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…

CMS Schedules Listening Session on Opioid Prescriber Accountability

In October 2018, President Trump signed the SUPPORT for Patients and Communities Act into law; in doing so, he enacted sweeping legislation designed to address the nationwide scourge of opioid abuse.  Among the numerous provision of interest to the hospice community included in the new law was authority for hospices, under specific circumstances, to allow…

OIG Finds Medicare Part D Still Spending Millions for Hospice Drugs

Over recent years the Department of Health & Human Services Office of the Inspector General (OIG) and others have conducted analyses of spending outside of hospice while patients are on service and determined that Medicare may be paying separately for care (including prescription drugs under Part D) that should be the responsibility of the hospice. …

OIG Report Finds States Need to Do More on Background Checks for Long-Term Care Workers

A new report from the Office of Inspector General (OIG) of the Department of Health and Human Services finds that nine of the 11 states that concluded their participation in the National Background Check Program in 2017 and 2018 did not implement all of the selected Program requirements, primarily due to a lack of legislative…

Controversial “Conscience Rights” Rule Delayed

The U.S. Department of Health and Human Services (HHS) has agreed to postpone the effective date of the Protecting Statutory Conscience Rights in Health Care; Delegations of Authority  rule.  The rule, commonly referred to as “the conscience rule”, was set to take effect this month and has been delayed by at least four months to…

HHS Renews Settlement Conference Facilitation for Appeal Resolutions

The Department of Health and Human Services (HHS) has renewed its Settlement Conference Facilitation (SCF) program. The SCF is available to all Medicare Part A and Part B providers and suppliers with appeals pending at the Administrative Law Judge (ALJ) or the Medicare Appeals Council (Council) level. The appeals must have been filed on or…

Proposed Rule from CMS Revises Non-Discrimination Regulations

The Department of Health and Human Services (HHS) and Centers for Medicare & Medicaid Services (CMS) have issued a proposed rule significantly revising the non-discrimination regulations that implemented Section 1557 of the Affordable Care Act (ACA). The revisions are intended to reduce burden, eliminate redundancy with several other non-discriminatory regulations, and provide clarity in the…

New HHS Fact Sheet on Direct Liability of Business Associates under HIPAA

The Health and Human Services (HHS) Office for Civil Rights (OCR) has issued a new fact sheet that provides a clear compilation of all provisions through which a business associate can be held directly liable for compliance with certain requirements of the HIPAA Privacy, Security, Breach Notification, and Enforcement Rules (“HIPAA Rules”), in accordance with…

OIG: CMS & States Must Work Together on Background Checks for Long-Term Care Employees

The Centers for Medicare & Medicaid Services (CMS) must help states completely implement background checks for long-term caregiver employees, according to a new report released by the Office of Inspector General (OIG) of the Department of Health and Human Services (HHS). Nine million beneficiaries rely on long-term-care services each year for safe, dependable care and…

Recently Added OIG Work Plan Item May Impact Home Health and Hospice Providers

The Department of Health and Human Services (HHS) Office of Inspector General (OIG) work planning is dynamic and adjustments are made throughout the year to meet priorities and to anticipate and respond to emerging issues. A Work Plan has been developed, made public, and updated monthly with new issues.  This month, there are two new issues…