Tag: home health

OIG reviewing OASIS fall reporting

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 […]

Home health agency to pay $2.1 million in DOJ settlement

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 […]

DOJ alleges $10 million home health fraud scheme

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 updates nine-state HHVBP model’s results

CMS has released the fifth annual report of the Home Health Value-Based Purchasing Model as officials prepare to roll the nine-state model out nationwide beginning in 2023. The findings from the new report note Total Performance Scores were 7% higher among agencies in the HHVBP states: Arizona, Florida, Iowa, Maryland, Massachusetts, Nebraska, North Carolina, Tennessee […]

Sad News from AHCC and DecisionHealth

We’re writing on behalf of the Association of Home Care Coding & Compliance (AHCC) and DecisionHealth to let you know that our dear friend and former Board of Medical Specialty Coding & Compliance board member Vonnie Purvis Blevins has passed away. We will miss the way she brought our community together. Vonnie worked constantly to […]

CMS adds two new responses to the RCD FAQs

With a February update to the Review Choice Demonstration (RCD) frequently asked questions, CMS addresses questions about claims not subject to RCD and notes that number of visits does not matter when it comes to RCD. From the updated FAQ: Are any claims exempt from the RCD process?  Home health claims for Veteran Affairs, Indian […]

Latest system issue incorrectly identifies NOAs as duplicates

CMS’ Medicare Administrative Contractors (MACs) have alerted providers to a new system issue with the Notice of Admission (NOA). The NOA replaced the RAP in 2022 as the way for an agency to note it is the primary home health provider for a patient at the start of care. According to the MACs, an issue […]

CMS issues reminder on skilled nursing and therapy services in home health

CMS is reminding providers that Medicare covers skilled nursing care and skilled therapy services under the home health benefit when a beneficiary needs skilled care to maintain function or to prevent or slow decline. The reminder was included in the weekly MLN Connects newsletter on Dec. 2, 2021. To qualify for skilled care, the beneficiary […]

OIG report shows survey focus on infection control in home health

A recent home health audit by the Office of Inspector General (OIG) serves as a reminder to keep up your focus on infection control policies and procedures. The audit found that six out of eight agencies reviewed were in full compliance. Still, it opens the door for CMS surveyors to probe extensively in this area. […]

LHC Group: Pandemic, hurricane exacerbates Q3 staffing challenges

In a message to investors last month, LHC Group noted the impact that the pandemic and Hurricane Ida had on results in the third quarter. The combination of Hurricane Ida and clinicians on quarantine led to a sequential decline of 1.5% in average daily home health census from 85,553 in the second quarter of 2021 […]