Beyond Hospice: Home Health Agencies Plagued by UPICs and SMRCs
In spring 2024, the Centers for Medicare and Medicaid Services (CMS) finalized the Medicaid access rule, which includes a provision that requires that 80% of Medicaid payments for most Medicaid-funded home health aide,...more
In May 2023, the Centers for Medicare and Medicaid Services (“CMS”) proposed a series of rule changes intended to help promote the availability of home and community-based services (“HCBS”) for Medicaid beneficiaries. Chief...more
The US Centers for Medicare & Medicaid Services (CMS) finalized important changes to the Medicare enrollment regulations applicable to hospices and home health agencies (HHAs), including increasing the level of screening that...more
The Centers for Medicare & Medicaid Services (CMS) announced on April 27, 2023, that it will publicly release all ownership information of home health and hospice agencies. This move is aimed at increasing transparency and...more
On April 27, 2023, the Centers for Medicare & Medicaid Services (CMS) released a Notice of Proposed Rulemaking entitled Ensuring Access to Medicaid Services (Proposed Rule) which would, among other things, establish...more
In this episode, we continue our discussion of home health enforcement trends, focusing on other audits currently troubling agencies. These include audits from Unified Program Integrity Contractors (UPIC), Supplemental...more
The Biden Administration’s recent “Path Out of the Pandemic” expands the COVID-19 vaccine mandate covering nursing home workers and will soon reach 17 million healthcare workers at Medicare and Medicaid-certified facilities....more
On November 25, 2020, the Centers for Medicare & Medicaid Services (CMS) gave hospitals facing another surge in COVID-19 patients more flexibility to care for Medicare patients outside of the walls of their hospitals. In...more
On March 30, 2020, the Centers for Medicare & Medicaid Services (CMS) announced additional measures to provide home health agencies (“HHA”) greater flexibility when treating patients during the National Emergency....more
On October 31, 2019, the Centers for Medicare and Medicaid Services (CMS) finalized its 2020 payment and policy changes rule for Home Health Agencies (HHA Rule). The final rule is scheduled to be posted in the Federal...more
The Social Security Act grants the Centers for Medicare and Medicaid Services (“CMS”) the authority to impose a moratorium on enrollment of home health agencies (“HHAs”) in the Medicare and Medicaid programs if CMS...more
With the number of U.S. residents aged 65 and older projected to more than double from 46 million today to over 98 million by 2060, home care agencies face a litany of difficulties. Among these are that home care agency...more
Starting in 2019, providers of home health care services will be required to clock in electronically with Medicaid prior to performing services. However, disability rights advocates and a bipartisan group of senators are...more
ALERT: Immediate Action Required by Health Care Providers to Comply With Section 1557 of the Affordable Care Act by October 16, 2016 - The U.S. Department of Health and Human Services (“HHS”) Office of Civil Rights...more
The Centers for Medicare & Medicaid Services (CMS) announced that it would postpone the initiation of the CMS Pre-Claim Review Demonstration for Home Health Services (the “Demonstration”) in Florida, which was scheduled to...more
On June 27, CMS issued a proposal for the 2017 Medicare home health prospective payment system (HH PPS). CMS is proposing a $180 million reduction in 2017. This equates to a 1% drop in reimbursements for home health...more
On July 10, 2015, CMS published in the Federal Register the CY 2016 Home Health Prospective Payment System proposed rule effective for episodes ending on or after January 1, 2016. CMS estimates that the net impact of the...more
Lessons From the Frontlines: Strategies for Supporting Informed Consumer Decision-Making in the Health Insurance Marketplace - Editor's Note: As marketplaces prepare for the third open enrollment period, consumers are...more
Recent audits by the Department of Health and Human Services Office of Inspector General (“OIG”) conclude that state survey agencies in a number of states and a leading national accrediting agency serving the home health and...more
On January 23, 2015, the United States Department of Labor (DOL) filed a notice of appeal with the United States Court of Appeals for the District of Columbia (District Court) challenging two rulings in the case of Home Care...more