Senate Lawmakers Introduce New Legislation Urging Evidence-Based PDGM Changes

Newly introduced bipartisan legislation in the U.S. Senate is targeting the widely opposed behavioral adjustments set to hit home health agencies next year under the Patient-Driven Groupings Model (PDGM). If passed, the legislation would require the Centers for Medicare & Medicaid Services (CMS) to base Medicare reimbursement rates on observed evidence and data, instead of […]

Dombi, Myers: Dangerous Assumptions in PDGM Could Disrupt Home Health

Two prominent home health leaders are trying to keep pressure on federal lawmakers to eliminate components of the forthcoming Patient Driven Groupings Model (PDGM). Bill Dombi, president of the National Association for Home Care & Hospice (NAHC), and Keith Myers, CEO of LHC Group (Nasdaq: LHCG) and chairman of the Partnership for Quality Home Healthcare, […]

Legislation Targeting Home Health Reforms Gaining Ground on Capitol Hill

Industry-backed legislative efforts to take the teeth out of proposed home health payment reform are gaining ground on Capitol Hill. On Thursday, Rep. Ralph Abraham (R-La.) introduced H.R. 6932, a new bill that amends several provisions of the Bipartisan Budget Act of 2018 to thwart widely opposed behavioral adjustment aspects of the Patient-Driven Groupings Model […]

New Medicare Payment Model Looms Over Home Health Providers

Home health agencies should be prepared for a major unwelcome surprise that could hit in the near future—a comprehensive, complex overhaul of the Medicare payment system. When the Centers for Medicare & Medicaid Services (CMS) proposes its 2018 payment rates, likely within the next several weeks, the agency could also seek to establish a new payment […]

Monday Briefing: Tom Price Confirmed as Secretary of HHS

In the wee hours of Friday morning, after an all night session, the Senate confirmed Rep. Tom Price M.D (R-GA) as the secretary of the Department of Health and Human Services (HHS). Several industry organizations like the Partnership for Quality Home Healthcare and the American Health Care Association (AHCA)/ National Center for Assisted Living (NCAL) are […]

Senate Bill Would Extend Independence at Home Demonstration

A pilot program that incentivizes the delivery of home-based health care for chronically ill patients may be extended if newly introduced legislation passes. The Senate Finance Committee Chronic Care Working Group introduced the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2016 (S. 3504) on Dec. 6. The bipartisan legislation, among other […]

Majority of U.S. Seniors Against Pre-Claim Review

The start of the Centers for Medicare & Medicaid Services’ (CMS) pre-claim review demonstration has drawn harsh criticism from many stakeholders in the home health care industry. Now, they may be able to say that seniors themselves don’t like the initiative, either. Bring Home the Vote, which sponsored the poll, is a national initiative that […]

Home Health Agencies Grapple With Prior Authorization Rule

Home health providers and associations were quick to denounce a preauthorization requirement after the Centers for Medicare & Medicaid Services (CMS) revealed it will move forward with its formerly announced plans. Across the board, industry officials expressed disappointment and concern with the CMS plans for prior authorization, now deemed the Pre-Claim Review Demonstration for Home […]