Reduce Insurance Claim Denials
Admin by Lynn Labarta, SimiTree Reduce Insurance Claim Denials 2025 Guide for Home Health and Hospice Agencies Is your home health or hospice agency struggling with insurance claim denials? You’re in good company. As we move into 2025, claim denials remain the #1 challenge...Perfect Storm
Admin by Hannah Vale, CMO HealthRev Partners Care at Home Industry Faces Perfect Storm Industry Challenges in 2025 The care at home industry is grappling with an unprecedented crisis as staffing shortages, technological hurdles, and complex reimbursement models converge to...Threats to Your Business
Editorial by Tim Rowan, Editor Emeritus Threats to Your Business Two seemingly unrelated news items jumped out at me that could be threats to your business while I was away tending to funeral preparations for my brother’s wife. Before I analyze those reports, please...Treatment in Place from Emergency Medical Services
Clinical by Elizabeth E. Hogue, Esq. Treatment in Place Providers of services to patients in their homes are anecdotally familiar with situations in which patients need help at home, but do not qualify for home health services and have not arranged for or are unable to afford...Creditable Coverage for Medicare Part D
Admin by Kristin Rowan, Editor CMS 2026 Updates to Prescription Plan The Centers for Medicare & Medicaid Services (CMS), as part of the Inflation Reduction Act of 2022 (IRA), released a draft of the calendar year 2026 redesign program instructions. The new provisions...Is Medicaid Down for the Count?
Breaking News by Kristin Rowan, Editor Medicaid Payment System Goes Dark On Monday, January 27, President Trump, through the Office of Management and Budget, announced a temporary freeze on federal spending while his newly designated head of the Department of Government Efficiency...Bill Dombi to Continue the Care at Home Fight in D.C.
Advocacy by Kristin Rowan, Editor Bill Dombi Key Supporter of Care at Home The end of 2024 and the official merger of NAHC and NHPCO also brought to a close the extensive service to the care at home industry by former NAHC President Bill Dombi. Dombi served as vice president...Telemedicine Rules from DEA
Clinical by Elizabeth E. Hogue, Esq. DEA Issues Three Telemedicine Rules On January 16, 2025, the United States Drug Enforcement Administration (DEA) announced three new rules to make permanent some temporary flexibilities for telemedicine established during the COVID-19...Medicare Advantage Increase for Payers, not Providers
Artificial Intelligence by Kristin Rowan, Editor CMS Announces Medicare Advantage Pay Hike On January 13, 2025, CMS announced its plans to increase payments to Medicare Advantage plans by 4.33%. Policy changes for Medicare Advantage and Part D include changes in how the agency calculates...Care at Home Coming to Medicaid?
Advocacy by Elizabeth E. Hogue, Esq. Brown v D.C. Decision is Another Boost for Care at Home In Olmstead v. L.C., the U.S. Supreme Court decided that unjustified segregation of disabled persons constitutes discrimination in violation of Title II of the Americans with...Whistleblower Case Impedes Lawsuits
CMS by Kristin Rowan, Editor Whistleblower Action A United States District Court in Tampa, Florida ruled against a whistleblower action under the False Claims Act (FCA) against her former employer. In 2019, a family care physician filed a whistleblower, or qui tam, action...VitalCaring Pulls Agreement
Breaking News by Kristin Rowan, Editor Just as we were setting the article on UnitedHealth Group and Amedisys for publication, we received the following breaking news story: VitalCaring Divestment Agreement Cancelled VitalCaring entered into the agreement on June 28, 2024, just...Congress Allows Medicare Advantage to Deny Coverage
Advocacy by Kristin Rowan, Editor Medicare Advantage Bill Dies in Congress The 118th United States Congress, ran from January 3, 2023 to January 3, 2025. This Congress’s first law was passed on March 20, 2023, much later than most previous congressional sessions. In its...Good News for Veterans and Care at Home
Advocacy by Kristin Rowan, Editor Biden's Final Acts With only a short number of days left in office, President Joe Biden has been making headlines. Not all of his final decisions have been met with absolute approval, but his latest one will make a difference for our veterans...
