CMS Allows Medicare Advantage Homemaker Coverage
In April, we learned that CMS was opening Medicare Advantage plans up to include coverage for homemaker services. While this is great for patients, you can expect more traditional Medicare …
Insights and News
Hospice 2019 Proposed Rule
Most hospices will like some aspects of the proposed rule for 2019 but some might not. These are just proposed changes for 2019, not what will actually happen. However, the …
Pre-Claim Review Coming Back for Home Health
CMS has introduced a new round of pre-claim reviews for home health agencies and the likelihood of it becoming a reality is getting closer than ever. This next round adds …
Humana Moves Forward with Kindred Purchase and Walmart is Interested
Humana has been allowed to move forward with the ability to purchase a 40% stake in Kindred at Home. The insurer also has the first right to purchase the additional …
Home Health Targeted Probe and Educate
As many agencies are aware and undergoing, CMS has implemented a Targeted Probe and Educate program. Aside from the obvious jokes about being probed by Medicare and feeling uncomfortable, the …
Home Health Agency Appeals ZPIC & Wins
Home health agencies know that overzealous survey and fraud programs can do more harm than good. A Texas agency knows this all too well. Family Rehabilitation Inc. located in Texas …
MedPac: Home Health Margins Too High!
Does MedPac really understand home health? From their latest report to Congress it is safe to assume that their understanding stops at the basics. Their financial understanding of how well …
Define Healthcare Fraud and Abuse
We often hear about agencies or clinicians committing fraud or partaking in abuse. But what are the clear definitions of fraud and abuse? The new Conditions of Participation (COPs) when …
Do physicians really read orders and info sent to them?
A recent study in the Annals of Internal Medicine shed some interesting light on, and evidence of what many in home health have always thought occurred but didn’t have tangible …
Surveys: Supplying Patient Lists Could be a Thing of the Past
A recent Inspector General’s (IG) report outlines the biggest and sometimes most conflicting item provided during a survey: the patient list. Agencies typically provide a list of all patients or …