Online resource packed with regulatory news and expert guidance, tips & tools pertinent to professionals across the post-acute care continuum.
Agencies should ensure clinicians are familiar with the high-risk drug classes ahead of OASIS-E implementation and the addition of N0415 (High-risk drug classes: use and indication). Explain why it’s important. Be sure that staff are educated and competent in the various high-risk drug classes. Designate education around different medications. Make sure you’re asking the right […]
Agencies preparing for Home Health Value-Based Purchasing (HHVBP) in 2023 now have access to achievement thresholds and benchmarks for each quality measure via the Internet Quality Improvement and Evaluation System (iQIES) portal at https://iqies.cms.gov/. The achievement thresholds and benchmarks were calculated using quality measure data for 2019, the model baseline year, according to a CMS […]
The Department of Health and Human Services Office of Inspector General has announced a new review of the “accuracy of falls reporting in home health OASIS assessments,” according to a work plan update for May 2022. The OIG noted that Care Compare now includes the percentage of patients in home health care who fell and […]
CMS has released the much-anticipated draft guidance manual for the OASIS-E version of the OASIS data set. The OASIS-E will be used for assessments beginning Jan. 1, 2023. The new 396-page guidance manual includes an item-by-item guide to the OASIS-E assessment instrument (page 13), as well as a 10-page description of the changes from OASIS-D […]
A home health agency has paid $2.1 million to settle claims of improper billing for services provided to patients in Florida, according to an announcement May 5, 2022, by the U.S. Attorney’s Office in the Western District of Kentucky, where the agency is headquartered. According to a complaint filed in the United States District Court […]
NGS, a Medicare administrative contractor serving agencies in 19 states, reports to its providers that there has been a resolution for the months-long issue with Notices of Admission that was causing a return to provider incorrectly with edit code U537F. The error was due to the Common Working File not correctly recognizing discharges, according to […]
In a new message to providers May 5, 2022, CMS is noting that the FDA has limited the authorized use of the Janssen (Johnson & Johnson) COVID-19 vaccine. The vaccine is now only authorized for patients 18 years or older: For whom other authorized or approved COVID-19 vaccines are not accessible or clinically appropriate Who […]
A Texas home health agency owner is accused of fraudulently billing Medicare for more than $10 million, according to a release by the U.S. Department of Justice’s Southern District of Texas. Okorie Oko, 63, of Fresno, was arrested Thursday, April 28, 2022, and faces a five-count indictment, along with patient recruiter Henry C. Dobbins, 57, […]
CMS has provided a new video and guidance to get agencies ready for the national rollout of the Home Health Value-Based Purchasing model in 2023. The new tools include: The on-demand video Quality Measures Used in the Expanded HHVBP Model, providing measure-specific information on each of the quality measures included in the expanded Model. A […]
CMS is updating the requirements when an agency is working with a nurse practitioner for home health orders or the care plan. The new language, added to Chapter 7 §30.2.1 in the benefit policy manual, notes: “In the absence of State law governing collaboration, collaboration is to be evidenced by the NPs documenting their scope […]