News & Analysis as of

Home Health Care Health Insurance

Bass, Berry & Sims PLC

Healthcare Trends & Transactions Q1 2025

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The healthcare mergers and acquisitions (M&A) market began 2025 with a slower start than expected given the easing headwinds and building momentum at the end of last year, with the number of deals reported in Q1 lower than...more

Sheppard Mullin Richter & Hampton LLP

Building a Smarter Long-Term Care System in New York

New York State has a long-standing commitment to supporting its most vulnerable populations through Medicaid-funded services for older adults and those requiring long-term care. However, rising costs and an increasingly...more

McDermott+

Virtual Care Policy Update: What to Expect in Lame Duck

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Updated November 18, 2024 – The Consolidated Appropriations Act (CAA), 2023 (Public Law 117-328), signed into law on December 29, 2022, extended certain key telehealth flexibilities instituted during the COVID-19 public...more

Mandelbaum Barrett PC

Medicaid Final Agency Decision Reaffirms Criteria Necessary to Qualify for Caregiver Child Exception

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Certain Medicaid programs impose a transfer penalty on applicants who have transferred resources (assets) for less than fair market value within five (5) years preceding the Medicaid application. Simply stated, the transfer...more

Falcon Rappaport & Berkman LLP

Pooled Income Trusts for Medicaid Home Care

One of the biggest misconceptions related to Community (Home Care) Medicaid is the idea that one thinks they and/or their loved one is not eligible for services because “they make too much money.” In New York State, for one...more

McCarter & English, LLP

New Jersey Statutory Update Part II

Below is Part II of our New Jersey Statutory update. As you can see from the below, several statutes were passed imposing requirements on health insurance payers, including new requirements for prior authorization request and...more

Segal McCambridge

Deciphering Reimbursement: Insights from the Central Home Health Care Servs Inc v. Progressive Mich Ins Co Decision

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Introduction - The Michigan Court of Appeals has concluded that for purposes of MCL 500.3157, providers of in-home healthcare services are not subject to reimbursement based on their charge description master or other...more

Polsinelli

Florida Legislative Session 2024: Health Care Highlights

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The Florida Regular Legislative Session began on January 9, 2024, and ended on March 8, 2024. Below is a summary of relevant health care laws that will be effective July 1, 2024, if they are approved by Governor DeSantis....more

Falcon Rappaport & Berkman LLP

ELDER LAW LEGAL UPDATE: Important Changes to Social Security Income, Medicaid Resource and Income Allowances, and Regional Rates...

The Elder Law Practice Group at Falcon Rappaport & Berkman would like to share some important Elder Law legal updates with our clients and professional partners that will impact Medicaid eligibility for applicants/recipients...more

Lippes Mathias LLP

New York State Medicaid Updates for 2024

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Medicaid is a joint federal and state program that provides health coverage to millions of Americans. Federal law requires states to comply with certain minimum requirements, but New York is considered a maximum state in that...more

Benesch

2024 Outlook: Behavioral Health Trends

Benesch on

Healthcare systems are facing significant challenges in recruiting and retaining talent within the burgeoning field of behavioral health services, primarily due to competition from telehealth providers and inconsistent...more

Robinson+Cole Health Law Diagnosis

CMS Announces 0.8 Percent Aggregate Home Health Payment Increase in 2024

On Wednesday, November 1, the Center for Medicare & Medicaid Services (CMS) released its Home Health Prospective Payment System Rate Update final rule for CY 2024 (the Final Rule). The Rule estimates that the aggregate...more

Nelson Mullins Riley & Scarborough LLP

Payment Cuts and Program Changes: CMS Issues Calendar Year 2024 Home Health Prospective Payment System Proposed Rule

On June 30, the Centers for Medicare and Medicaid Services (CMS) released the proposed rule for the Home Health Prospective Payment System for the 2024 calendar year. The proposed rule aims to permanently update the payment...more

Robinson+Cole Health Law Diagnosis

CMS Proposes New Rule that Would Require 80% of Payment to Go Toward Home Care Worker Compensation

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

Nelson Mullins Riley & Scarborough LLP

Home Health and Hospice – A Look at Value-Based Initiatives Underway in 2023

By now, we are all familiar with the concepts of value-based care and the transition away from a payment system built primarily on a fee-for-service reimbursement methodology to a patient centered model that focuses on...more

Robinson+Cole Health Law Diagnosis

CMS Issues Calendar Year 2023 Home Health Final Rule

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

Chambliss, Bahner & Stophel, P.C.

Medicaid's Coverage of Nursing Home Care

For better and for worse, Medicaid is the primary method of paying for nursing home care in the United States. But navigating the Medicaid system is complicated and confusing. Here are the basics. ...more

Genova Burns LLC

New York Home Health Care Agencies Beat Aides’ Lawsuit Over Use of a Captive To Meet Wage Parity Law

Genova Burns LLC on

When New York adopted a wage parity law setting minimum wage and benefit levels for home care workers, innovative home health care agency companies created a captive plan structure to meet the benefits requirements. Although...more

Downs Rachlin Martin PLLC

Vermont Health Care Update | Week 19

Appropriations committee reviews health care workforce bill  - The House Appropriations committee reviewed H.607 on Tuesday, a bill aimed at increasing the health care workforce in Vermont. The bill requires the Vermont...more

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 28, Number 40. News Briefs - November 2019 #2

Report on Medicare Compliance Volume 28, Number 40. (November 11, 2019) - - In a new Medicare compliance review, the HHS Office of Inspector General (OIG) said Angels Care Home Health in Salina, Kansas, didn’t comply with...more

FordHarrison

Home Care Agencies Sued for Illegal Use of Captive Insurance Company

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Class action attorneys recently filed a first-of-its-kind class action against Edison Home Health Care (“Edison”) and Preferred Home Care of New York (“Preferred”) alleging that the home care agencies used a “captive”...more

Bass, Berry & Sims PLC

Healthcare Fraud & Abuse Review 2017

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A LOOK BACK... A LOOK AHEAD - While the uncertainty associated with legislative efforts to repeal the Patient Protection and Affordable Care Act (PPACA) dominated most of the headlines for the healthcare industry last year,...more

Chambliss, Bahner & Stophel, P.C.

Home Health Care Patients With Chronic Conditions Are Having Trouble Getting Medicare

Medicare is supposed to provide up to 35 hours a week of home care to those who qualify, but many Medicare patients with chronic conditions are being wrongly denied such care, according to Kaiser Health News. For a variety of...more

Sheppard Mullin Richter & Hampton LLP

Day 4 Notes on the 2018 JP Morgan Healthcare Conference

San Francisco (January 11, 2018) – The final day of the 2018 JP Morgan Healthcare Conference gave us food for thought about the topic of healthcare navigation, as well as updates on the home health sector. Post-acute has...more

Stinson LLP

CMS Issues Final Rule on New Medicare and Medicaid Conditions of Participation for Home Health Agencies

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The Centers for Medicare & Medicaid Services (CMS) recently issued a final rule, 42 C.F.R. pt. 484, implementing significant changes to the conditions of participation (CoPs) that home health agencies (HHAs) must satisfy to...more

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