Hospice Insights Podcast: What’s the Latest on UPICs? Highlights from Recent Audit Activity, Part I
AGG Talks: Home Health & Hospice Podcast - Episode 5: Understanding Palliative Care: Strategies for Compliance and Reimbursement
Hospice and Home Health Survey Perspectives: A Conversation with Kim Skehan, VP of Accreditation at CHAP
Episode 172: Matthew Roberts and Lauren DeMoss, Maynard Nexsen Health Care Attorneys
A Very “Special” Episode: Amid Controversy, CMS Launches the Hospice Special Focus Program
Grace from CMS: Unexpected Good News on HIS and CAHPS Appeals
This Bandwagon Has a Broken Wheel: OIG Joins the Inconsistent Approach to Hospice GIP Claims
Beyond Hospice: Home Health Agencies Plagued by UPICs and SMRCs
Beyond Hospice: The OIG Renews Its Scrutiny of Home Health Agencies
Earlier this year, the Centers for Medicare and Medicaid Services (CMS) confirmed that, effective January 1, 2025, CMS will pay for acute kidney injury (AKI) renal dialysis treatments at-home at the daily rate based on...more
The Centers for Medicare & Medicaid Services (CMS) have released significant updates affecting Medicare payments for 2025. The changes, outlined in two final rules, will impact both physicians and hospitals, eliciting strong...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”) has finalized 2024 home health rules to include application of the home health “36-month rule” to hospice providers. The revised rule will forbid any change in majority...more
The Centers for Medicare & Medicaid Services (“CMS”) issued a Proposed Rule on July 10, 2023, that, if finalized, will revise the Medicare Provider Enrollment requirements to expand the current Home Health Agency (“HHA”)...more
On April 20, 2023, the US Department of Health and Human Services (HHS) made ownership data of all Medicare-certified hospices and home health agencies publicly available for the first time. This move is consistent with the...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 Thursday, April 20, 2023, the U.S. Department of Health and Human Services (HHS) released ownership data for all Medicare-certified hospice and home health agencies on the Centers for Medicare & Medicaid Services (CMS)...more
On November 4, 2022, the Centers for Medicare & Medicaid Services (CMS) published the calendar year 2023 Home Health Prospective Payment System Rate final rule, which updates Medicare payment policies and rates for home...more
On November 2, 2021, the Centers for Medicare & Medicaid Services (“CMS”) issued a final rule (“Final Rule”) that advances the shift from paying for Medicare home health services based on volume to a system that pays based on...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
The Calendar Year (CY) 2021 final rule updating the Home Health Prospective Payment System (HH PPS) includes increases in the national, standardized 30-day period payment and per-visit payment for home health agencies (HHAs)...more
The U.S. Fifth Circuit recently upheld convictions and sentences against five named defendants, each charged with conspiracy to commit health care fraud, conspiracy to violate the Federal Anti-Kickback Statute (AKS) and...more
Report on Medicare Compliance 29, no. 39 (November 2, 2020) - Medtronic USA Inc., a medical device maker, has agreed to pay $8.1 million to settle allegations it violated the False Claims Act by paying kickbacks to induce...more
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
Report on Medicare Compliance 29, no. 30 (August 24, 2020) - Mission Home Health of San Diego Inc. was overpaid $61,718 in 2015 and 2016, which was extrapolated to $5.9 million, according to the latest Medicare home health...more
Home health agencies (HHAs) in Ohio had a brief reprieve from the audits of their Medicare claims under the Review Choice Demonstration (RCD), but that reprieve is about to end. ...more
On April 30, 2020, CMS issued several new and revised blanket waivers for health care providers retroactively effective March 1, 2020, through the end of the emergency declaration. CMS’s authority to grant blanket waivers...more
On March 10, 2020, the Centers for Medicare & Medicaid Services (“CMS”) supplemented the guidance that we previously discussed in our March 6, 2020 blog post in order to provide additional guidance to healthcare providers,...more
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
On October 31, 2019, CMS issued a final rule with comment period (Final Rule), CMS-1711-FC, updating the payment rates for home health agencies (HHAs) for calendar year (CY) 2020...more
On September 26, 2019, the Centers for Medicare and Medicaid Services and Department of Health and Human Services published commentary and its final rule affecting how hospitals, including critical access hospitals (“CAHs”),...more
On September 26, 2019, CMS issued the Omnibus Burden Reduction (Conditions of Participation) Final Rule (“Final Rule”) that seeks to remove Medicare regulations that are “unnecessary, obsolete, or excessively burdensome on...more
On September 26, 2019, the Centers for Medicare & Medicaid Services (CMS) announced a new Final Rule, Revisions to Discharge Planning Requirements (CMS-3317-F) in a bid to “improve engagement, choice and continuity of care...more
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