Home Health Industry Has ‘Very Limited Chance’ of Derailing CMS’s RAP Plans

Home health agencies hoping the industry will derail the Centers for Medicare & Medicaid Services (CMS) in its quest to eliminate pre-payments shouldn’t hold their breath. In its July 11 proposed payment rule, CMS floated plans to phase out Requests for Anticipated Payment (RAPs) starting next year and eliminate them completely by 2021. The agency […]

New Trump Order Seeks Rate Equality Between Advantage Plans, Fee-for-Service Medicare

President Donald Trump signed a new executive order Thursday designed to bolster and expand Medicare Advantage (MA), the private Medicare insurance program for seniors that currently covers roughly 22 million individuals. While the executive order is relatively wide-ranging in scope, one major detail should immediately win the attention of home health providers. In the order, […]

Encompass Health Looks to Improve Clinical Collaboration Rate, Expects $45M PDGM Headwind

For most home health providers in the U.S., adapting to the Patient-Driven Groupings Model (PDGM) remains priority No. 1 for the rest of 2019. That’s certainly true for Birmingham, Alabama-based Encompass Health Corp. (NYSE: EHC), though the national operator of both in-patient rehabilitation hospitals (IRFs) and home health agencies is also actively looking to improve […]

Aging-in-Place Program from Johns Hopkins on the Verge of ‘Exponential Growth’

CAPABLE — the innovative program developed out of the Johns Hopkins School of Nursing that combines nursing care, occupational therapy and handyman services — is on the verge of “exponential growth” and one step closer to becoming Medicare-reimbursable. It’s also another example of how complex and comprehensive in-home care is becoming. Since its first pilot […]

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 […]

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 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 […]

[Updated] CMS Proposes Elimination of RAPs, $250 Million Medicare Payment Increase

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 […]

Home-Based Care Ally Adam Boehler to Leave CMMI

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 […]