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)
Beginning on November 15, 2017, hospice agencies must be prepared to demonstrate compliance with the Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers Final Rule. CMS is releasing a new Appendix Z of the State Operations Manual (SOM) that contains the interpretive guidelines and survey procedures for the final rule. An advance copy can be
On August 1, 2017, CMS published the FY 2018 Hospice Final Rule. In the final rule, Medicare hospice payments, adjusted for inflation and other factors, will increase an estimated 1% or an estimated $180 million in 2018. This is in comparison to the 2017 final rule, which included a 2.1% increase, or $350 million, in payments.
Home health regulatory requirements create a variety of documentation and management challenges that home health agencies must be prepared to address. In particular, emerging regulatory changes surrounding Medicare home health fraud are pressuring agencies to keep an especially close watch over every facet of operations. According to a CMS Comprehensive Error Rate Testing (CERT) report
Home Health Fraud Prevention: HEALTHCAREfirst White Paper Released We are pleased to announce the release of a new white paper that takes a look at the current home health regulatory environment and the efforts to crack down on home health fraud by the federal government. The Home Health Fraud Prevention white paper, “Home Health Regulatory Pressures
Corresponding to an aging population and an increase in the incidence of chronic health conditions, more than 3.4 million people currently receive Medicare skilled home health care services. With home health care service utilization on the rise, Medicare home health care spending has nearly doubled from 9.7 billion in 2001 to 18.3 billion in 2012.1 Additionally, home health agency growth has soared while profit margins have declined.
Centers for Medicare and Medicaid Services (CMS) recently released the FY2018 Hospice Proposed Rule. The rule proposes that the overall payments for Hospice providers increase by 1% ($180 Million). Additionally, the Hospice cap amount for the 2018 cap year would be $28,689.04. In addition to the cap and payment updates, the rule solicits comments regarding
On Friday, July 7, 2017, CMS issued a final rule to change the new Home Health Conditions of Participation effective date from July 13, 2017 to January 13, 2018. Despite this delay, home health agencies should not cease or postpone preparation for the new Home Health CoPs. HEALTHCAREfirst has created a home health conditions of participation
Update: On March 31, 2017, CMS stated that the Pre-Claim Review Demonstration will not expand to Florida on April 1, 2017 as planned. CMS will notify providers at least 30 days in advance via an update on their website of further developments related to the demonstration. HEALTHCAREfirst will continue to monitor the status, provide updates as
Before providing home health services that will be reimbursed by Medicare, it's important for agencies to determine home health Medicare eligibility. Having the tools you need to verify home health Medicare eligibility and provide quality care allows you to put patients before paperwork. What Determines Home Health Medicare Eligibility? Medicare eligibility for home health services