Counterpoint: Elimination of RAPs Isn’t a ‘Sky-Is-Falling Issue’

Since the Centers for Medicare & Medicaid Services (CMS) announced its proposal to phase out Requests for Anticipated Payments (RAPs) last month, home health providers have voiced their concerns about what the change will mean for them. Industry-wide, the consensus isn’t good. Many providers worry the removal of RAPs, in addition to the other regulatory […]

Ohio Home Health Agencies Are Next in Line for the Review Choice Demonstration

The Review Choice Demonstration (RCD) is expanding. The Centers for Medicare & Medicaid Services (CMS) announced Monday that home health providers in Ohio will be next in line for RCD, a revived version of the failed Pre-Claim Review Demonstration (PCRD) meant to combat improper billing. Home health providers in Illinois — the only state with […]

Encompass Health’s April Anthony: PDGM Isn’t a ‘Free Pass’ for Breaking Coding Rules

Encompass Health Corp. (NYSE: EHC) has lowered internal estimates on how the Patient-Driven Groupings Model (PDGM) will impact its home health operations, though the company remains firmly against assumption-based behavioral adjustments included in the payment overhaul. CEO Mark Tarr — along with home health and hospice segment leader April Anthony as well as other execs […]

PDGM Check-In: ‘There’s a Slight Sense of the Wild West’

With just five full months to go before the Patient-Driven Groupings Model (PDGM) becomes a reality, home health providers have reached crunch time. As it has been all along, the assumption-based behavioral adjustment baked into PDGM remains the home health industry’s No. 1 issue. Orginally, the behavioral adjustment was estimated to create a 6.42% payment […]

OIG Calls for Additional Oversight of Home Health, Personal Care Service Providers

In a new report released Monday, the U.S. Department of Health and Human Services Office of Inspector General (OIG) highlighted dozens of its unimplemented recommendations for reducing fraud, waste and abuse throughout the Medicare and Medicaid systems. Many of the recommendations were tied to home health, hospice and personal care services, in addition to how […]

CMS Proposal Takes Home Health Agency Closure Estimates and ‘Lights Them on Fire’

After federal health care policymakers fine-tuned the Patient-Driven Groupings Model (PDGM) last October with a 6.42% cut based on certain behavioral assumptions, some industry experts predicted there would be a modest uptick in home health bankruptcies in 2020. “The last time the industry went through this kind of major change was in the late 1990s […]

Why CMS’s Home Health Therapy Proposal May Not Be Enough

As part of its Patients Over Paperwork initiative and as a way to make home health requirements more consistent with other settings of care, the Centers for Medicare & Medicaid Services (CMS) is proposing to allow therapist assistants to furnish maintenance therapy. Under current home health rules, only physical therapists (PTs), occupational therapists (OTs) and […]

CMS Finding New Ways to Penalize Home Health Providers

The Centers for Medicare & Medicaid Services (CMS) is finding new ways to penalize home health providers. In its proposed payment rule for 2020 released last week, CMS floated the idea of phasing out pre-payments for home health services starting in 2020, killing them completely by the following year. Currently, home health providers can receive […]