CMS Proposes Policy Changes to Medicare C & D
CMS From the NAHC Newsroom Public comments due January 5, 2024 CMS Policy Changes to Medicare C & D. On November 5, 2023, the Centers for Medicare & Medicaid Services (CMS) issued the Contract Year 2025 Policy and Technical Changes to the Medicare Advantage...CMS is Already Hurting Home Care and Now MedPAC Wants to Make it Worse
CMS by Kristin Rowan, Editor Last week, MedPAC met for their December meeting to discuss “Assessing payment adequacy and updating payments.” Hospice services and Home health care services were each presented separately to Congress and commissioners are set to...Medicare Advantage Dominated November News
CMS by Tim Rowan, Editor Emeritus MA Plans Continue to Exaggerate Patient Conditions for Profit As we reported in October (More MA Plans Caught Inflating Patient Assessments, 10/11/23), insurance companies operating Medicare Advantage plans routinely pad the patient...OIG Crackdown on Employees Ineligible to Work for Medicare
CMS Dear Friends, I have some news that may be upsetting. Frankly, that is my intention, to frighten you into action. In August, a Home Health provider in New York paid an $$866,339.25 fine for violating the “Civil Monetary Penalties Law.”* The Chinese-American...CMS Issues Final Rule for 2024 with Drastic Pay Cut
CMS By Kristin Rowan, Editor On November 1, CMS issued its Home Health Final Rule for CY 2024. As expected, the final rule includes drastic pay cuts to Medicare home health services payments. The original proposed rule issued earlier this year included a 5.653% rate...Big Win for Advocacy in Home Care
Admin by Kristin Rowan, Editor Marking a significant victory for the HCAOA Connecticut Chapter and the home care industry, in the legislative session that ended last week, lawmakers unanimously passed a bill to reverse the policy guidance issued by the Department of...Should Insurance Companies Own Home Health Agencies?
Editorial by Kristin Rowan, Editor UnitedHealth Group Makes Bid to Buy Amedisys after Acquiring LHC Group Amedisys is one of the leading providers of home health, hospice, and other healthcare at home services. It operates more than 500 locations in 37 states and the District...EEOC Sues Licensed Home Care Agency for Discrimination
CMS by Tim Rowan, Editor Home Care Agency Removed Black and Hispanic Home Health Aides from Assignments to Accommodate Racial Preferences of Clients, Federal Agency Charges There is a question that appears on social media chat pages with great regularity. What does a home...Supreme Court Takes Action About Knowledge Required to Prove False Claims
CMS by Elizabeth Hogue, Esq. For providers to be liable under the federal False Claims Act, enforcers must prove that they knowingly submitted false claims. The U.S. Supreme Court recently issued an opinion in United States ex rel. Schutte v. SuperValu, Inc. [No. 21-1326...Crackdown is Coming: Are You Paying Overtime?
Admin by Tim Rowan, Editor T he Department of Labor, Wage and Hour Division, has selected several southeastern states as targets for its investigation into a practice that appears to be quite common, underpaying in-home caregivers. It appears, based on early DoL reports,...CMS News: New Rule Cracks Down on Medicare Advantage Upcoding
CMS by Tim Rowan, Editor CMS Rule to Protect Medicare The U.S. Department of Health and Human Services, through the Centers for Medicare & Medicaid Services, finalized the policies for the Medicare Advantage “Risk Adjustment Data Validation” program, which...Bi-Partisan Congressional Committees Demand CMS Administrator Repay Misspent Funds
CMS Bi-Partisan Congressional Committees Demand CMS Administrator Repay Misspent Funds his month, two House committees and two Senate committees published a report of a joint investigation into Centers for Medicare and Medicaid Services Administrator Seema Verma’s...
