Online resource packed with regulatory news and expert guidance, tips & tools pertinent to professionals across the post-acute care continuum.
A State Health Insurance Program (SHIP) is an insurance counseling service that is provided free of charge by the Administration on Community Living in partnership with the Centers for Medicare & Medicaid Services as well as state aging agencies to help assist Medicare beneficiaries and their caregivers. By discussing coverage, cost and convenience, the goal […]
The latest release of CMS OASIS quarterly Q&As delve into issues around the Patient-Driven Groupings Model (PDGM) and OASIS-D1 as well as GG items capturing mobility and self-care. The October 2019 Q&As — published to the CMS website Oct. 15 — include 37 questions and responses on a range of topics. PDGM was the dominant […]
By: Roger B. Schechter, MD, Fellow of American College of Wound Specialists; Chief Medical Officer, Synergy Wound Technology Wound care has always been a considerable challenge in the post-acute setting. Patients with skin breakdown usually have a plethora of chronic comorbid conditions. Chronic wounds themselves, including pressure injuries, diabetic foot ulcers, venous leg ulcers, severe […]
By: Navin Gupta, VP, Home Health, Hospice & Private Duty, MatrixCare The digital age has created an overhaul of technology within the healthcare industry – transforming health records into collections of electronic data that should simplify administration processes for providers everywhere. But just because health records have gone digital, doesn’t mean it makes communication any […]
CMS has issued a change request outlining the rebuttal process for providers or suppliers whose Medicare billing has been deactivated. CR 10978 provides instruction to Medicare Administrative Contractors (MACs) to advise providers of rebuttal rights and how to receive and process rebuttals. The change request takes effect Dec. 31, 2019. Providers can submit a rebuttal […]
Home health agencies found out of compliance with the Home Health Quality Reporting Program (HHQRP) will soon receive notification from CMS. Non-compliance will affect agencies’ CY2020 annual payment update. Medicare Administrative Contractors (MACs) mailed non-compliance notifications Oct. 1. The notifications are also available in agency CASPER folders as of Oct. 1. The agencies that receive a […]
A New Jersey local official has admitted to accepting bribes in exchange for referring patients who needed home health care aides. Myrtha Nicolas, 61, of Jersey City, N.J., pleaded guilty to one count of extortion under color of official right, according to the U.S. Attorney’s Office, District of New Jersey. According to a release from […]
Some hospice period dates have not been calculating correctly through the Common Working File (CWF), according to Medicare Administrative Contractor (MAC) Palmetto GBA. Period three and later should be no more than 60 days from the start through termination dates. Palmetto found that third or later periods have more than 60 days calculated in the […]
Congress is considering legislation that would automate the prior authorization process within Medicare Advantage plans. Home health agencies and other providers under Medicare Advantage plans must receive prior authorization before they can visit a patient, which has caused some frustration among agencies. For example, a patient is being discharged from the hospital to home health […]
The Review Choice Demonstration will begin in Texas on Dec. 2, 2019 — about a month before the Patient-Driven Groupings Model (PDGM) takes effect. After implementation in Texas, CMS says it will wait to begin the demonstration in the two remaining states — Florida and North Carolina — to “allow for the transition” to PDGM. […]