For the second consecutive year, the Medicare Payment Advisory Commission (MedPAC) has issued a draft recommendation advising Congress to reduce Medicare payments to home health agencies by 7% beginning in 2026. During its December meeting, MedPAC discussed the adequacy of Medicare payments across various provider settings and reviewed its draft recommendations to Congress regarding payment […]
Medicare
Residents in neighborhoods with lower socioeconomic status were more likely to use lower-quality home health agencies, according to a recent study by researchers at the University of Georgia, Athens. Using data from the Outcome and Assessment Information Set (OASIS), Area Deprivation Index and Patient Care Star Ratings, researchers examined 1,657,133 Medicare beneficiaries who received home […]
A new analysis by the Kaiser Family Foundation (KFF) reveals that Medicare spending is higher for beneficiaries who switch from Medicare Advantage (MA) to traditional Medicare compared to similar beneficiaries who have continuously been enrolled in traditional Medicare. These beneficiaries cost Medicare an average of 27% more, according to the analysis, which examined health costs […]
Congress has begun discussions on important health care policies set to expire on Dec. 31. On Dec. 3, Republicans submitted a preliminary proposal to Democrats, which includes a three-year extension of Medicare’s telehealth and hospital-at-home programs. They also suggested funding for community health centers and extensions for public health programs in Medicare and Medicaid. The […]
Less than a month before election day, the Democratic and Republican candidates for president are dueling over home-based care plans. Vice President Kamala Harris announced on “The View” this week a proposal that would allow home care to be administered through traditional Medicare. On the same day, former President Donald Trump and his campaign released […]
A Detroit-area couple who owned home health care companies was sentenced to prison last week for Medicare fraud and tax evasion, according to U.S. Attorney Dawn Ison. Noli and Isabel Tcruz of Washington Township, Michigan, were sentenced on Sept. 4. Noli Tcruz received six years in prison, and his wife was given three years and […]
Home health agencies and other Medicare-reimbursed health care providers are just a couple weeks away from the return of sequestration. For many agencies, the restart of the 2% cut will merely be a return to normal, pre-pandemic business. For others, however, it presents another cash-flow disruption that could, at worst, put some smaller operators out […]
President Donald Trump has opened the door to possible Medicare cuts, an alarming scenario for U.S. home health providers already facing a major reimbursement overhaul and increased compliance pressure from federal watchdogs. Speaking during an interview with CNBC while attending the World Economic Forum in Davos, Switzerland, Trump suggested that he would consider cuts to […]
Three additional home health agency owners have been sentenced to a combined 117 months in prison for their roles in multi-million dollar fraud schemes. The recent sentencings bring April’s home health-related fraud cases to at least five overall, a total that broadly reflects the increased scrutiny and oversight the industry currently faces. On April 22, […]
The home health industry has won another victory in Washington, D.C., in its battle against certain parts of the Patient-Driven Groupings Model (PDGM) and shift toward a more pre-acute care identity. Sens. Susan Collins (R-Maine), Bill Nelson (D-Fla.) and Debbie Stabenow (D-Mich.) introduced the Home Health Payment Innovation Act — S. 3545 — on Wednesday. […]
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