What are You Hiding?
Admin by Elizabeth E. Hogue, Esq. Bring on the Fraud Enforcers We Have Nothing to Hide! Oh, but you do! Statements like this from providers are cringe-worthy. If you have said it before, please don’t ever say it again. Here’s why: First, many providers think that when fraud...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...NonCompete Agreements and What to do About Them
Admin by Elizabeth E. Hogue, Esq. What to do About Noncompete Agreements The Federal Trade Commission (FTC) published a final rule earlier this year that banned noncompete agreements. The final rule was effective on September 4, 2024. Requirements of the rule included: A...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...NHPCO and NAHC Announce New Name and Website
Advocacy by Kristin Rowan, Editor The Alliance Since the announcement that the National Hospice and Palliative Care Organization and the National Association for Home Care and Hospice would merge, the default name for the combined entities has been “The Alliance.”...HHA to pay Nearly $4 Million after False Claims Act Violations
Regulatory by Kristin Rowan, Editor False Claims Act Violations According to allegations in U.S. es rel. Jones v Intrepid U.S.A. Healthcare Inc. and U.S. es rel. Rigney v Intrepid U.S.A. Inc., Intrepid U.S.A. Inc. (Intrepid) violated the False Claims Act multiple times over five...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,...Cat on a Hot Tin…Keyboard?
Admin by Elizabeth E. Hogue, Esq. HIPAA Violation HIPAA violation: Trent James Russell was convicted in federal Court on charges of obtaining another person’s health care information in violation of the Health Insurance Portability and Accountability Act (HIPAA). Russell...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...Federal Regulations for Adult Protective Services
Regulatory by Elizabeth E. Hogue, Esq. Dept of Health & Human Services Final Rule On May 7, 2024, the U.S. Department of Health and Human Services (HHS) issued a final rule establishing the first federal regulations for Adult Protective Services (APS). The regulations took...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...
