Medicare

Changes to the requirements for Medicare provider enrollment could have major consequences for home health providers down the line. Under provider enrollment requirements, the U.S. Centers for Medicare & Medicaid Services (CMS) has the authority to rescind providers’ Medicare enrollment if they are associated with “bad actors” and are at risk for fraud due to
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Since last spring, there has been a consistent — and justifiable — narrative that long-term care residents are particularly vulnerable to the deadly COVID-19 virus. New research, however, suggests it’s not so simple. A team of researchers from the Cleveland Clinic and Health Data Analytics Institute (HDAI) explored how the COVID-19 virus affects actual versus
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Among its many provisions, last year’s Coronavirus Aid, Relief and Economic Security (CARES) Act pressed pause on the government’s 2% payment cut to all Medicare-reimbursed health care providers. The “sequestration holiday” was immediately seen as a common-sense lifeline for cash-strapped home health providers on the front lines of the COVID-19 pandemic, many of whom had
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An innovative care concept designed to keep patients at home and out of skilled nursing facilities (SNFs) is reportedly gaining ground in Congress and among special interest groups. The concept — known as “Choose Home” — is a type of SNF-at-home model that leverages both medical and non-medical home care services for certain patients. LHC
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Despite the once-in-a-generation COVID-19 pandemic, the home health industry’s transition to the Patient-Driven Groupings Model (PDGM) was pretty seamless. Looking into the not-too-distant future, the U.S. Centers for Medicare & Medicaid Services (CMS) will now likely attempt to make modest tweaks to a handful of key areas, payment experts believe. The agency will do so
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Two in-home care providers — ConcertoHealth and Perfect Health — announced Wednesday that their organizations have merged. Together, the companies will operate under the name “ConcertoCare.” Aliso Viejo, California-based ConcertoHealth is a value-based care provider organization that delivers a variety of home-based care services. The company’s teams consist of complex care physicians, complex care nurses,
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Among payment-related policy changes for the home health industry in 2021 is the elimination of traditional Requests for Anticipated Payment (RAPs) — and the introduction of the “no-pay RAP.” While the change is a potentially costly one for home health agencies, they’re not the only ones struggling to keep up. Medicare Administrative Contractors (MACs) have
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Under the Trump administration, federal health care policymakers have long been vocal about the ability of Medicare Advantage (MA) to lower costs and improve outcomes among vulnerable populations. A recent report from the Washington, D.C.-based Better Medicare Alliance (BMA) and consulting firm Avalere Health is now putting hard numbers on that claim, particularly around home
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U.S. Representatives Brad Schneider (D-Ill.) and David McKinley (R-W.Va.) introduced the Medicare Sequester COVID Moratorium Act last week. If passed, the bill would extend the temporary suspension of Medicare sequestration payment reductions, giving home health agencies and other providers more financial flexibility headed into an uncertain 2021. Since 2014, the U.S. Centers for Medicare &
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The home health industry is in a “dynamic state” and evolving into “multiple types of care,” according to the Medicare Payment Advisory Commission (MedPAC). As a result, health care policymakers should start thinking about how to redesign the traditional home health benefit to make it more nimble, perhaps by breaking it up into pre-acute and
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After one of the closest and most hotly contested campaigns in modern history, President-Elect Joe Biden addressed the nation on Saturday from an outdoor platform in Wilmington, Delaware. While it’s far too early to say what the first 100 days of a Biden administration will look like from a detailed policy perspective, the president-elect has
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