Archive | CMS

CMS Unveils Proposed Rule for Medicare Home Health Payments

On July 2nd. CMS published itsMedicare Home Health Rate Rule and plans for 2020 payment reform. Here’s a synopsis of rate changes: The HHPPS episodic payment rate, after case mix and wage index adjustments, will increase by 2.1%. Per visits payments will also increase by 2.1% The rural add-on for 2019 will be 3% for […]

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CMS Releases Proposed 2019 HHPSS Update

CMS released its 600-page 2019 Proposed Medicare HHPPS Update at 4:15pm yesterday.  You can download the document at this link: https://s3.amazonaws.com/public-inspection.federalregister.gov/2018-14443.pdf While it will take a while to digest the entire proposal, below is a list of the basic elements, as sent to State Associations by Bill Dombi, president of NAHC. 2019 Payment rates The […]

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NH DHHS Proposes Changes to Home Care and Hospice Licensing Rules

  The NH Bureau of Health Facilities Licensing has released proposed revisions to the He-P 809 rules for licensing of home health care agencies and the He-P 823 rules for home hospice agencies. Public hearings will be held on June 11th — noon for the hospice rules and 1:00 pm for the home care rules. […]

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CMS Provides Guidance on Medicare Advantage Supplemental Benefits

Home care agencies could have an expanded role in providing services to enrollees in Medicaid Advantage (MA) Plans. CMS has issued two memos to the MA Plans instructing the plans on changes for contract year 2019. One memo relates to the expanded interpretation of the definition for “primarily health-related” supplemental benefits that plans will be permitted […]

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Get Answers from NGS

  On April 5th, NGS’s Home Health Clinical Consultant Lauri Domingo will be in Concord for a half-day education session on CMS’s Targeted Probe & Educate Process and home health documentation requirements. It’s from 9:00am – 12:30pm at the Holiday Inn, 172 North Main Street in Concord. Don’t miss this chance to get your questions […]

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Update: Medicare Targeted Probe & Educate

the new CMS Targeted Probe & Educate (TPE) initiative that started on October 1. The Targeted Probe & Educate (TPE) is for ALL types of Medicare providers. It is modeled after demonstration projects with home health agencies and hospitals. Both home health providers and hospice providers may be the subject of a TPE. Theoretically, an […]

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CMS Releases Draft Version of the HHCOP Interpretive Guidelines

The Centers for Medicare & Medicaid Service (CMS) has issued a draft version of the home health Conditions of Participation (CoPs) Interpretative Guidelines (IGs). CMS issued the IGs to the National Association for Home Care & Hospice (NAHC) with a request for stakeholder feedback. CMS is unable to entertain individual comments and requests that aggregated […]

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HHGM Rescue Bill

NAHC, Elevating Home, and the Partnership for Home Health offered what they are calling a “unified compromise proposal” to the House Ways and Means Committee in an effort to gain a withdrawal of the HHGM proposal from the CY2018 Home Health Prospective Payment System final rule.    The CMS Final rule is expected to be released within […]

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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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