CMS

FY2020 hospice proposed rule released by CMS

2019-10-25T01:17:14+07:00May 17, 2019|News|

On April 19, 2019, CMS issued the FY2020 Hospice Proposed Rule. The following is a brief summary of the rule and what it could mean to hospice agencies. FY2020 Hospice Proposed Rule In this rule, CMS proposes to rebase the FY2020 per diem payment rates for Continuous Home Care (CHC), Inpatient Respite Care (IRC), and

PDGM resource hub

2019-11-20T03:11:17+07:00March 14, 2019|Home Health|

The implementation date for the Home Health Patient-Driven Groupings Model (PDGM) is on or after January 1, 2020. PDGM is an alternative case-mix methodology designed to put the focus on patient needs rather than volume of care. It relies heavily on patient characteristics to more accurately pay for home health services and uses 30-day

Provisional period of enhanced oversight for new home health providers

2019-10-25T01:29:28+07:00March 14, 2019|News|

On February 15, 2019, the Centers for Medicare and Medicaid Services (CMS) announced that effective immediately, all new home health providers will be placed in a provisional period of enhanced oversight. Provisional Period of Enhanced Oversight The provisional period of enhanced oversight means that new home health providers won’t receive Request for Anticipated Payments (RAP)

CMS Proposes to Reform Home Health and Hospice Regulatory Requirements

2018-10-08T19:32:47+07:00September 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

2019-11-20T02:00:08+07:00August 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

2019-11-20T02:01:18+07:00August 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+07:00July 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

2019-11-20T02:00:06+07:00May 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+07:00May 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+07:00May 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