Have you figured out what it means to you that CMS has changed the way it counts your hospital readmissions? We interviewed SHP CEO Barbara Rosenblum to get more detail on her recent blog note on the subject.
What does it mean when more than three-quarters of payment denials handed down by Medicare contractors are voided by Administrative Law Judges when appealed? Our conclusion, based on interviews over the years with home health care consultants who specialize in walking agencies through the appeal process, is that auditors at the RHHI, MAC, ZPIC […]
On March 29, 2013, the Centers for Medicare & Medicaid Services (CMS) issued a final rule with request for comment to implement provisions of the Affordable Care Act on increased Federal Medical Assistance Percentage (FMAP), or matching, rates for certain Medicaid beneficiaries in states. This rule codifies the increased FMAP rates that will be applicable […]
April 2013 Quarterly System Release – Claim Hold On April Fool’s Day, the first day federal payment cuts resulting from Congress’ failure to reach a budget compromise went into effect, CMS announced that the changes it made to its claims paying system rendered that system unable to properly process home health claims. It will […]
by Tim Rowan, Editor As this issue was going to press, the March 1 Sequestration deadline came and went, with all sides spending more time arguing who is to blame than writing legislation. Medicare providers will face a 2% rate reduction if sequestration is not avoided but it is not that simple.
To help healthcare providers prepare for ICD-10, CMS has released new checklists and timelines for small and medium provider practices, large provider practices, small hospitals and payers. These resources are designed to give a high-level understanding of what the ICD-10 transition requires and how each provider’s ICD-10 preparations compare with recommended time frames. Many […]
The Hospice Education Network (HEN) has announced the development of a new series of eight online courses, Disease-Specific Hospice Eligibility Determination and Documentation. The instructor, Terri Maxwell, PhD, APRN, is Vice President of Strategic Initiatives for Weatherbee Resources. Details are provided about the needs for these courses in regard to reducing exposure to risks […]
CMS announced the first three participants in a program designed to help consumers get more information regarding their local doctors, hospitals, and other health care providers. The Medicare Data Sharing for Performance Measurement program, made possible by the Affordable Care Act, will make Medicare claims data available, under strict privacy requirements, to groups that […]
by H. Carol Saul Almost fifteen years ago, the Centers for Medicare & Medicaid Services (CMS) adopted a final rule requiring home health agencies (HHAs) to post surety bonds in the amount of $50,000, or 15% of the annual amount received from Medicare, whichever was greater. That regulation quickly faced opposition by Congress and by […]
When HIPAA was new, there was an excellent software product available to help home care agencies and hospices conduct risk assessments and perform all the other required duties to achieve Privacy and Security Rule compliance. Known as GetHIP, from Stony Hill Management, it fell by the wayside when our industry noticed that enforcement by the […]
