Archive | CMS

Help Stop HHGM!

CMS’s Proposed HHGM Payment System Will Disrupt Home Health Payments and Access to Care CMS is planning major changes for the way home care agencies are reimbursed for Medicare services, and the industry is pushing back hard. New Hampshire providers need to voice their concerns by contacting our Congressional Delegation and submitting comment letters to […]

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New PEPPER Available for Home Health Agencies and Partial Hospitalization Programs

New Program for Evaluating Payment Patterns Electronic Reports (PEPPERs) through CY 2016 are available for Home Health Agencies (HHAs) and Partial Hospitalization Programs (PHPs). PEPPERs are distributed by TMF® Health Quality Institute under contract with CMS. These reports summarize provider-specific data statistics for Medicare services that may be at risk for improper payments. Providers can […]

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Meet Ayla: Another Face of Medicaid

Meet Ayla, the daughter of the MA Pediatric Home Nursing Care Campaign Founder, Angela Ortiz. The campaign is a coalition partner of the Home Care Alliance of Massachusetts. Feel free to share to protect all medically fragile children. Meet Ayla: Another Face of Medicaid Meet Ayla: Another Face of Medicaid – created at http://animoto.com

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Check Your HIS Preview Reports NOW!

Hospice provider Hospice Item Set (HIS) “Preview Reports” are now available in CASPER. These preview reports show hospice quality measure scores for Q4 2015 – Q3 2016 and give a glimpse of the first Medicare Hospice COMPARE Reports to be launched this summer. Click here for info about accessing your hospice’s preview report.   Hospice […]

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Interpretive Guidelines for Emergency Preparedness

  CMS has issued an advance copy of the interpretive guidelines (IGs) and survey procedures for the Medicare and Medicaid emergency preparedness requirements. These IGs are for state surveyors.  They will be incorporated into the Medicare State Operations Manual under  Appendix Z. The IGs apply to all of the 17 provider types listed in Emergency Preparedness Requirements […]

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CMS Posts FY2018 Hospice Payment and Quality Reporting Requirements Rule

Following is a NAHC summary of the FY2018 proposed hospice rule: CMS Posts FY2018 Hospice Payment and Quality Reporting Requirements Rule –Outlines Public Reporting Plans for Quality Measures and Seeks comment on Sources of Info for 6-month Life Expectancy, Comprehensive Assessment Instrument Late April 27, the Centers for Medicare & Medicaid (CMS) posted the proposed […]

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CMS Announces Delays in Home Health Regulations

CMS showered the home health industry with good news last Friday.  The agency announced proposed rules to delay implementation of the new Medicare Home Health Conditions of Participation (COPs.)  The much-maligned Pre-Claim Review Demonstration Program was also suspended.   CMS’s proposed rule will extend the effective date for the new home health COPs from July […]

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NGS: Home Health and Hospice Virtual Conference Registration Open

The 3rd Annual Home Health and Hospice Virtual Conference will take place Thursday April 13, 2017. The virtual conference will begin at 2:00 PM Eastern Time with courses being offered every hour until 7:00 PM. The virtual conference is free to attend but registration is required. To register, visit the National Government Services website at […]

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CMS Clarifies NWPT, Outlier Payments, and Updates Medicare Benefit Policy Manual for Home Health

Last week, CMS issued Change Request 9898, transmittal #233.  All Medicare-certified agencies should review this document.  It clarifies the payment policy changes for Negative Pressure Wound Therapy (NWPT) using a disposable device, and also clarifies the methodology to calculate outlier payments for home health.  The implementation date is March 27, 2017. In addition, the CR […]

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CDC Finds Seniors’ Hospital Use Has Increases for Illness Over Injury

The number of New Hampshire’s seniors who land in emergency rooms after falling has risen sharply in recent years, as their population grows and they live longer with more chronic illnesses often requiring an array of medications. The percentage of the U.S. population aged 65 and over has grown, and it is projected to continue […]

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My Turn: Block grants for Medicaid would injure the vulnerable

Opinion Column By BRENDAN WILLIAMS For the Concord Monitor Wednesday, January 25, 2017 A serious threat to seniors and those with disabilities is being ignored in the debate over repealing the Affordable Care Act. We must not forget that the Medicaid program dates back to 1965, not the ACA expansion for the working poor. This […]

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CMS’s training for the Hospice QRP program

CMS has scheduled an all-day (8:30 a.m. to 4:30 p.m.) training on the Hospice Quality Reporting Program for Wednesday, January 18.  The training will be available in-person as well as via webcast. CMS has now posted a link to the host site for the webcast; it’s advisable that organizations planning to participate in the webcast […]

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Home Health Conditions of Participation Final Rule Released from the Office of Management and Budget

FROM VISITING NURSE ASSOCIATIONS OF AMERICA On January 5th, the Home Health Conditions of Participation (CoPs) were released from the Office of Information and Regulatory Affairs (OIRA) at the Office of Management and Budget (OMB) back to the Centers for Medicare and Medicaid Services (CMS). VNAA submitted comments to CMS on the proposed CoPs. In general, VNAA […]

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Probe and Educate Alive and Well for 2017

Since 2015 CMS has instructed Medicare Administrative Contractors (MACs) to request records for 5 claims from each home health agency within their jurisdiction to review on a pre-payment basis.  For the time being, this practice (affectionately known as Probe and Educate) isn’t’ going anywhere. 2017 brings us to round 2 of the Probe and Educate […]

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CMS Issues Final Rule to Modernize Home Health Conditions of Participation

Earlier this week the Centers for Medicare & Medicaid Services (CMS) released a final rule (CMS-3819-F) that set minimum standards for home health agencies as Conditions of Participation (CoPs). According to CMS the rules are aimed at improving the quality of care for beneficiaries and boosting patients’ rights. There are 39 home health agencies providing […]

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CMS Billing Clarification

Last week, CMS issued the CY 2017 Medicare Home Health Prospective Payment System Final Rule. Overall, CMS estimates a 0.7% reduction in Medicare home health payments ($130 million in 2017 nationally.) Here are the ingredients: A market basket update of 2.5%  (a $450 million increase) A 0.97% reduction in the national, episodic base rate due […]

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CMS Publishes Final Rule for 2017 Medicare Home Health Rates

Yesterday, October 31st, the Centers for Medicare and Medicaid Services (CMS) announced its final rule regarding changes to the Medicare home health prospective payment system (HHPPS) for Calendar Year (CY) 2017. The final rule also includes payment policy provisions, updates to the home health quality reporting program (HHQRP) and proposed changes to the Home Health […]

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Quality of Patient Care Star Ratings Preview Reports now available

The Home Health Quality of Patient Care Star Ratings Preview Reports and the Home Health Compare Provider Preview Reports are now available in the Provider CASPER folders. These reports contain data that will be publicly reported on the Home Health Compare website in January 2017. The deadline to submit a request to have the Quality […]

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