When it comes to the Patient-Driven Groupings Model (PDGM) and the impact the overhaul will have on the home health industry in 2020, outlook largely varies depending on who you talk to. On one hand, some industry insiders have told Home Health Care News that PDGM — mandated to be budget neutral by Congress — […]
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 […]
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 […]
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 […]
The Centers for Medicare & Medicaid Services (CMS) is moving forward with many of the provisions originally included in the Patient-Driven Groupings Model (PDGM) while also proposing to implement a new home infusion benefit, eliminate home health pre-payments and make Value-Based Purchasing Model (VBPM) performance data public. CMS detailed its plan for PDGM and other […]
A key ally for home health providers and a major proponent of value-based care may be leaving his federal post. The Trump administration revealed late Wednesday it has nominated Adam Boehler — director of the Center for Medicare & Medicaid Innovation (CMMI) and a senior adviser to the secretary of the U.S. Department of Health […]
The flood of home health support from Congress on the Patient-Driven Groupings Model (PDGM) front continues. On July 2, a bipartisan, bicameral group of lawmakers sent a letter to Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma, urging the agency’s leader to revisit certain widely opposed provisions of PDGM during CMS’s annual rulemaking […]
As the pages on the calendar continue to turn toward January 2020, the Patient-Driven Groupings Model (PDGM) remains a top priority for home health agencies big and small. But while the payment overhaul does mark the beginning of a new era in the industry, it can’t be providers’ sole focus. “It shouldn’t be: ‘PDGM is […]
Among its many changes, the Patient-Driven Groupings Model (PDGM) aims to completely refocus how home health providers are paid for the therapy services they deliver, mainly by moving away from visit volume as the determining factor in calculating reimbursement. When the Centers for Medicare & Medicaid Services (CMS) first proposed PDGM in July 2018, some […]
Earlier this week, a bipartisan pair of U.S. senators released a “secret list” of nursing homes under consideration for placement on the federal government’s roster of properties with serious quality issues. Maintained by the Centers for Medicare & Medicaid Services (CMS), the list features more than 400 nursing homes that are “candidates” for the Special […]
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