‘Perpetuity Of Uncertainty’: Home Health Providers Await Another Poor Payment Proposal While Left In Limbo On Massive Clawbacks

The Medicaid Access Rule has been finalized, with six years until the implementation of the 80-20 provision. There’s no time to rest for home-based care providers and advocates on the regulation front, however. Summer is near, and that means so is the home health proposed payment rule from the Centers for Medicare & Medicaid Services […]

How Personal Care In Acute Care Settings Could Become Popularized, Benefiting Patients And Providers

In March, the U.S. Centers for Medicare & Medicaid Services (CMS) approved a request from one state to allow more personal care service delivery within acute care facilities. Though not yet widespread, the amendment could open doors for providers and patients needing personal care in alternative settings in the future.  One change to a Medicaid […]

‘This Battle Is Far From Over’: Federal Court Dismisses NAHC’s Lawsuit Against CMS

Last summer, the National Association for Home Care & Hospice (NAHC) made waves when it filed a lawsuit against the Centers for Medicare & Medicaid Services (CMS) and the U.S. Department of Health and Human Services (HHS) over Medicare home health payment calculations. Last week, a federal court in Washington D.C., dismissed NAHC’s lawsuit against […]

Payment Cuts Are Having A Compounding, Dire Effect On The Home Health Industry

Home health providers’ fight against cuts to fee-for-service Medicare payment has become a year-by-year battle. But the yearly cuts are compounding, which is exactly what industry advocates are trying to illustrate to Congress prior to the next payment rule proposal.  Since the adoption of the Patient-Driven Groupings Model (PDGM) in 2020, the Centers for Medicare […]

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, […]

What The ‘Fundamentally Contradicting’ Medicaid Access Rule Includes

The White House teased the finalized Medicaid Access Rule early Monday, and the Centers for Medicare & Medicaid Services (CMS) later revealed more intricate details attached to the rule. Firstly, the timeline of the rule is now clear. Specifically: – In three years, states must “report on their readiness to collect data regarding the percentage […]

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 […]

Home Health Benefit Will Become A ‘Skeleton’ If Medicare Payment Adjustments Continue, Industry Leader Cautions

As the breadth and depth of home health care continues to grow, providers are exposed to an abundance of opportunities. To get a crack at that upside, however, providers will need to overcome and adapt to a litany of challenges. Those that don’t could contribute to the consolidation that the home health industry is already […]