CMS Proposes to Reform Home Health and Hospice Regulatory Requirements

2018-10-08T19:32:47+00:00September 27, 2018|News|

On September 17th, CMS held a public event to share its proposal to reform several home health and hospice regulatory requirements. The proposal includes changes to current home health and hospice regulatory requirements, Conditions of Participation (CoPs), and Conditions for Coverage. According to CMS, this will “simplify and streamline the current regulations and thereby increase provider

Review Choice Demonstration for Home Health Agencies

2018-09-27T16:25:51+00:00August 31, 2018|News|

Since the pause of the Pre-Claim Review Demonstration in April 2017, CMS has been working to develop an alternative called the Review Choice Demonstration. It states that this new demonstration will, "offer more flexibility and choice for providers, as well as risk-based changes to reward providers who show compliance with Medicare home health policies." Participation is

FY2019 Hospice Final Rule Published

2018-09-24T19:45:10+00:00August 3, 2018|News|

On August 1, 2018, CMS issued the FY2019 Hospice Final Rule for Medicare hospice agencies. The final rule includes changes to the hospice payment rates as well as updates to the Hospice Quality Reporting Program (HQRP). Burden Reduction CMS will no longer display the seven component measures from which a composite measure is calculated on

2019 Home Health Proposed Rule Released by CMS

2018-08-23T02:05:15+00:00July 3, 2018|News|

On July 2, 2018, CMS released the 2019 Home Health Proposed Rule. It includes considerable proposed changes to the Home Health Prospective Payment System designed to “strengthen and modernize Medicare, drive value, and focus on individual patient needs rather than volume of care.” Payment Rate Changes for CY2019 CMS projects that Medicare payments for CY2019

Pre-Claim Review: What Home Health Agencies Need to Know

2018-09-06T19:55:16+00:00May 31, 2018|News|

In this blog post, we will discuss what the pre-claim review demonstration is, the history of pre-claim review, and the latest updates. In June 2016, CMS announced implementation of a three year Home Health Pre-Claim Review Demonstration. The demonstration was designed to test whether a Pre-Claim Review (PCR) process would improve the identification, investigation, and

Medicare Fraud: Home Health & Hospice Agencies Beware

2018-05-30T18:44:50+00:00May 18, 2018|Archive, News|

Over the years, our industry has seen reports of crimes related to Medicare fraud including conspiracy to commit health care fraud, violations of the anti-kickback statutes, and money laundering. Recently, the OIG released its Health Care Fraud and Abuse Control Program Report for FY2017. In its report, the OIG discusses several significant criminal and civil investigations

FY2019 Hospice Proposed Rule: What You Need to Know

2018-05-11T19:30:13+00:00May 11, 2018|News|

On April 27, 2018 CMS released the FY2019 Hospice Proposed Rule. The rule includes a proposed increase in hospice reimbursements as well as changes to the Hospital Quality Reporting Program (HQRP), although no new measures are proposed. Highlights of the FY2019 Hospice Proposed Rule include: Payment Update CMS is proposing a 1.8% increase in reimbursements to

Medicare Beneficiary Identifier (MBI): What Home Health & Hospice Agencies Need to Know

2018-06-06T03:06:40+00:00March 29, 2018|News|

Designed to help protect the privacy of Medicare recipients, a new Medicare Beneficiary Identifier (MBI) will replace the social security number-based Health Insurance Claim Number (HICN) for Medicare transactions such as billing, eligibility status, and claim FISS/DDE submissions starting April 1, 2018. Beginning in April, CMS will mail new Medicare cards to all people with

Home Health Final Rule Released for 2018

2018-03-29T03:19:45+00:00November 3, 2017|News|

On November 1, 2017, CMS released the 2018 Home Health Final Rule. To the delight of home health agencies, the rule was finalized without the implementation of the Home Health Groupings Model (HHGM), which was proposed for roll-out in 2019. CMS stated, “We are not finalizing the implementation of the Home Health Groupings Model (HHGM)

Emergency Preparedness Training Open to Home Health & Hospice

2018-06-01T01:37:00+00:00October 20, 2017|News|

Home health and hospice providers have until November 15, 2017 to implement and be in full compliance with the new emergency preparedness requirements. Now is the time for agencies to get ready with HEALTHCAREfirst's emergency preparedness training courses! CMS has developed an Emergency Preparedness Training: Basic Surveyor Course to train surveyors on what to look