Tag Archives: Home Health

CMS Finalizes Medicaid Home Health and Medical Equipment Policy Changes, Including Face-to-Face Encounter Requirements

CMS published a final rule on February 2, 2016 to implement statutory requirements regarding documentation of face-to-face encounters with Medicaid beneficiaries within certain timeframes as a condition of Medicaid coverage of home health services and certain medical equipment.  The rule also makes several clarifications to Medicaid policies related to coverage of home health services, including … Continue Reading

CMS Announces Extension of Moratoria on Enrollment of HHAs, Ambulance Suppliers in Designated Areas

CMS published a notice February 2, 2016 announcing an additional 6-month extension of its current temporary Medicare enrollment moratoria for new ground ambulance suppliers and home health agencies (HHAs), subunits, and branch locations in designated metropolitan areas.  The moratoria, which also apply to enrollment in Medicaid and the Children’s Health Insurance Program, apply to: New … Continue Reading

CMS Call on IMPACT Act: Connecting Post-Acute Care across the Care Continuum (Feb 4)

On February 4, 2016, CMS is hosting a provider call on Improving Medicare Post-Acute Care Transformation (IMPACT) Act requirements regarding the reporting of standardized patient assessment data by post-acute care (PAC) providers (skilled nursing facilities, home health agencies, inpatient rehabilitation facilities, and long-term care hospitals). During this call, CMS and the Office of the National … Continue Reading

Congressional Leaders Announce Spending/Tax Deal with Medicare and ACA Provisions; House Approves Tax Package

On December 15, 2015, Congressional leaders released sweeping spending and tax proposals, including a number of provisions impacting Medicare and the Affordable Care Act (ACA). The legislation is being considered on a fast track; the House approved the tax component of the package today, and it is scheduled to vote on the appropriations bill tomorrow, with … Continue Reading

CMS Call on Upcoming Home Health Value-Based Purchasing Model (Dec. 17)

On December 17, 2015, CMS is hosting an “Open Door Forum” on the Home Health Value-Based Purchasing Model (HHVBP), which begins January 1, 2016 in nine states. All Medicare-certified HHAs delivering services within these states will be required to compete for payment adjustments based on quality performance.… Continue Reading

Medicare Home Health PPS Payments to Fall by $260 Million in 2016

CMS published its final CY 2016 Medicare Home Health Prospective Payment System (PPS) rule on November 5, 2015.  CMS projects that overall Medicare payments to home health agencies (HHAs) will be reduced by 1.4% — or $260 million – in CY 2016 compared to 2015 levels as a result of the policies finalized in the … Continue Reading

CMS Publishes Proposed Rule on Hospital/HHA Discharge Planning Requirements

Today the Centers for Medicare & Medicaid Services (CMS) published a proposed rule that would modify the discharge planning conditions of participation (COPs) for hospitals, including long-term care hospitals and inpatient rehabilitation facilities, critical access hospitals, and home health agencies (HHAs). The proposed rule would implement the discharge planning requirements of the Improving Medicare Post-Acute … Continue Reading

CMS Sends Final 2016 Medicare Payment Rules to OMB for Review

This week CMS referred major final calendar year 2016 Medicare payment rules to the White House Office of Management and Budget (OMB) for regulatory clearance. Specifically, OMB is reviewing the final CMS rules to update the Medicare physician fee schedule, the hospital outpatient prospective payment system (PPS) and ambulatory surgical center payment update, the home … Continue Reading

CMS Again Extends Moratoria on Enrollment of HHAs, Ambulance Suppliers in Designated Areas

CMS has announced another 6-month extension of its current temporary enrollment moratoria for new ground ambulance suppliers and home health agencies (HHAs), subunits, and branch locations in designated metropolitan areas. The moratoria, which affect enrollment in Medicare, Medicaid, and the Children’s Health Insurance Program, apply to: New ground ambulances in the Houston and Philadelphia metropolitan … Continue Reading

President Obama Signs Steve Gleason Act and Independence at Home Act

On July 30, 2015, President Obama signed into law: S. 984, “Steve Gleason Act of 2015” – a bill to cover as durable medical equipment eye tracking and gaze interaction accessories for speech generating devices furnished to individuals with a demonstrated medical need for such accessories; and S. 971, “Medicare Independence at Home Medical Practice … Continue Reading

CMS Proposed Medicare Home Health PPS Rule Would Reduce HHA Payments by $350 Million in 2016

CMS has released its proposed calendar year (CY) 2016 Medicare home health prospective payment system (HH PPS) update, which CMS estimates would reduce overall Medicare payments to home health agencies (HHAs) by $350 million in 2016, compared with 2015 levels. This decrease reflects a 2.3% home health payment update percentage (derived from a 2.9% market basket … Continue Reading

CMS Proposed 2016 Medicare Payment Rules in the Pipeline

CMS recently sent several major proposed Medicare CY 2016 payment rules to the White House Office of Management and Budget (OMB) for regulatory clearance – the last step before publication in the Federal Register. Specifically, OMB is reviewing proposed rules to update the Medicare physician fee schedule, the hospital outpatient PPS/ambulatory surgical center payment update, … Continue Reading

OIG Reviews HHA Background Check Policies

In response to a Congressional request, the OIG has reviewed the extent to which home health agencies (HHAs) have employed individuals with criminal convictions and whether state requirements should have disqualified such individuals from HHA employment. The OIG points out that there are no federal requirements that HHAs conduct background checks on employees, and state requirements … Continue Reading

CMS Announces Open Door Forum on Home Health Patient Survey Star Ratings (May 7)

On May 7, 2015, CMS is hosting a Special Open Door Forum to discuss its plans to use Home Health CAHPS survey results to create Patient Survey Star Ratings for the Home Health Compare website. CMS will provide an overview of the HHCAHPS Patient Survey Star Ratings, describe the methods for calculating the ratings and assigning … Continue Reading

OIG Issues 2015 Compendium of Unimplemented Recommendations

The OIG has released its March 2015 “Compendium of Unimplemented Recommendations,” which highlights the OIG’s top 25 recommendations for cost savings and/or quality improvements in HHS programs, along with other significant unimplemented recommendations. High-priority recommendations address the following areas, among others: Payment Policies and Practices: Expand the DRG window to include additional days prior to the inpatient … Continue Reading

MedPAC Report to Congress on Medicare Policy

The Medicare Payment Advisory Commission (MedPAC) has released its annual recommendations to Congress on Medicare policies, including Medicare fee-for-service (FFS) payment updates and a status report on the Medicare Advantage and Medicare Part D programs. The following are highlights of the recommendations for 2016 (many of which were recommended previously):… Continue Reading

CMS Call on Home Health Clinical Templates (March 11)

On March 11, 2015, CMS is hosting a call to discuss paper and clinical templates intended to assist physicians and practitioners in documenting patient eligibility for Medicare home health benefits. In announcing the call, CMS notes that the fiscal year 2014 Comprehensive Error Rate Testing (CERT) program identified a high proportion of claims with inadequate … Continue Reading

CMS Announces New 6-Month Extension of Moratoria on Enrollment of HHAs, Ambulance Suppliers in Designated Areas

CMS is extending — for another 6 months — its current enrollment moratoria for new ground ambulance suppliers and home health agencies (HHAs) in designated metropolitan areas. The moratoria, which affect enrollment in Medicare, Medicaid, and the Children’s Health Insurance Program, apply to new ground ambulances in the Houston and Philadelphia metropolitan areas and new HHAs … Continue Reading

CMS Schedules Provider Calls on Medicare Payment, Quality, Coding & Program Integrity Topics

CMS has scheduled a series of provider calls in February and March on the following topics: February 3: Special Open Door Forum on the upcoming Prior Authorization of Non-Emergent Hyperbaric Oxygen Therapy model to be implemented in March in Illinois, Michigan, and New Jersey. February 4: Special Door Forum on the introduction of star ratings on … Continue Reading

CMS Announces DMEPOS/Home Health/Hospice RAC, Improvements to RAC Process

CMS has announced that it has awarded the Region 5 Recovery Audit contract to Connolly, LLC (although the Government Accountability Office subsequently reported that a bid protest has been filed regarding this award). The purpose of this contract will be to identify improper Medicare payments for durable medical equipment (DME), orthotics, prosthetics, and supplies and home health/hospice … Continue Reading
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