Where, When And Why Home Health Billing Fraud Becomes Obvious

A new comprehensive study is shining a light on potential factors that have led to home health billing fraud over the years. Among other findings, researchers at Dartmouth’s Geisel School of Medicine concluded that home health agencies that share patients across multiple agencies, and those that had high rates of expenditures across hospital referral regions […]

Medicaid Wage Proposal Could Prompt HCBS Operators To Exit Market, Discourage New Providers From Entering

The U.S. Centers for Medicare & Medicaid Services (CMS) recently published two proposed rules that have major implications for home-based care providers. The provision that has created the greatest waves among providers and industry stakeholders is the potential requirement that at least 80% of Medicaid payments for personal care, homemaker and home health aide services […]

22 States Petition For CMS To Repeal Vaccine Mandate For Health Care Workers

A group of 22 states — led by Montana Attorney General Austin Knudsen — have urged the Centers for Medicare & Medicaid Services (CMS) to lift the COVID-19 vaccine mandate for health care workers in the Medicare and Medicaid space. The 22 states include Montana, Louisiana, Tennessee, Arizona, Alabama, Alaska, Arkansas, Florida, Indiana, Kansas, Kentucky, […]

Government Watchdogs Looking to Ding Home-Based Care Providers

With the light at the end of the COVID-19 tunnel finally visible, home-based care agencies will now have to worry about checking their peripherals once they reach the other side. Government watchdog agencies are expected to come hard for providers in 2022 and beyond. The Biden administration released a 68-page report Monday pertaining to the […]

‘It’s Now for the Wealthy’: Regulation Creating Cost Barriers for Live-In Home Care Services

In 2013, the Obama administration included live-in caregivers in U.S. wage and overtime law. Previously, those caregivers – along with salaried workers – had been exempt from overtime provisions. The administration’s goal at the time was to raise caregiver wages. That has certainly happened, albeit in a small number of cases. Mostly, though, the Obama-era […]

CMS Launches Enhanced Oversight Initiative for New Home Health Agencies

With major regulatory volleys such as the Patient-Driven Groupings Model (PDGM) and the Review Choice Demonstration (RCD) on the table, keeping track of other industry-shaping issues can often feel like a losing battle. For some home health stakeholders, that may have meant missing a subtle yet important announcement from the Centers for Medicare & Medicaid […]