Category: Home Health

MACs announce fix for HIPPS code payment error

Medicare Administrative Contractors (MACs) have addressed a payment error impacting some claims that were tied to the generic HIPPS code used on RAPs. The HIPPS code on the RAP is only used by the CMS system to pair RAPs with the final claim. Under PDGM, the CMS payment system is expected to determine the actual […]

HHS revises reporting requirements for Provider Relief Fund payments

The U.S. Department of Health and Human Services, through the Health Resources and Services Administration, is releasing revised reporting requirements for recipients of Provider Relief Fund (PRF) payments. This announcement includes expanding the amount of time providers will have to report information, aims to reduce burdens on smaller providers, and extends key deadlines for expending […]

Agency to pay $140,000 after overtime lawsuit from DOL

A Pennsylvania home health agency will pay $66,000 in back wages and an equal amount in liquidated damages to 98 registered nurses and licensed practical nurses after an investigation by the U.S. Department of Labor noted a failure to pay overtime wages, including payment for ancillary work and work-related travel, according to a DOL news […]

California HHS rebuffs CDC, extends mask guidance through mid-June

California state health officials announced this week that they will extend a mask mandate through June 15, despite Centers for Disease Control and Prevention guidelines that lifted many of the restrictions for fully vaccinated people. “Until June 15, when California plans to fully reopen the economy, California will keep our existing guidance around masks in place,” California […]

Medical reviews begin for pandemic claims

Medicare Administrative Contractors (MACs) have resumed post-payment medical reviews on claims during the public health emergency, according to Palmetto GBA and the latest MLN Connects newsletter. Since August, MACs have limited medical reviews to claims with dates of service before March 2020. “MACs may now begin conducting post-payment medical reviews for later dates of service,” […]

Agency owner accused of Provider Relief Fund fraud

A Burbank, Calif., home health agency owner is accused of misappropriating nearly $230,000 in federal assistance granted to businesses during the pandemic, according to a U.S. Department of Justice release Wednesday, May 26. Petros Hannesyan, 36, owner of Hollywood Home Health Services in Los Angeles, was charged with theft of government property and wire fraud. […]

CMS outlines changes for notice of admission replacing RAPs in 2022

The notice of admission (NOA), expected to replace RAPs beginning January 1, 2022, will be submitted just once establishing the agency as the primary provider. That will cover all contiguous 30-day periods until discharge, according to updates to the Medicare Claims Processing Manual released May 11. This will end a monthly routine for agencies that […]

CMS extends comprehensive care model for joint replacement

CMS recently issued a final rule extending and changing the Comprehensive Care for Joint Replacement (CJR) Model, which was implemented to support better and more efficient care for beneficiaries who are undergoing inpatient surgeries for hip and knee replacements. The CJR program is an opportunity for home health agencies to form and deepen strategic partnerships […]

Simione and BlackTree form SimiTree Healthcare Consulting

Simione Healthcare Consultants and BlackTree Healthcare Consulting have combined to form SimiTree Healthcare Consulting, according to announcement from investors Sheridan Capital Partners on Tuesday, May 18. The new company will “invest significantly in technology, talent and acquisitions of other businesses serving the post-acute market,” according to the announcement. See more of the news release and […]

CMS seeking HOPE beta test participants

CMS and its contractor, Abt Associates, are now recruiting Medicare-certified hospice providers to participate in a beta test of the draft hospice patient assessment instrument called Hospice Outcomes & Patient Evaluation (HOPE). Recruitment ends June 14, with data collection anticipated to begin in fall 2021, according to an announcement May 12. The detailed recruitment announcement […]