Tag: payments

CMS announces expansion of Home Health Value-Based Purchasing Model

CMS will expand the Home Health Value-Based Purchasing (HHVBP) Model, officials announced January 8, 2021. Currently implemented in nine states, the model has saved Medicare an average of $141 million annually, with an average improvement in quality scores of 4/6%, according to a news release. The HHVBP Model adjusts payments to agencies based on quality […]

Senate approves delayed recoupment of Medicare accelerated payments

On September 30, 2020, the U.S. Senate approved a continuing resolution (CR) that would delay the recoupment of Medicare Accelerated and Advanced Payments, according to CMS. Details of the plan include the delay of recoupment for one full year. The actual recoupment schedule would be stretched over 29 months. Recoupment for each claim would be […]

Early PDGM data reveal surprising findings about agency behavior

Data from a recent study of Medicare home health cost reports supports the case that the home health industry didn’t respond with the behavioral adjustments that CMS predicted prior to PDGM. And agencies have experienced increased challenges due to the public health emergency (PHE) that CMS should consider when finalizing the 2021 payment rule. The […]

CMS releases additional FAQs on COVID-19 relief payments

CMS released additional Frequently Asked Questions (FAQs) for Medicare providers regarding the Department of Health and Human Services’ (HHS) Provider Relief fund and Small Business Administration’s Paycheck Protection Program payments. These are also commonly referred to as “coronavirus disease 2019 (COVID-19) relief payments.” These FAQs cover how to report provider relief fund payments, uninsured charges […]

CMS expands accelerated payments for qualified Medicare providers

Accelerated and advance payments (AAP) could be retrieved in the next few weeks for qualified Medicare providers during the COVID-19 Public Health Emergency (PHE). CMS has released a fact sheet titled “Expansion of the accelerated and advance payments program for providers and suppliers during COVID-19 emergency.” The AAP has been expanded to a broader group […]

CMS proposes amendment to the HHS-RADV program

CMS issued a proposed rule on May 29 to amend requirements for the U.S. Department of Health and Human Services’ risk adjustment data validation (HHS-RADV) program. The proposal includes changes to two technical aspects of the HHS-RADV program, the error rate calculation, and application of results. CMS outlines the changes in the newly published fact […]

Hospice payment increase of 2.7% proposed, but it’s not a straightforward change

While the hospice industry is expected to receive about $540 million in increased payments in 2020, hospice providers should curb the enthusiasm until they fully analyze how the changes will impact the business. That’s because the payment rate for the first 60 days of routine home care (RHC) is actually decreasing slightly, according to CMS’ […]

CMS announces post-acute participants for bundled payment initiative

The Centers for Medicare & Medicaid Services (CMS) has announced the most recent participants in its Bundled Payments for Care Improvement (BPCI) Initiative. Under the BPCI Initiative, organizations enter into payment arrangements that include financial and performance accountability for episodes of care. These models may lead to higher quality, more coordinated care at a lower […]