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Medicaid › Home Health Agencies

Medicaid is a partnership program between states and the federal government to provide healthcare coverage for lower income individuals, people with disabilities, older people, and certain families with... more +
Medicaid is a partnership program between states and the federal government to provide healthcare coverage for lower income individuals, people with disabilities, older people, and certain families with children.  less -
Husch Blackwell LLP

Hospice Insights Podcast: What’s the Latest on UPICs? Highlights from Recent Audit Activity, Part I

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UPIC activity is picking up, and the UPICs are reviving some old tactics. In this episode, Husch Blackwell’s Meg Pekarske and Bryan Nowicki discuss these trends which include extrapolation, Medicaid nursing home room and...more

Parker Poe Adams & Bernstein LLP

Medicaid's 80/20 Rule: New Restrictions on Funding for Home and Community Based Services

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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

Polsinelli

The 80/20 Rule is Here: CMS Finalizes HCBS Care Worker Payment Requirements

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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

Nelson Mullins Riley & Scarborough LLP

CMS Continues Transparency Efforts for Home Health and Hospice

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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

Manatt, Phelps & Phillips, LLP

NYS DOH Releases New Application Requirements for Licensed Home Care Services Agencies

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On August 17, 2022, the New York State (NYS) Department of Health (DOH) released a long-awaited Dear Administrator Letter (DAL) setting forth application changes for licensed home care services agencies (LHCSAs) in New York,...more

King & Spalding

OIG Issues Advisory Opinion for Payment of Tuition for CNA Certification for HHA Employees

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On February 14, 2022, OIG issued Advisory Opinion No. 22-03 analyzing a proposed arrangement under which home health agency (HHA) owners would pay tuition costs of nurse aid certification programs for new employees who are...more

Robinson+Cole Health Law Diagnosis

OIG Issues Favorable Advisory Opinion Regarding Home Health Agency’s Proposal to Pay Tuition Costs for New Employees

Robinson+Cole Health Law Diagnosis on

On February 14, 2022, the Office of Inspector General (OIG) issued Advisory Opinion No. 22-03 (Advisory Opinion) regarding a home health agency’s (Requestor) proposal to pay nurse aide certification tuition costs on behalf of...more

Foley & Lardner LLP

OIG Has Seven (Yes Seven!) Different National Telemedicine Audits

Foley & Lardner LLP on

Companies who feel the Public Health Emergency (PHE) waivers and exceptions have rendered telemedicine “immune” from compliance oversight might be surprised to learn what federal regulators have in the works. The Office of...more

Baker Donelson

OIG Permits Medicaid Enrollment Application Assistance for SNF and HHA Patients

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On December 23, 2020, the OIG published Advisory Opinion 20-06, concluding that it would not impose penalties or sanctions under either the beneficiary inducement prohibitions of the civil monetary penalty statute (CMP) or...more

Baker Donelson

Key Health Care Extenders Expiring During the 116th Congress

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As the House and Senate returned from August recess, the 116th Congress remained in a political impasse with respect to what they can accomplish before they adjourn in December. Included on their list of priorities is a...more

Rivkin Radler LLP

VNSNY Agrees to $57 Million Settlement

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The Visiting Nurse Service of New York (VNSNY) has agreed to pay $57 million to settle a whistleblower lawsuit that alleged it billed the Medicare and Medicaid programs for hundreds of millions of dollars in home care visits...more

Baker Donelson

Health Care Providers: President Trump's Declaration of National Emergency Paves Way for Additional Regulatory Flexibility

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With the emergency declaration under the National Emergencies Act related to the coronavirus (COVID-19) on March 13, 2020, President Trump paved the way for CMS to temporarily waive certain Medicare, Medicaid, and Children's...more

Health Care Compliance Association (HCCA)

OIG Audit Report: CMS could use CERT data to identify high-risk home health agencies

Health Care Compliance Association (HCCA) on

Compliance Today (November 2019) - In September 2019, the US Department of Health and Human Services Office of Inspector General released the result of an audit report, “The Centers for Medicare & Medicaid Services Could...more

Sheppard Mullin Richter & Hampton LLP

CMS Finalizes Rule Expanding its Authority to Deny and Revoke Medicare Program Enrollment, Among Other Changes

Sheppard Mullin Richter & Hampton LLP on

On September 5, 2019, the Centers for Medicare and Medicaid Services (“CMS”) released a final rule with comment period entitled, “Program Integrity Enhancements to the Provider Enrollment Process” (the “Final Rule”). The...more

Sheppard Mullin Richter & Hampton LLP

CMS Proposes New Home Health Agency Rule Including Potential Changes to Reimbursement, Coverage, Quality, and More: CMS Accepting...

Sheppard Mullin Richter & Hampton LLP on

On July 11, 2019, the Centers for Medicare and Medicaid Services (“CMS”) announced a proposed rule for home health agency Medicare reimbursement that would increase payments by an aggregate 1.3% for 2020, amounting to $250...more

Downs Rachlin Martin PLLC

Vermont Legislative Update 03-29-2019 - An analysis from DRM's Government & Public Affairs Team

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House passes budget bill - The House approved a $6.1 billion FY 2020 budget this week. The bill, H.542, provides for a 3.1 percent growth in spending over FY 2019....more

Mintz - Health Care Viewpoints

As CMS Lifts HHA Medicare Provider Enrollment Moratorium, States Continue to Limit HHA Licenses

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As of January 30, 2019, CMS lifted its temporary provider enrollment moratoria (“Enrollment Moratorium”) for home health agencies (“HHAs”) in Florida, Illinois, Michigan and Texas. The Enrollment Moratorium had prevented new...more

Chambliss, Bahner & Stophel, P.C.

Looming Deadline for Electronic Check-in for Home Care Workers Raises Concerns

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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

Morgan Lewis

Home Health Prospective Payment System Update and Redesign: Part Deux?

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In the home health proposed payment rule released July 2 (Proposed Rule), the Centers for Medicare & Medicaid Services (CMS) continues its efforts to alert on six proposed Medicare payment updates to put “patient-centered...more

Bradley Arant Boult Cummings LLP

CMS Continues Shift toward Value-Based Payments with New Home Health Groupings Model in Proposal - Healthcare Alert

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On July 2, 2018, the Centers for Medicare & Medicaid Services (CMS) published its annual proposed rule outlining both payment and policy changes for home health agencies. In a press release announcing the proposed rule, CMS...more

Epstein Becker & Green

Regulatory Changes Impacting Florida’s Home Health Agencies Take Effect July 1

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Florida Governor Rick Scott recently signed into law CS/CS/SB 622 (“Bill”), which effectuates a variety of changes to regulations impacting the operation of home health agencies (“HHAs”). Providers, HHA facility owners, and...more

FordHarrison

Have You Properly Prepared for a WPA Audit?

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Audits of compliance with the Wage Parity Act ("WPA") are on the rise. The NYS Attorney General's Medicaid Fraud Unit, Medicaid Inspector General ("OMIG"), and Department of Labor ("DOL") are all auditing home care agencies....more

Robinson+Cole Health Law Diagnosis

CMS Issues Temporary Enrollment Moratorium on Home Health Agencies and Non-Emergency Ambulances in Selected States

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On January 29, 2017, the Centers for Medicare and Medicaid Services (CMS) announced a temporary moratorium on enrolling Part B non-emergency ambulance providers/suppliers and home health agencies, subunits and branch...more

Pullman & Comley - Connecticut Health Law

New Home Health Rules Effective in January 2018—Some Traps for the Unwary

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The Centers for Medicare & Medicaid Services (CMS) have issued new Conditions of Participation (CoP) for home health agencies (HHA) that are effective January 13, 2018. The CoP were originally scheduled to take effect on...more

Bass, Berry & Sims PLC

Final Home Health Rule Drops Controversial Proposed Payment Model

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Last week, home health agencies welcomed the Centers for Medicare & Medicaid Services' (CMS) decision to drop a controversial proposed payment model and leave largely unchanged the current payment system. Responding to...more

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