Changes to the Medicaid Provider Reassignment regulation would eliminate state’s ability to divert Medicaid payments away from providers.
New name, same proposal for 30-day billing and loss of therapy as a reimbursement factor.
On February 1, 2017, a judge in the so-called Jimmo case ordered the Centers for Medicare and Medicaid Services (CMS) to enter into a Corrective Action Plan (CAP). The CAP requires CMS to provide more education about the addition of a coverage standard for maintenance therapy. That is, CMS is required to provide additional education to providers regarding the fact that improvement is not required in order to be eligible for Medicare coverage for skilled care in skilled nursing facilities (SNFs), home health agencies (HHAs), outpatient therapy centers and inpatient rehabilitation hospitals.
by Tim Rowan The uncertainty that hangs like a cloud over Healthcare at Home providers and patients, employees and investors, seems heavier and perhaps harder to peer through than it was the last two times a moving van had recently pulled away from the White House.
by Julianne Haydel Imagine if every one of your Face-to-Face documents and plans of care were scrutinized prior to payment. Would 90 percent of them be found compliant with existent rules? If a non-clinical person determined that your documentation did not meet Medicare coverage guidelines, would you take their word over your nurses’? How would […]
In a unanimous decision, a three-judge panel strongly disagreed with a lower court’s January decision that the Department of Labor had improperly re-defined in-home senior care late last year.
by Tim Rowan Massachusetts’ Executive Office of Health and Human Services has released proposed rates for remote patient monitoring reimbursement by home health agencies. The proposed regulation’s new service and associated payment rate,
by Fred Schulte A new whistleblower case accuses a Texas medical consulting firm and more than two dozen health plans for the elderly of ripping off Medicare by conducting in-home patient exams that allegedly overstated how much the plans should be paid.
by Tim Rowan On July 31, 2015, the Centers for Medicare & Medicaid Services issued a final rule (CMS-1629-F) that updates fiscal year 2016 Medicare payment rates and the wage index for hospices serving Medicare beneficiaries. For convenience, we reprint the official CMS summary of the final rule in the sidebar at the bottom of […]
"I have been in home health for 26 years and this is the most frustrating it has ever been!" Comments like this one permeated the responses to our survey asking readers whether they have noticed an increase in the number of payment denials. We reprint your comments here, with some background comment for perspective. The consensus among HCTR readers? A suspicion that MACs, ZPICs, UPICs and other Medicare contractors decide first what percentage of claims they want to deny and develop denial reasons later.
