‘The Patient Pays The Price’: Home Health Stakeholders Slam Medicare Advantage Plans As CMS Comment Period Closes

Medicare Advantage (MA) – the offshoot of traditional Medicare that’s administered by private insurance companies – has recently caught a lot of flak. As it pertains to home health care specifically, MA plans have been criticized for their cumbersome prior authorization requirements and provider reimbursement rates that are typically far below fee-for-service Medicare. What’s more, […]

Debbie Stabenow, Susan Collins Advocate Against Home Health Payment Cuts In Letter To CMS

Sens. Debbie Stabenow (D-Mich.) and Susan Collins (R-Maine) recently sent a letter to Centers for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure, urging her and the agency to avoid cuts to home health payment as it nears time to release a proposed rule for 2025.  “We appreciate CMS’ commitment to helping people get the […]

With Medicaid Access Rule Finalized, Home Care Providers Enter ‘Wait-And-See’ Mode

On Tuesday, Centers for Medicare & Medicaid Services (CMS) officials vehemently backed the thought process behind the “80-20” wage mandate in home- and community-based services (HCBS). Providers and advocates, on the other hand, continued to argue that the policy could be disastrous. During a press call Tuesday, CMS stuck with the theme that, in general, […]

Minimum-Staffing Rule For Nursing Homes Finalized, Likely Complicating Post-Acute Care Labor Dynamics

The White House on Monday announced that the nursing home minimum-staffing rule has been finalized. Effectively, the rule requires all nursing homes that receive Medicare and Medicaid funding to maintain a certain staffing threshold at all times. The U.S. Centers for Medicare & Medicaid Services (CMS) first proposed the minimum-staffing requirement last fall. “Medicare and […]

Home Care Industry Slams Finalized 80-20 Rule, Warns Agency Closures Are Coming

The “Ensuring Access to Medicaid Services” rule has been finalized. Most importantly, the bemoaned “80-20” provision has gone through as proposed, meaning providers will eventually be forced to direct 80% of reimbursement for home- and community-based services (HCBS) to caregiver wages.  First proposed by the U.S. Centers for Medicare & Medicaid Services (CMS) in April […]

CMMI’s Proposed TEAM Model Offers Another Risk-Based Opportunity For Home Health Providers

Last week, the Centers for Medicare & Medicaid Services (CMS) Innovation Center announced a new proposed model that will undoubtedly affect home health providers, and also allow them the opportunity to get more involved in value-based care initiatives. The Transforming Episode Accountability Model (TEAM), which would eventually be mandatory if finalized, would have selected acute […]

Discrepancies In Home Health Enrollment Data Raise Red Flags In Congressional Hearing

U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra fielded questions in a House Ways & Means committee hearing on Capitol Hill Wednesday, a few of which were pointed at concerns around potential fraud in home health. Rep. Michelle Steel (R-Calif.) grilled the secretary about an apparent lack of progress on curbing certifications […]