CMS Home Health Rule: Quality Reporting Program

By:

CMS proposed and finalized to end the suspension of the collection of Outcome and Assessment Information Set (OASIS) data on non-Medicare and non-Medicaid patients, and to require HHAs to report all-payer OASIS data for purposes of the HH QRP for CY 2025.  The Centers for Medicare & Medicaid Services (CMS) proposed for the CY 2025 […]

Read More

CMS Proposed Rule Risks Stability of Home Health Care

By:

NAHC analysis of payment information & more The Centers for Medicare and Medicaid Services (CMS) issued its annual proposed rule regarding Medicare home health services payment rates for CY 2023. As usual, the rule also includes a hodgepodge of non-rate related proposals as well. This article provides a summary of the proposed rule. NAHC will […]

Read More

CMS Issues Corrections to Claims Processing Policy and 60 Day Calculation Inconsistency

By:

The Centers for Medicare & Medicaid Services (CMS) has issued Change Request (CR) 12657, removing the requirement to submit a Notice of Admission (NOA) before billing for home health denial notices. The CR also revises home health edit criteria to ensure Medicare systems calculate 60-day gaps in service consistently. CMS’ long-standing policy to exclude billings […]

Read More

CMS Finalizes Payment Rate Update to Home Health for 2022

By:

NAHC webinar on the CY2022 Final Rule on Friday! Free for NAHC members! Learn more! Home health payment rates increased by 2.6% CMS does not increase or decrease behavioral adjustment 432 case mix weights recalibrated using 2020 data CMS refuses to continue the 5% cap on negative wage index changes HHVBP demonstration expansion nationwide delayed […]

Read More

CMS Open Door Forum: Updates to Home Health Quality Reporting Program & More

By:

On April13, 2021 The Centers for Medicare & Medicaid Services (CMS) held the Home Health, Hospice, and Durable Medical Equipment Open Door Forum. The majority of information shared with the participants pertained to hospice providers. However, several issues impacting home health agencies were also discussed. Home Health Quality Reporting Program (HHQRP) CMS announce that five […]

Read More

Common Working File Edit Causing Incorrect Payments on Some LUPA Claims

By:

The Centers for Medicare & Medicaid Services (CMS) has issued Change Request (CR) 12085 – Correction to Period Sequence Edits on Home Health Claims. The CR addresses an edit in the Common Working File that bypasses period of care sequencing on Low Utilization Payment Adjustment (LUPA) claims. Before the implementation of the Patient-Driven Groupings Model […]

Read More

Recommendations and Clarifications for HHAs on the No-Pay RAP

By:

Beginning January 1, 2021, home health agencies (HHAs) will be required to submit a request for anticipated payment (RAP) that will be paid at 0 percent, prior to each claim. The Centers for Medicare & Medicaid Services (CMS) finalized the No-pay RAP policy in the CY 2020 Home Health Prospective Payment System Rate Update rule. […]

Read More

NAHC to CMS: Roll Back 2020 Rate Adjustment Based on Faulty Prediction of HHA Behavior

By:

The National Association for Home Care & Hospice (NAHC) urged the Centers for Medicare & Medicaid Services (CMS) to roll back the 2020 rate adjustment CMS instituted based on a prediction of how home health agencies (HHA) would behave that has not materialized. That recommendation, and several more, are part of NAHC’s formal comments to […]

Read More

OIG: CMS Could Save Money Reviewing Home Health Claims With Visits Slightly Above LUPA

By:

The Centers for Medicare & Medicaid Services (CMS) could have saved $192 million by targeting home health claims for review with visits slightly above the threshold that triggers a higher Medicare payment, according to a new report from the Office of Inspector General (OIG) of the Department of Health & Human Services. Home health agencies […]

Read More

What the 2020 Medicare Home Health Final Rule Means

By:

The National Association for Home Care & Hospice held a free-to-all webinar on Wednesday, November 5, 2019, to discuss the 2020 Medicare Home Health Final Rule and answer any questions. If you missed the webinar and would like to view the recording, please GO HERE. On October 31, 2019, the Centers for Medicare & Medicaid […]

Read More

CMS Issues Instructions for PDGM Claims Processing

By:

The Centers for Medicare & Medicaid Services (CMS) has issued Change Request 11081, which provides claim processing  instructions to the Medicare Administrative Contractors ( MACs) that will be necessary to process home health claims with the implementation of the Patient Driven Groupings Model (PDGM). The PDGM will assign 30-day periods of care into one of […]

Read More