CMS Article Provides Clarity on the Role of Therapy in PDGM

The Centers for Medicare & Medicaid Services (CMS) posted a special edition MLN Matters article, SE20005 – The Role of Therapy under the Home Health Patient-Driven Groupings Model (PDGM). This article provides information on the continuing role of therapy under the newly implemented PDGM. While there has been a change to the case-mix adjustment methodology…

NAHC to Host 6 New Free Webinars: PDGM in Real Time

The National Association for Home Care & Hospice (NAHC) will present a new six part webinar series, PDGM in Real Time, that will cover the essential topics of the Patient Driven Groupings Model (PDGM) and also feature an open forum in which attendees can have their specific questions answered by the top PDGM experts in…

The PDGM Education Your Agency Needs is Coming to You!

The Patient-Driven Groupings Model (PDGM), the revolutionary new payment model, is finally here. Does your agency have the proper systems in place today to ensure its success tomorrow, and in the future? The National Association for Home Care & Hospice (NAHC), in partnership with the NAHC Forum of State Associations, the Home Care & Hospice…

NAHC Plans Push to Protect Home Health Therapy under PDGM

In advance of the official implementation of the Patient Driven Groupings Model (PDGM) for Medicare home health, the National Association for Home Care and Hospice (NAHC) met with regulatory experts from the trade associations representing physical and occupational therapists, as well as speech language pathology. The meeting focused on advocacy efforts to mitigate the more…

CMS Updates Medicare Benefit Policy Manual for Home Health Agencies

The Centers for Medicare & Medicaid (CMS) recently released Transmittal 265/Change Request (CR) 11577 Manual Updates Related to Calendar Year (CY) 2020 Home Health Payment Policy Changes, Maintenance Therapy, and Remote Patient Monitoring This CR updates the Medicare Benefit Policy Manual, (Publication 100-02), Chapter 7, to reflect policy changes finalized in the CY 2019 and…

CMS Updates Claims Processing Manual

The Centers for Medicare & Medicaid Services (CMS) has again updated Change Request (CR) 11081 – Home Health (HH) Patient-Driven Groupings Model (PDGM) – Split Implementation through Transmittal 4489. As previously reported, this CR has been updated more than once since its original publication in early 2019 (see previous NAHC Report coverage here and here).…

Open Door Forum Summary: Updates on iQIES Transition Update and Home Health & Hospice

The Centers for Medicare & Medicaid Services (CMS) held a Home Health, Hospice, & DME Open Door Forum (ODF) on January 8, 2020.¬† A summary is provided below, beginning with home health and followed by hospice. HOME HEALTH iQIES Transition CMS indicated in the ODF that it is aware of several issues with the iQIES…

CMS Updates Review Choice Demonstration FAQs to Address PDGM

The Centers for Medicare & Medicaid Services (CMS) has updated the Frequently Asked Questions (FAQs) and the Operational Guide for the Review Choice Demonstration(RCD)to include additional information on how the Patient-Driven Groupings Model (PDGM) will affect the demonstration. CMS updated the Operational Guide in early December¬† to include instructions for submitting documentation relate to PDGM,…

The Year in Review: Home Health and Hospice in Congress in 2019

Congress Actively Pursued Key Home Health and Hospice Concerns NAHC scored some big victories for patients and providers While 2019 was frequently marked by intense partisan wrangling in Congress, a year-end review by the National Association for Home Care & Hospice (NAHC) shows that elected officials still found time to pursue a number of issues…

Home Health Reminder and CMS Update to PDGM Split Implementation Instructions

REMINDER: Home Health RAPs Hold Medicare Administrative Contractors (MACs) typically hold claims for a brief period each quarter when they implement system releases. This January, home health Requests for Anticipated Payment (RAPs) are affected by implementation of the Home Health Patient-Driven Groupings Model. MACs will hold RAPs with From Dates on or after January 1,…