Abuse & Neglect in the Medicare Population: A Recent OIG Report

Editor’s Note:  Special thanks go to Bill Musick, President of Integriti3D, for his contribution of this article.  Integriti3D helps hospice chief executives and boards of directors reach their highest potential through strategic planning, board development and creating a culture of integrity, fairness and respect. While not specifically focused on home health or hospice, the OIG’s…

Submissions Using Health Insurance Claim Number Will Be Rejected January 1

The Centers for Medicare & Medicaid Services (CMS) has announced it will reject claims submitted with the Health Insurance Claim Number, with very few exceptions, starting January 1, 2020. All eligibility transactions using the Health Insurance Claim Number will be rejected after that date, with no exceptions. Providers must use the Medicare Beneficiary Identifier (MBI).…

Statement of NAHC President William A. Dombi Regarding the Medicare Home Health Proposed Rule Issued on July 11

CMS late today issued the proposed rule for the 2020 payment model, PDGM, including rates of payment that would start January 1, 2020. The new payment model had been finalized in its design in the 2019 rulemaking cycle. The proposed rule offers some minor tweaks in the payment model and sets out 2020 payment rates…

CMS Primary Care First Seriously Ill Population Webinar Rescheduled

The Primary Care First Model Options team will be hosting a payment webinar on Wednesday, July 24, 2019 from 12:00 p.m. – 1:00 p.m. EDT. Topics to be discussed include how eligible practices can participate in the SIP payment model option of Primary Care First, eligibility requirements, quality measures, and payment. The event had previously been scheduled for July 10.…

Everything You Need to Know from the Latest CMS Open Door Forum on Home Health and Hospice

The Centers for Medicare & Medicaid Services (CMS) held its Home Health, Hospice, and Durable Medical Equipment (DME) Open Door Forum earlier this week.  It was a light agenda with much of what was presented being a summary of recent CMS news which has also been covered in NAHC Report.  Below is a summary of…

CMS Open Door Forum on Home Health, Hospice, DME

The Centers for Medicare & Medicaid Services (CMS) will hold an Open Door Forum on Tuesday, July 9, 2019 from 2:00 PM to 3:00 PM Eastern Time to discuss the latest developments in home health, hospice, and durable medical equipment. Please call in at least 15 minutes before the start of the ODF. The agenda…

House Approves Labor-HHS Spending Blueprint for FY2020

Last week the House of Representatives approved legislation that provides discretionary funding for the Department of Health and Human Services (HHS). In total, H.R. 2740 would dole out a combined $192 billion for the Departments of Labor, HHS, and Education, and their related agencies. Every year in the appropriations process specific funding levels need to…

Home Health Quality Reporting Program Update: Preview Reports Delayed and New Section GG Resources

Important news regarding the Quality Reporting Program (QRP) Updated Section GG Web-based Training Course The Centers for Medicare & Medicaid Services (CMS) is offering a web-based training course on how to properly code Section GG. This 45-minute course is intended for providers in the following care settings: Skilled Nursing Facilities (SNFs), Long-Term Care Hospitals (LTCHs),…

CMS Issues Clarification on Billing and Payment

The MLN Matters article, SE17027 – Clarification of Billing and Payment Policies for Negative Pressure Wound Therapy (NPWT) Using a Disposable Device, has been revised with additional billing information for home health agencies. Specifically, the article was updated to clarify the description for coding the TOT UNIT/COV UNIT field on Type of Bill 34X on…