Category: Payment/economy

CMS to hold webinar on APU/market basket increases

CMS announced it will hold a webinar 2 p.m. to 3:30 p.m. EST June 19 for home health agencies on “Achieving a Full Annual Payment Update (APU)/Market Basket Increase.” During the webinar, CMS plans to discuss: The relationship between the APU and quality reporting Data submission requirements. The reconsideration process for providers identified as noncompliant. […]

CMS schedules PDGM call

Source: Home Health Line CMS has scheduled an MLN call 1:30 p.m. to 3 p.m. EST Feb. 12 to discuss PDGM. During the call, CMS will provide a broad overview about PDGM and walk agencies through specific payment adjustments within the model. Afterward, CMS will hold a PDGM question-and-answer session. CMS will post presentation materials […]

Four steps to take now for adjusting your therapy contracts before the PDPM transition

Here are four steps for therapy contract adjustment that you should take now to prepare for PDPM implementation on October 1, 2019. The PDPM Transition: Step 1 Analyze your Part A fee‐for‐service utilization data What is your RUG distribution? What is your average length of stay by RUG? What is your reimbursement per RUG category? What is […]

2018-2019 Assisted Living Salary & Benefits Report released

The Assisted Living Salary & Benefits Report 2018-2019 has been released. The lengthy report delves into salary by region, type of facility, and position at facility, among many other metrics. Interestingly, one finding is that overall, those who hold the position of assisted living administrator saw a slight dip in salary, of 0.07%, with an […]

CMS removes functional reporting requirements and changes therapy provisions

CMS has released an update on therapy caps and functional reporting. Effective for dates of service on or after January 1, 2018, providers of therapy services shall continue to report the KX modifier on claims as applicable; however, the modifier no longer represents an exception request but serves as a confirmation that services are medically […]

MedPAC — yet again — recommends a 5% home health payment reduction

Source: Home Health Line The Medicare Payment Advisory Commission (MedPAC) is once again recommending a 5% Medicare payment reduction for home health agencies. During a Jan. 17 meeting, MedPAC voted in a favor of a draft recommendation that Congress “reduce the calendar year 2019 Medicare base payment rate for home health agencies by 5 percent.” […]

Revenue integrity enthusiasts: Do you have what it takes to present at RIS?

The National Association for Healthcare Revenue Integrity (NAHRI) is currently seeking speakers to present at the 2019 Revenue Integrity Symposium (RIS), to be held October 15–16, 2019, at the Renaissance Orlando at SeaWorld in Orlando, Florida. RIS attendees will be eligible to earn CHRI CEUs and speakers will be eligible to earn additional CHRI CUEs. […]

Key elements of ACO program overhaul

Source: The Bottom Line CMS finalized a rule with new requirements for accountable care organizations (ACO) last week, reducing the amount of time an ACO is allowed to stay in the program without assuming risk and expanding the three-day stay waivers for nursing homes. “Most Medicare ACOs do not currently face financial consequences when costs […]

PPS final rule increases agencies’ payments for 2019, finalizes PDGM

CMS has finalized a plan to launch a budget-neutral payment model for home health that utilizes 30-day payment periods and stops using the number of therapy visits to determine payment. That’s according to the 2019 PPS final rule posted Oct. 31 on the Federal Register website. The Patient-Driven Groupings Model (PDGM) will launch “on or […]