Aetna Bucks Medicare Advantage Trend, Continues To Invest In Home-Based Care Benefits

Funding for fee-for-service home health care and home- and community-based services ebbs and flows. But the payer source most likely to dictate the future of home-based care providers – across the board – is Medicare Advantage (MA). MA plans aren’t immune to tough rate environments, either. In fact, they’re in one right now. That’s one […]

Editor’s Picks: Pre-Claim Delays and Woes

It’s been a big week for the home health Pre-Claim Review Demonstration. The poorly-received program made several Home Health Care News headlines, first with its delayed start in Florida, and then due to home health providers still calling for the program’s total suspension everywhere. Meanwhile, the Department of Health and Human Services Office of Inspector General […]

Support Grows for Legislation to Improve Medicare Competitive Bidding

A new piece of proposed legislation that would reform the Medicare competitive bidding program to make it more equitable is being met with positive reception among government officials and industry leaders.  The Medicare DMEPOS Competitive Bidding Improvement Act, H.R. 4920, if passed, would make bids from suppliers to provide durable medical equipment, prosthetic and orthotic devices and […]

Medicare Advantage Plans Overcharge $70 billion for Home Visits

Health plans are cashing in on home visits, taking advantage of Medicare profits when the house calls unearth patients’ medical problems, according to a report by The Center for Public Integrity, a nonprofit investigative news organization in Washington, D.C. Some senior citizens are finding that their Medicare Advantage health plans were eager to send a […]

CMS Issues Rule Outlining SNFs and Hospice Partnerships

The Centers for Medicare & Medicaid Services (CMS) have issued a final rule that outlines the roles and responsibilities for developing a written agreement between long-term care (LTC) and hospice providers, should a LTC resident or patient elect to receive hospice care.  Under the rule, a LTC facility will be required to have only one […]

CMS Delays DME Face-to-Face Rule

The Center for Medicare & Medicaid Services (CMS) announced today that it will be delaying the face-to-face rule regarding its durable medical equipment (DME) reimbursement program effective July 1, reports HomeCare Mag.  The three-month extension moves the deadline to October 1, and according to the American Association for Homecare, the delay will allow DME providers […]

CMS Announces New Medicare DME Pricing, Aims For Expansion

New prices for durable medical equipment looks to save billions for both Medicare and its beneficiaries over the next decade, announced the Centers for Medicare & Medicaid Services (CMS) on Wednesday. Between 2013 and 2022, the CMS Office of the Actuary estimates Medicare will save $25.7 billion for its Part B Trust Fund, and $17.1 […]