New PEPPER Retrieval Maps are Available Now
From the RELI Group: “PEPPER is an educational tool that summarizes provider-specific data statistics for Medicare services that may be at risk for improper payments. Providers can use the data …
Insights and News
CMS to Combine All “Compare” Websites for Hospice, SNFs, Home Health, etc.
Today, CMS’ “Compare” websites are separate entities that provide information on different provider types. Last week, CMS announced plans to combine and standardize these eight existing Compare tools, allowing users …
New DRAFT version of the MDS 3.0 Item Set Change for October 2020
A new DRAFT version of the MDS 3.0 Item Set Change History for October 2020 (v1.18.0) was posted. This document reflects the changes in the DRAFT version of the 2020 …
Top Home Health and Hospice Medical Review Denial Resources
From CGS: CGS monitors quarterly data for the top home health and hospice (HHH) medical review denial reasons. In addition to the quarterly data, you will find CGS and CMS …
OASIS Quarterly Q & As Now Available! Important PDGM Info Inside!
CMS has posted the January 2020 refresh of the OASIS Quarterly Q and As. These are always worth reading, and with PDGM causing confusion and headaches for most home health …
CMS Requests Feedback on Using Out-of-State Providers for Medicaid-Covered Children
CMS is requesting input from providers to determine “best practices for using out-of-state providers to provide care to children with medically complex conditions; determine how care is coordinated for such …
The DOJ Recovers over $3 Billion from False Claims Act Cases in 2019
The Department of Justice obtained more than $3 billion in settlements and judgments from civil cases involving fraud and false claims against the government in the fiscal year ending Sept. …
CMS Releases New Survey Process for Psychiatric Hospitals
Yesterday, CMS announced a streamlined survey and certification process for psychiatric hospitals. Beginning in March 2020, CMS will implement a streamlined process in which psychiatric hospitals will receive one comprehensive hospital survey …
Four Times as Many Medicare Advantage Plans Offer Palliative Care in 2020 than in 2019
Duke University’s Margolis Center for Health Policy has released a new study examining all the latest changes in supplemental benefits offered by Medicare Advantage Plans. Key among the changes is …
IRS Tools for Gig Economy Workers
The gig economy—also called sharing economy or access economy—is activity where people earn income providing on-demand work, services or goods. Often, it’s through a digital platform like an app or …