Targeted Probe & Educate – The New Normal

We all know or should know by now that CMS and its contractors are very active in today’s home health and hospice provider environment in conducting pre-payment and post-payment review of Medical [...]

Proposed 2020 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Requirements

I often say that the only thing that stays the same for Medicare providers is that things will change! The proposed Hospice update for 2020 was released April 25, 2020. Included are plans to [...]

Hospice Documentation is Critical

In the last few weeks our consultants have been working hard to assist hospices with claim denials resulting from UPIC and SMRC audit. The focus of these audits generally is review of Long Length [...]

Review Choice Demonstration Project – Home Health

The industry anticipated the RCD to start in Illinois in December 2018. Through January & February we continued to see education offerings from Palmetto GBA. The delay has been tied to Office [...]

Moratorium Not Extended / CMP Suspension Ends

It is hard to believe that January 2019 is already in the books. So much is changing fast in the home care and hospice industries. Several years ago Civil Monetary Penalty laws were revised to [...]

Medicare Conditions of Payment

The Medicare Conditions for Payment of Home Health services can be found at CFR 424.22. It is very important to understand fully the requirements for home health claims to be paid. Recently, our [...]

OIG Workplan Offers a Heads-up to Hospice Providers

For the last several years CMS has identified concerning hospice industry trends in various studies and payment updates. Among the issues identified are long-lengths of stay, live discharges, [...]

Home Health Challenges for 2019

As we turn the page on the year 2018, the year ahead promises to be another year for home health agencies to buckle down and prepare for major changes and continuation of CMS initiatives to [...]