News & Articles

If you operate a home health agency, Laura Long and her colleagues are probably the last people you want to hear from.  Long is the Medicare operations lead at AdvanceMed, one of five unified program integrity contractors (UPICs) nationwide hired by the Centers for Medicare & Medicaid Services (CMS) to audit and investigation home health...
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The long-standing moratoria on new Medicare home health agencies is no longer in effect anywhere in the U.S. The Centers for Medicare & Medicaid Services (CMS) allowed the temporary ban to expire on Jan. 30, a move that will likely improve patient access to home-based care in related markets, experts say. CMS initially implemented a...
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Rural hospitals close when they don’t have enough paying patients to care for, but they’re also dinged when the same patients show up over and over again. That puts outlying medical facilities in the precarious position of needing to avoid repeat customers. Charlotte Potts is the type of patient some hospitals try to avoid. She...
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In many ways, 2018 was a coming of age for the home care industry, as it steadily became recognized as a key part of the overall continuum of care due to its ability to keep older adults safely at home and out of the hospital.  Among the biggest changes to home care in 2018: the...
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By Kaitlyn Mattson | October 7, 2018 The home health industry has won another victory in Washington, D.C., in its battle against certain parts of the Patient-Driven Groupings Model (PDGM) and shift toward a more pre-acute care identity. Sens. Susan Collins (R-Maine), Bill Nelson (D-Fla.) and Debbie Stabenow (D-Mich.) introduced the Home Health Payment Innovation...
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To combat improper billing, the Centers for Medicare & Medicaid Services (CMS) in 2016 rolled out the controversial pre-claim review demonstration in Illinois, an initiative that required home health providers to send in their claims earlier in the care process. With the help of Congress, however, stakeholders were able to seemingly stop pre-claim review dead...
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To our IAHHC Membership, our friends in the industry need our help! Please see the email below which is forwarded from Tim Rogers, President and CEO of the Association for Home and Hospice Care of North Carolina. Please help as you are able. Cindi Wessel, Home Health and Hospice Resource Director, IAHHC www.ahhcnc.org/florence We want...
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Failing to supply medical records in response to additional documentation requests (ADRs) was Medicare Administrative Contractor (MAC) Palmetto GBA’s most common reason for denial of home health claims between April and June 2018, Palmetto data show. Face-to-face encounter requirements not met took the No. 2 slot. Denial code 56900 (Auto denial — requested records not...
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The Proposed New National Standardized 60-Day Episodes Rates are listed below: Proposed National Standardized Episode Rate $3,151.22 Proposed Rate (Did Not Submit Quality Data) $3,089.49 Remember your individual agency rate will be adjusted by wage index. If your patients live in a rural area you will receive an additional payment. We will go over the...
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