CMS Announces Plans to Test Coverage of Hospice under Medicare Advantage

–“VBID” Plans may offer coverage beginning CY2021 As part of a release announcing a “broad array of Medicare Advantage (MA) health plan innovations that will be tested in the Value-Based Insurance Design (VBID) model for CY2020,”  the Centers for Medicare & Medicaid Services’ (CMS)  has indicated it plans, beginning in CY2021, to test including the…

Report: Home Health, Hospice Show Steady Growth

Home health admissions grew in the year from the second quarter of 2017 to the second quarter of 2018, while hospice utilization also got a boost with particularly strong activity in western states, according to a new report from Excel Health. The narrative of the report, which tracks statistics for Medicare, post-acute discharge, home health,…

Reports: Medicare Advantage Plans Improperly Denying Claims

— Anthem Adds Home Care Benefits Under Relaxed Medicare Advantage Rule Medicare Advantage plans are improperly denying medical insurance claims to patients and physicians, according to a report from the Office of the Inspector General (OIG) of the Department of Health and Human Services (HHS) and a separate report in the New York Times. Roughly 20…

NAHC Applauds Bipartisan Legislation to Stop Harmful Payment Rate Cuts

  STOP THE PROPOSED CMS HOME HEALTH RATE CUT! In another step towards curtailing the Centers for Medicare and Medicaid Services (CMS) attempts to cut Medicare home health rates, Senators Susan Collins (R-ME), Debbie Stabenow (D-MI), and Bill Nelson (D-FL) have introduced legislation designed to protect patients and providers from harmful reimbursement reductions. The Collins-Stabenow-Nelson…

‘Silver Tsunami’ Swells Medicare Rolls, Home Health and Hospice Admissions

America’s rapidly aging population is swelling the ranks of Medicare beneficiaries and increasing admissions for hospice and home health in the process, according to the new Excel Health Quarterly Industry Trend Report 2018. Hospitals are still discharging most of their patients with no post-acute care services or to skilled nursing facilities, but strong growth in…

Future of Home Health & Hospice will be Full of Challenges and Opportunities, Says Fred Bentley of Avalere

The “silver tsunami” — about 10,000 Americans turning 65 every day — that has been a recurring topic at NAHC Report, is still a few years away from crashing, but that day is approaching and while the demographic change holds great promise for a generation unwilling to be shunted into institutional care, policymakers are likely…

MedPAC Report Considers Unified PAC Payment System, Finding Best Providers

The Medicare Payment Advisory Commission (MedPAC report released on June 15, 2018 included refinements to their proposed unified post-acute care prospective payment system and for greater patient usage of high quality post-acute care providers. The refinements to a unified post-acute care prospective payment system would focus on increasing Medicare payment accuracy for patients involved in…

CMS Issues Guidance on New Medicare Advantage Plan Benefits

The Centers for Medicare & Medicaid Services (CMS) has issued two memos to the Medicare Advantage (MA) Plans with instructions on changes for contract year 2019. One memo relates to the expanded interpretation for health related benefits that plans will be permitted to offer their enrollees, such as home based support services. The second memo addresses…

Home Care Aid/Personal Care Services Allowed for Medicare Advantage Plans

Medicare Advantage plans may allow home care aid/personal care services as a supplemental benefit beginning in 2019, according to a final rule issued Monday by the Centers for Medicare & Medicaid Services (CMS). The rule is the first time CMS has permitted supplemental benefits that include daily maintenance in Medicare Advantage plans. According to the…

NAHC Submits Comments on Medicare Advantage Call Letter

On February 2, 2018, the Centers for Medicare & Medicaid Services (CMS) proposed changes to the Medicare Advantage (MA) program in the 2019 Call Letter. These changes increase flexibility to allow more options and new benefits to Medicare beneficiaries enrolled in MA plans. As a part of these changes, CMS is redefining health-related supplemental benefits…