OIG Report Recommends CMS Use CERT Data to Identify High Risk Home Health Agencies

CMS Remains Opposed to Using CERT Data to Identify Improper Payments, Prefers TPE & RCD The Health and Human Services (HHS) Office of the Inspector General (OIG) recently released a report pertaining to home health agencies (HHA), The Centers for Medicare & Medicaid Services Could Use Comprehensive Error Rate Testing Data To Identify High-Risk Home…

Office of Inspector General Continues Focus on Home Health Agencies

The Department of Health and Human Services (HHS), Office of the Inspector General (OIG) issues updates to its work plan on a monthly basis through out the year. Since our last report on the OIG’s recent activity updates (NAHC Report https://report.nahc.org/recently-added-oig-work-plan-item-may-impact-home-health-and-hospice-providers/), the OIG announced this month a revision of an issue for home heath agencies…

Hospice Supplemental Medical Review Contractor Activity

The Centers for Medicare and Medicaid (CMS)’ Supplemental Medical Review Contractor (SMRC), Noridian Healthcare Solutions LLC, has posted a current hospice project – General Inpatient Hospice.   CMS contracted with Noridian on February 13, 2018 to help lower improper payment rates and increase efficiencies of Medicare and Medicaid medical review. The SMRC conducts medical review of…

Special Alert for All Home Health Operators!

An extremely serious issue involving Medicare home health has surfaced that requires the immediate attention of your organization. Effective January 13, 2018, the “Plan of Care” (POC) Condition of Participation under 42 CFR 484.60 also became a Condition for Payment under the home health benefit, 42 CFR 409.43. This means that all the elements must…

Improper Payment Rates Fall for Home Health and Hospice Providers

Improper payments to home health providers fell by almost 15 percent and to hospices by three percent, according to the 2018 Medicare Fee-for-Service Improper Payment Data report. As NAHC has stated previously, these sharp reductions in improper payments demonstrates that Center for Medicare & Medicaid Services’ (CMS) plan to initiate the Review Choice Demonstration is…

In Light of New Evidence, NAHC Pushes OMB, CMS to Back off Review Choice Demonstration

The National Association for Home Care & Hospice (NAHC) is calling on the Office of Budget Management (OMB) and the Centers for Medicare & Medicaid Services (CMS) to stop the planned Review Choice Demonstration (RCD) before it begins, in light of new evidence showing that “improper payments” in home health have been rapidly declining without…

CMS Home Health Open Door Forum on Templates and Clinical Data Elements

The Centers for Medicare and Medicaid Services (CMS) will hold a special home health open door forum conference call on templates and clinical data elements (CDEs) on Thursday, March 1, 2018 from 3:00 to 4:00 PM Eastern time. The special open door forum will allow physicians, provider and supplier professional associations, and/or all other interested…