Category: Home Health

Home health agencies continue to struggle on targeted probe-and-educate review

Of CGS’ 81 probes completed for eligibility and medical necessity edit 5A000 from Jan. 1, 2019, through March 31, 2019, only two were compliant after Round 1 — 79 agencies advanced to Round 2. Nineteen providers didn’t respond to additional documentation requests (ADRs) for Round 1 during that timeframe. Meanwhile, of CGS’ 10 probes completed […]

One in three adults die from hip fracture within the year

According to a recent article in Science Times, one in three adults aged 50 or older dies within 12 months following a hip fracture. The risk of death increases when a patient has an existing health condition and the risk of death may be related to complications from the fracture, such as infection, internal bleeding, […]

Proposed bill would innovate use of home health services

The Home Health Payment Innovation Act of 2019, H.R. 2573, would preserve Medicare recipients’ access to home health services and provide a pathway for innovative approaches to using these services. According to LeadingAge, which supports the bill, H.R. 2573 would prevent unwarranted payment rate cuts of Patient Driven Groupings Model (PDGM) by basing any behavioral […]

Create a clinical documentation improvement program to achieve PDGM success

Strong documentation is key in home health, and implementation of the Patient-Driven Groupings Model (PDGM) will add a new level of urgency to improvement in this area, industry experts contend. Coding will play a major role in how agencies are paid under PDGM, from determining the clinical group to whether a patient qualifies for a […]

Button down your infection control as measles, HAV outbreaks spread

Recent measles outbreaks in the United States are a grim reminder that infection control is crucial for post-acute providers. Twenty-two states have seen outbreaks of rubella in recent months, according to the U.S. Centers for Disease Control and Prevention (CDC). The disease had been considered eradicated in 2000, and anti-vaccination sentiments are thought to have […]

HHS, in partnership with industry, releases voluntary cybersecurity practices for the health industry

On Friday, December 28, the Department of Health and Human Services (HHS) released the “Health Industry Cybersecurity Practices (HICP): Managing Threats and Protecting Patients” publication. The four-volume publication aims to provide voluntary cybersecurity practices to healthcare organizations of all types and sizes, ranging from local clinics to large hospital systems. The industry-led effort was in […]

Quarterly OASIS Q&As offer detail on wound coding

CMS in its latest quarterly OASIS Q&As provided agencies with details about how to code a specific wound scenario. In Question 1 of the April Q&As, one agency asked CMS about a patient admitted with two distinct areas caused by pressure. Notes the agency: “A wound on the left buttock presents with purple localized discolored […]

CMS to hold ODF on Documentation Requirement Lookup Service prototype

CMS is holding a special open door forum (ODF) from 2 p.m. to 3 p.m. EST May 14 to provide education about “a new initiative underway to develop a Medicare Fee for Service (FFS) Documentation Requirement Lookup Service prototype.” The forum also will allow suppliers, physicians and others to provide CMS feedback. “The goals of […]

Palmetto GBA provides updates on TPE

Source: Home Health Line by: Josh Poltilove Medicare Administrative Contractor Palmetto GBA has posted Q&As from its recent teleconference on targeted probe-and-educate (TPE) reviews. Among other things, Palmetto leaders addressed when it will reach out to providers with questions. Palmetto encouraged agencies to include the name of their designated contact person when responding to additional […]