The Wrong Way to Use AI in Healthcare
Admin by Tim Rowan, Editor Emeritus Lawsuits are beginning to pile up against insurance companies participating in the Medicare Advantage program. The complaint? The wrong way to use AI in healthcare is with faulty algorithms to approve or deny claims. While AI can be...Understanding Differences in Medicare Policy and Conditions of Participation
Admin by Johnathan Eaves, Senior Director of Communications, Axxess Treating Medicare patients comes with a level of nuance that is important to understand to ensure that organizations remain compliant and patients receive appropriate care. Standards for quality care and...80/20 Finalized Rule
CMS by Kristin Rowan, Editor The Centers for Medicare and Medicaid Services (CMS) has finalized the “Ensuring Access to Medicaid Services” rule, more commonly known as the 80/20 rule. The 80/20 finalized rule requires at least 80% of Medicaid payments for home...HOPE is on the Way: Part 3
CMS By Beth Noyce, RN, BSJMC, BCHH-C, COQS CHAP-certified home health & hospice consultant This is part 3 of the 3 in the series, outlining the discussions and implications in adopting new outcome and process measures for Hospice care. The final segment addresses...HOPE is on the Way: Part 2 – Process Measures
Clinical by Beth Noyce, RN, BSJMC, HCS-C, BCHH-C, COQS CHAP-certified home health & hospice consultant Process Measures The outcome measures being considered look at effectiveness of hospice clinical efforts to decrease pain and other symptoms. The process measures paired...Adding Insult to Injury: Change Healthcare Attacked Again
Admin by Kristin Rowan, Editor For a few weeks now, we have been covering the Change Healthcare cyberattack by ALPHV/BlackCat and the subsequent updates from CMS. Pharmacy and medical orders have been delayed, providers and patients are suffering, and CMS has issued...HOPE is on the Way: Part 1 – Outcome Measures
Clinical By Beth Noyce, RN, BSJMC, HCS-C, BCHH-C, COQS Home health & hospice consultant The Hospice Outcome Patient Evaluation is a step closer to implementation. After four years of considering options, the Technical Expert Panel (TEP) has finished its work that will...CMS Hospice Payment Rate FY 2025 Proposal
CMS By Kristin Rowan, Editor On March 28, CMS issued a new proposed rule to update Medicare hospice payments. Here’s what we know. The new proposed rule: Would change the existing hospice wage index Clarifies current policy related to the hospice “eletion...Cost of Home Health Care Services Increased Nationwide
CMS By Kristin Rowan, Editor Illumifin, an insurance administration and claims solution provider for long term care (LTC) insurance, has released its 2023 Cost of Care study. The longitudinal study is now in its tenth year and includes national, state, and regional costs...MedPAC Recommends More Pay Cuts
CMS By Kristin Rowan, Editor In December, 2023, The Medicare Payment Advisory Committee (MedPAC) recommended a 22% payment reduction for hospice providers. This week, they’ve recommended additional cuts once again. MedPAC has just released the March, 2024 Medicare...CMS Issues Medicaid Guidance on Change Healthcare Hack
CMS From the NAHC News Desk, March 19, 2024 On March 15th, the Centers for Medicare & Medicaid Services (CMS) issued a Center Informational Bulletin (CIB) that provides guidance and flexibilities to mitigate the impacts on providers resulting from the Change...MedPAC Exposes More Medicare Advantage Crimes
CMS by Tim Rowan, Editor Emeritus This week, we look at the state of the healthcare industry, vis a vis payers that do not pay. While Home Health and Hospice leaders talk at every gathering about refusing to accept Medicare Advantage clients, some large Integrated...Access to Care at Home in Underserved Communities
CMS by Kristin Rowan, Editor The U.S. House Ways and Means Committee held a hearing on March 12, 2024 to address the need for access to care-at-home services in rural and underserved communities. The advisory board heard from several witnesses including two care at home...Onslaught of Audits Worries Hospice Providers
Clinical By Kristin Rowan, Editor March 12, 2024, the National Association for Home Care and Hospice (NAHC), Leading Age, the National Hospice and Palliative Care Organization (NHPCO), and the National Partnership for Healthcare and Hospice Innovation (NPHI), published their...
