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New Senate Bill Seeks to Loosen Homebound Requirements for Home Health Services

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 […]

Home Health Industry Can’t Fight CMS’ New Pre-Claim Review Initiative

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 […]

Palmetto GBA Releases Top Denial Reason Codes for Home Health

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 […]