What Happens When You Lose an Insurance Contract?
It seems far-fetched – or at least it did…but Highmark, who provides Medicare Advantage plans to residents in the Pittsburg, PA area, recently terminated its agreement with 8 home health …
Face to Face for Medicaid & Telehealth
CMS has released the effective date of the new F2F ruling for Medicaid home health services. July 1, 2016 is the official date. However, states will be allowed to phase …
Mass Gets Tough on Fraud
Joining the chorus of many other states throughout the country, Massachusetts Governor Charlie Baker has announced under his direction, home health agencies are going to be put under review. Starting …
Prior Authorizations – Not Just for Commercial Insurance Anymore
Ready for the next step in healthcare evolution? We know there is a lot to handle all at once, but for 5 states, the changes keep on coming. CMS …
Home Health’s Role: A Goal for 2016
As healthcare continues to evolve, new groups are forming – ACOs. Accountable Care Organizations or ACOs are becoming the newest and hottest trend in healthcare. From hospital systems to physician …
PROBE AND EDUCATE ISSUES
Medical Review Additional Documentation Requests (ADR) have begun. We were first notified in the fall about this new type of ADR that selects episodes that began after August 1, 2015 …
MedPac Continues to Think Your Agency Has a High Profit
MedPac seems to come out with their recommendations a few times a year and each time, it reinforces the point that the advisory committee is not working within the reality …
Legislative Update: Proposal for OTs to Perform SOC
Two senators have introduced legislation to allow Occupational Therapists to finally open patients with a SOC OASIS. The Medicare Home Health Flexibility Act of 2015 (S. 2364) would allow an …
CMS Data Released
CMS is continuing with its transparency initiative and releasing more data about your home health agency. Data that has been released is from 2013, but provides very interesting benchmarking data …
OASIS changes in 2017
On January 1, 2017, OASIS-C2 will be released. The newest iteration of the OASIS will be complying with the 2014 IMPACT Act. The changes will include more standardized data collection …