Another One Bites the Dust
CMS by Kristin Rowan, Editor Essentia Drops Medicare Advantage Essentia Health is an integrated health system with locations in Minnesota, North Dakota and Wisconsin. The health system offers 285 different services across more than 1,700 locations. They employ more than...Hospice Fraud Oversight
Admin by Kristin Rowan, Editor CMS Oversight in Fraud-Ridden States In 2023, The Centers for Medicare and Medicaid Services (CMS) cited research suggesting that hospices profit from fraud far too often. CMS has identified cases of hospices certifying benficiaries who are...More Rural Providers Say ‘No’ to MA
Artificial Intelligence by Tim Rowan, Editor Emeritus O ne just does not know whom to believe anymore. This week, we were sent three opinions of the pros and cons of Medicare Advantage programs. One says they reduce costs and improve patient satisfaction for rural residents. Another says...HHVBP Model Payments Begin January 1, 2025
Admin by Kristin Rowan, Editor Background on the HHVBP Model The Home Health Value Based Purchasing (HHVBP) Model, implemented by CMS in 2016, began in nine states. The goal is “to provide incentives for better quality care, to study new quality and efficiency...Medicare Advantage Predatory Marketing
CMS by Kristin Rowan, Editor Leading Associations Attempt to Curb Medicare Advantage Marketing Practices that Prey on the Unsuspecting For some time now, we’ve been reporting on the marketing practices that Medicare Advantage uses to lure new members. And,...NAHC NHPCO Town Hall
Advocacy by Kristin Rowan, Editor The Alliance On June 18, 2024, the National Association for Home Care & Hospice (NAHC) and the National Hospice and Palliative Care Organization (NHPCO) announced they had met in Washington D.C. to formally sign an affiliation agreement...2025 Hospice Final Rule
CMS by Kristin Rowan, Editor 2025 Hospice Final Rule Update On July 30, 2024, CMS issued its final rule for the 2025 Hospice Final Rule Update (CMS-1810-F), with updates to HQRP and HOPE. The rule also finalizes a proposal to change the statistical area delineations. This...MA Past, Present, and Possible Future: Nothing Good to Report
CMS by Tim Rowan, Editor Emeritus Past For at least the last five years, every Home Health conference this reporter has attended has featured at least one keynote speaker or expert panelist complaining about sparse and shrinking payments from Medicare Advantage plans. As...BREAKING NEWS: Warren, Cassidy React to Supreme Court Ruling
CMS by Kristin Rowan, Editor The Background Senators Warren and Cassidy react to the landmark decision by the Supreme Court in Loper Bright Enterprises v. Raimondo. That decision effectively overturned the Chevron Doctrine, which gave deference to federal agency decisions...Payer or Competitor?
Admin by Tim Rowan, Editor Emeritus UnitedHealth Making Home Health Visits Payer or Competitor…that is the question. According to a report in the Wall Street Journal, and questioned by the insurance industry’s lobbying arm, AHIP, UnitedHealth Group has increased...Chevron Deference Derailed
Advocacy by Kristin Rowan, Editor Chevron Deference “A government agency must conform to any clear legislative statements when interpreting and applying a law, but courts will give the agency deference in ambiguous situations as long as its interpretation is...Poor Joe is Out of A Job
CMS by Tim Rowan, Editor Emeritus We have been keeping an eye on the Medicare Advantage business as the number of beneficiaries who switch exceeds fifty percent. In past reports, we have described the federal lawsuits that accuse MA insurance companies of illicitly...The Future of Care at Home
Admin by Kristin Rowan, Editor Home Nurses are joining unions. The advent and unionization of Hospital-at-Home (H@H) is changing the care at home landscape. Large hospital systems across the country have engaged in H@H studies and launched H@H programs, providing...BREAKING NEWS – CMS Proposed Rule for 2025
CMS by Kristin Rowan, Editor CMS Proposed Rule for 2025 Citing “budget neutrality adjustments”, the Centers for Medicare & Medicaid Services (CMS) June 26 issued its proposed rule for 2025 for the home health prospective payment system. Here are the...
