Medicaid Services (CMS) will delay the implementation of Review Choice Demonstration (RCD) so agencies can adapt to the upcoming Patient-Driven Groupings Model (PDGM) first. Providers in Texas, however, won’t be as lucky. CMS announced Wednesday it is moving forward […]

Physician Education Likely to Pose Major Challenge Under PDGM

When it comes to the Patient-Driven Groupings Model (PDGM) and common concerns, most home health providers are quick to cite the overhaul’s widely opposed behavioral adjustments or controversial changes to therapy reimbursement. Although those two points are certainly important, PDGM also brings several lesser talked about, hidden challenges to the table as well. At the […]

Rogers: PDGM’s 8% Cut ‘A Double Slap in the Face’ to Home Health Providers

While home health advocacy efforts are routinely focused on national policies, state-level organizations often help pave the way. Among them is the Association for Home & Hospice Care of North Carolina (AHHC-NC), led by industry veteran Tim Rogers, its president and CEO. With the Patient-Driven Groupings Model (PDGM) and the Review Choice Demonstration (RCD) on […]

Home-Based Care Providers Can’t Afford to Overlook These Legal ‘Sleeping Giants’ in 2020

Home-based care providers have no shortage of regulatory hurdles and legal changes to keep them on their toes. For most home health agencies, the Patient-Driven Groupings Model (PDGM) and Review Choice Demonstration (RCD) are top of mind. Meanwhile, home care agencies have minimum wage hikes and electronic visit verification (EVV) to worry about. With so […]

Encompass Health’s April Anthony: Unified PAC Payment Model ‘Could Happen Before PDGM Even Settles’

For home health providers and their policy advocates on Capitol Hill, the Patient-Driven Groupings Model (PDGM) is priority No. 1, 2 and 3. Lurking in the background, though, is possibly an even bigger, more drastic reimbursement overhaul — a unified payment system for the entire post-acute care landscape. Currently, post-acute care (PAC) providers include skilled […]

A Perfect Storm: Amedisys, Encompass Health and LHC Group CEOs Brace for PDGM

The Patient-Driven Groupings Model (PDGM) is a perfect storm of regulatory and reimbursement changes, according to top executives from Amedisys Inc. (Nasdaq: AMED), Encompass Health Corporation (NYSE: EHC) and LHC Group Inc. (Nasdaq: LHCG). For agencies, managing cash flow and making sure staff are operating at the top of their licenses will be keys to […]

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 […]

State Home Health Leaders Go on the PDGM Offensive 

On a federal level, the National Association for Home Care & Hospice (NAHC), LeadingAge and the Partnership for Quality Home Healthcare (PQHH) have all ramped up their home health advocacy efforts this summer and in early fall. Increasingly, state home health leaders have joined in on those efforts as well. Over the past three months, […]