MatrixCare Leaves Resmed

by Kristin Rowan | Sep 4, 2026 | M&A, Vendor Watch

by Kristin Rowan, Editor

MatrixCare is Independent Again

Resmed Acquisitions

In 2019, Resmed (formerly ResMed) acquired MatrixCare for $750 million. Resmed also acquired Healthcare First (2018) and Citus Health (2021) and bundled them under the MatrixCare brand. Resmed also acquired Brightree in 2016 and several other software companies that are outside the care at home ecosystem.

PE Firm Acquires MatrixCare; Names CEO

On September 1, 2026, private equity firm Frazier Healthcare announced its acquisition of MatrixCare. According to records, the sale included both Healthcare First and Citus Health. Brightree was not included.

Frazier named Jonathan Lujan as CEO of MatrixCare. Lujan, a Frazier Executive in Residence, most recently served as CEO of Sight Growth Partners, an administrative services provider in the vision care field. The press release from Frazier notes that Lujan has experience in healthcare and technology.

“Frazier has spent several years evaluating the post-acute care technology sector and believes MatrixCare has established itself as a leading platform serving skilled nursing, senior living, and home health and hospice providers. We are excited to partner with the MatrixCare team and to invest in the product innovation and capabilities customers need as the post-acute care landscape continues to evolve.”

Ryan Lucero

General Partner, Frazier Healthcare Partners

MatrixCare Announces Independence

In a separate press release on Tuesday, MatrixCare announced its independence from Resmed. The press release also included the appointment of Lujan as CEO, but did not mention Frazier Healthcare. Lujan’s experience and job history was identical in both announcements.

Lujan Statement from Frazier

In the Frazier press release, Jonathan Lujan says:

“MatrixCare has built a trusted platform with a strong market position and a critical role in the daily operations of post-acute care providers. I am excited to work alongside the MatrixCare team and Frazier to build on that foundation, accelerate product innovation, and help our customers deliver better outcomes for the people and providers they serve.”

The MatrixCare press release also included a quote from Lujan:

“Today marks an important milestone for MatrixCare. As an independent company, we have the focus and the resources to invest directly in our platform and our people. We will build on more than 40 years of trust earned with skilled nursing, senior living, home health, and hospice providers, and we will move faster to deliver the innovation our customers need. This is the start of MatrixCare’s next chapter, and I’m excited to lead the team into it.”

Final Thoughts

It is unclear at this time why the MatrixCare announcement did not mention Frazier Healthcare. The company left the Healthcare First and Citus Health platforms out of the press release as well. Whether Lujan works for Frazier or MatrixCare is also ambiguous. The Rowan Report reached out to MatrixCare for comment and has requested an interview with Lujan.

# # #

Kristin also runs Girard Marketing Group, a multi-faceted boutique marketing firm specializing in content creation, social media management, and event marketing. She works with care at home software providers to create dynamic content that increases conversions for direct e-mail, social media, and websites. Connect with Kristin directly at kristin@girardmarketinggroup.com or www.girardmarketinggroup.com

©2026 by The Rowan Report, Peoria, AZ. All rights reserved. This article originally appeared in The Rowan Report. One copy may be printed for personal use: further reproduction by permission only. editor@therowanreport.com

HHAeXchange Launches RCM Services

by Kristin Rowan | Sep 4, 2026 | Admin, Home Care, Medicaid, Partner News, Vendor Watch

by Kristin Rowan, Editor

HHAeXchange Announces RCM Services

An Interview with Phil Feldman

In April of 2026, HHAeXchange unveiled their new end-to-end Revenue Cycle Management (RCM) service. HHAeXchange is a leading provider of homecare program management designed for Medicaid Home and Community-Based Services. (HCBS).

Addressing Top Concerns

HHAeXchange’s 2025 Provider Voice Survey asks homecare agencies about the pain points facing the industry. Administrative workload and cost are significant areas of concern for homecare agencies, cited by 41% of providers. RCM services address these concerns by removing administrative tasks from agencies, freeing up personnel to focus on growth, community outreach, referrals, and caregiver training.

“Homecare providers are navigating diverse payers, rising costs, growing administrative demands, and an increasingly complex financial and regulatory environment. RCM Services relieves agencies of the operational burden of billing and collections while improving cash flow and business performance. By offloading revenue cycle management to experts who deeply understand homecare and the HHAeXchange platform, agencies gain clarity, efficiency, and more time to focus on care.”

Paul Joiner

CEO, HHAeXchange

From Submission to Resolution

End-to-end RCM services handle the full revenue cycle. The RCM Services team at HHAeXchange handles everything from the initial claim submission to handling discrepancies, resolving rejections, appealing denials, and shortening the cycle of aging receivables.

Improved Cash Flow

RCM services go beyond billing and collections. HHAeXchange uses operational intelligence to track denial trends, authorization issues, and payer challenges. With these issues addressed at the beginning, claims are cleaner, denials are reduced, and agencies stay in compliance. These are issues cited by 70% of homecare agencies.

With improved cashflow, agencies have the resources to grow, to invest in their staff, to scale operations, and to create a more stable work environment.

Phil Feldman, National Director of RCM

The Rowan Report sat down with Phil Feldman, the National Director of RCM for HHAeXchange. Feldman, and the RCM service platform, came from Sandata and joined HHAeXchange in the acquisition in 2024. We asked Feldman about RCM services:

The Rowan Report:

What makes HHAeXchange’s RCM different?

Phil Feldman:

The RCM service platform is specific. It is specific to home care, specific to Medicaid, and specific to HHAeXchange. Agencies are connected to resources within the organization. We have existing relationships with payors that we can resolve directly. And the customer-facing team, the experts handling your revenue cycle, are employees of HHAeXchange, not a partner or a 3rd party.

RR:

What is the agency experience with HHAeXchange’s RCM service?

Feldman:

We are currently only offering the RCM services within the HHAeXchange platform. You have one vendor and one platform. When there’s a finger to point, it points right back at us.

Every account has at least one RCM advisor who serves as the primary point of contact, working with the agency on their billing schedule, their time-keeping week, and the whole process from close to claim.

The intelligence in the platform goes beyond mechanically processing claims and takes a holistic approach. The system checks for demographic descrepancies from intake like member IDs, gender alignment, ID updates from new payors, overservicing on claims, providing services past the end date or outside allotted days. We look directly at the agency’s denial trends and go upstream in the revenue cycle to fix the whole process, not just one claim.

Results

With just under five months since the full launch, and nearly a year of data from beta test agencies, Feldman says their agency claims are in the 90% collection rate. Claim denials, clawbacks, and remit time are trending down. A full data set is forthcoming, but for now, Feldman is relying on anectodal evidence: Their customers are referring agencies that are looking for RCM solutions.

“You’re the best thing ever. I have a lot of friends that I consult with and help them run their business. I want to introduce them to you.”

– An Indiana Agency Owner

Final Thoughts

Hiring and retention issues, reimbursement rates, administrative workload, operational costs, denials, payor compliance, authorizations…these issues are universal across home care and aren’t going away any time soon. If you’re looking for ways to optimize your current workforce, reduce overhead costs and tasks, and create a steady cash flow for your agency, outsourcing RCM is one way to do it. If you’re already an HHAeXchange customer, well, it just makes good sense to work within the system you know, with advisors who take time to understand your agency, and the backing of decades of experience.

# # #

VA Policy Causes Death of Veteran

by Kristin Rowan | Aug 14, 2026 | Advocacy, Regulatory, Veterans Affairs

by Kristin Rowan, Editor

VA Policy Causes Death of Veteran

For the last couple of months, we’ve been reporting on the rate and hours changes from the VA in Texas and NM. Caregivers are taking pay cuts. Agencies are operating at a loss in order to continue serving our veterans. Many veterans are losing their caregiver, losing the comfort of having a familiar person in their home, losing the progress they’ve made against depression, PTSD, and isolation. And now, we’ve heard a story that we just cannot believe.

Last week, I spoke with an agency owner operating across four states. The agency has been impacted by the rate cuts in Texas and New Mexico. His story is disturbing and highlights the darkest realities of this policy. Here is his story:

End of Care

The administration in one VA not only cut the rates and cut veteran hours, but also just ended care for some veterans and kicked them out of the program. There were no in-home visits or assessments. A member of the VA office made phone calls and asked veterans if they needed care. One of these phone calls reached a veteran with dementia. She didn’t remember the 16 to 20 hours of ADL care she was receiving to dress, eat, and bathe every day. She told the caller she did not need care and the VA dropped her from the program completely.

End of Life

Another veteran, another call to determine whether he needed care, and another drastic cut in hours. This veteran needed home visits daily. He needed supervision and check-ins. The VA didn’t see it that way and cut his care down to six hours per week. The agency shifted from regular visits to twice a week. The caregiver saw him on Friday. He fell on Friday after the visit or sometime on Saturday. He lay in his home, alone and afraid, all weekend long. He died sometime Monday. The caregiver found him when she returned to the home on Tuesday.

End of a Deadly Policy

The rate cut at the federal level, the care balance between Home Health Aide and Homemaker, the cut in hours, the end of care without an assessment, and the unwillingness of the policymakers to acknowledge the lives they have put at risk has to end. If Texas and New Mexico serve as test runs for policy change and rate cuts across the country, all our veterans could suffer like the ones in this story, and countless others. Your agency could be next. If you haven’t already, please join the fight for veteran care.

Write a letter to Secretary Collins admonishing him for the rate cut and for believing it wouldn’t impact care.
Mail to: Office of the Secretary, Department of Veterans Affairs, 810 Vermont Avenue NW, Washington, DC 20420
Send a general inquiry to Ask VA
Join the coalition with Polsinelli – PolsinelliHomeCare@polsinelli.com

Final Thoughts

These stories are not the only ones out there. Veterans across Texas and New Mexico are suffering from the loss of care. Agencies dedicated to that care are shuttering their doors from upside down reimbursements. My source said it better than I ever could.

“My hope is that by sharing some of the difficult situations we’ve encountered, the article will help shed light on the real-world consequences of these decisions. I hope it encourages meaningful discussion about how we can better support our senior veterans. I truly believe there are better ways to reduce costs than by limiting access to the care they depend on. These men and women have already sacrificed so much in service to our country. As they age, caring for them should be one of our highest priorities, and we should treat each of them with the respect and gratitude they have earned.”

# # #

2027 Home Health Proposed Rule

by Kristin Rowan | Aug 7, 2026 | CMS, Home Health, Regulatory

by Kristin Rowan, Editor

2027 Home Health Proposed Rule

The Alliance Responds

On July 1, 2026, CMS released the 2027 Home Health Prospective Payment System proposed rule. The proposed rule includes updates to base pay, quality reporting system, value-based purchasing model, medicare provider enrollment, and DME policies. CMS is also considering ways to include palliative care. The comment period ends August 31, 2026.

The National Alliance for Care at Home issued a press release following the proposed rule publication.

“While the proposed rate update results in increased payments relative to last year – a reflection of our continued advocacy and a much-needed reprieve for providers under the stress of increasing costs – the Alliance remains focused on working to stop unwarranted temporary adjustments that are based on a flawed methodology with underlying data integrity issues. We will continue to partner with CMS on policies that strengthen the Medicare home health benefit. Ultimately, federal policy must preserve patient access to care at home, which remains the preferred choice of care for millions of families.”

Jennifer Sheets

CEO, the Alliance

Permanent and Temporary Rate Adjustments

CMS uses data from 2020 through 2025, actual and expected behavior changes resulting from the implementation of PDGM, and calculated overpayments from prior years to determine rate adjustments.

The actual CY 2025 base rate was $2,057.35 and the recalculated rate is $1,953.60; a difference of 5.043%
Prior permanent adjustments of -1.975% in 2025 and -1.023% in 2026 are factored in, but not directly subtracted
The 2024 budget-neutral rate multiplied by case-mix weights, wage index, and payment update factors yield the 2025 budget-neutral rate of $2,036.29, a difference of 1.024%
Estimated retroactive overpayments from CY 2020 through CY 2025 of $4,9 billion to be partially collected with a -3.0% temporary adjustment to the base pay rate.
Recalibrating the case-mix weight using reporting from CY 2025, CMS calculates a budget neutrality factor for CY 2027 of +1.0045
Applying the market basket (wages across the U.S.), CMS proposes a 3.0% increase to the home health market basket, offset by a -1.0% productivity adjustment, yielding a 2.1% increase.

With these calculations, CMS proposes a -3.0% temporary adjustment to be applied for CY 2027.

The Alliance acknowledges and appreciates the headway made with CMS in understanding the true cost of delivering home health care and the value it provides to the millions of Americans who depend on it. However, the Alliance emphasizes that Medicare payment rates – with the 3% temporary adjustment applied – still do not align with the actual cost of providing comprehensive, high-quality care. In a recent letter to CMS, the Alliance encouraged CMS to eliminate all permanent and temporary adjustments due to problems in the data and analyses used to calculate payment rates.

Alignment of HH QRP and HHVBP

CMS is considering changes that would better align measure sets, reporting perioeds and assessment process between HH QRP and HHVBP. The considered changes are:

Increasing alignment in expanded HHVBP Model and HH QRP Quality of Patient Care (QoPC) Star Ratings measure sets.

Aligning HH QRP and expanded HHVBP Model measure reporting periods.

Modifying HH QRP APU and expanded HHVBP Model annual payment reporting periods.

Altering expanded HHVBP Model Interim Performance and HH QRP QoPC Star Rating Reports.

Aligning timeframe of appeals/suppression review processes for the expanded HHVBP Model and HH QRP.

Updating scoring methodology to incorporate HH QRP APU penalties in expanded HHVBP Model payment adjustments and factoring HH QRP Quality Assessments Only (QAO) values into QoPC Star Ratings scoring.

CMS is NOT asking for comments at this time. The Technical Expert Panel meeting in 2025 discussed this alignment.

Read the TEP Summary Report.

LUPA Updates

CMS proposes updates to the functional points table and the table of functional impairment levels by clinical group. The proposed updates are:

Requests for Comment

Send your comments to CMS by August 31, 2026

CMS is soliciting comments on the proposal of applying a -3.0% temporary rate adjustment instead of applying a permanent adjustment.

There are proposed changes to the criteria for selecting and prioritizing HH QRP measures, identifying measurement gaps, and measures for filling those gaps. CMS is requesting input on the measure concepts as the relate to advanced care planning.

For CY 2027, CMS is using the hospital wage index as the basis for its calculations for the home health wage index. While they believe this is the best method, they are looking for information on alternative data sources such as occupation-level wage data or other publicly available wage data. They are exploring whether such data might better reflect geographic variations in labor costs for HHAs. CMS is concurrently exploring additional wage data for hospices, SNFs, and inpatient rehab facilities.

CMS is inviting public comments on the CY 2027 proposed case-mix weights and case-mix weights budget neutrality factor.

# # #

Kristin Rowan is the owner and Editor-in-chief of The Rowan Report, the industry’s most trusted source for care at home news. She is also a sought-after speaker on Artificial Intelligence, Technology Adoption and Lone Worker Safety. She is available to speak at state and national conferences as well as software user-group meetings.

Kristin also runs Girard Marketing Group, a multi-faceted boutique marketing firm specializing in content creation, social media management, and event marketing. She works with care at home software providers to create dynamic content that increases conversions for direct e-mail, social media, and websites. Connect with Kristin directly at kristin@girardmarketinggroup.com or www.girardmarketinggroup.com

©2026 by The Rowan Report, Peoria, AZ. All rights reserved. This article originally appeared in The Rowan Report. One copy may be printed for personal use: further reproduction by permission only. editor@therowanreport.com

VA Cuts Harm Another Provider

by Kristin Rowan | Jul 24, 2026 | Advocacy, Veterans Affairs

by Kristin Rowan, Editor

Veterans Losing Access to Care

The 90-year-old veteran clutched tightly to his medal, a Purple Heart, as he made his way to a VA health center to apply for care. That was nine months ago.

He is still waiting.

Franchise Executive Speaks Out

We spoke with Heidi Maddocks, VP of Health Care Strategies and National Alliance for Amada Senior Care, a national franchise system with franchisees in Texas and New Mexico. She describes herself as a “self-appointed veteran advocate.”

“The rate cuts for Texas and New Mexico don’t make any sense,” she told us. “The community care network was created for veterans to access care outside of VA facilities. The parts they cut hit hardest where it is already hard to get care, such as rural areas in both states.”

She added...

“This is only one of many issues we have with the VA, but that is a story for another day.”

“Who decided this? What data did they use? Why did they keep rates steady in every other state?” She has a lot of questions, but found that the VA does not answer such questions. Perhaps that would change if more agency owners spoke up.

Veterans Experience Office

Maddocks works closely with the Veterans Experience Office in DC but is disappointed to find that most veterans do not know it exists. “Personnel in their regional offices are trying to do better,” she said. “They are not responsible for the cuts but must try to increase awareness and enrollment in spite of them. 48% of veterans are not enrolled in VA healthcare, often because they are elderly do don’t know it is available to them.”

A mission of awareness

Enrolling veterans is one of her missions. “It is one of three pain points for veterans,” she continued. “Suicide and homelessness are the other two. All three accompany loneliness.” Even veterans who receive other benefits don’t know about healthcare benefits they may be entitled to because the VA Health Administration and the benefits side are siloed. “They don’t talk to each other,” she asserted.

Veterans' Needs Come First

Ms. Maddocks understands that the VA Administration is trying to manage their budget. She does not know why Secretary Doug Collins can not understand that cutting home care will not achieve that goal. Limiting in-home services has always led to higher total expenditures when patients and clients are forced into institutional care.

“We have to put the veterans first,” she emphasized. “That is why we have kept our Waco office open, for example, even though it is operating at a loss. We have to have caregivers drive in from Dallas, which means higher hourly rates and drive time reimbursement.

Peer Advocates

She has also compiled a list of zip codes where veterans are impacted, in order to facilitate planning for resource allocation.

Final Thoughts

As we quoted in the first of these reports, VA Secretary Doug Collins believes his cuts will merely bring these two states in line with national market rates. He said they will not impact veteran care. The experience of Amada and other agencies to which we have spoken proves him wrong.

The thought of veterans, especially rural veterans, losing their in home care is devastating. For some, this is the only human contact they have. For others, it is the only contact they can have. The consistency and familiarity that comes from having the same caregiver visit at the same time in a familiar setting is vital for veterans with PTSD or dementia. Disturbing that care and then claiming the rate change will not impact veteran care is ignorant and irresponsible. Whether you are operating in Texas and New Mexico or not, please consider writing to Secretary Collins and your local officials to ensure someone with decision-making authority is looking at the reality they have created.

# # #

Kristin Rowan is the owner and Editor-in-chief of The Rowan Report, the industry’s most trusted source for care at home news. She is also a sought-after speaker on Artificial Intelligence, Technology Adoption and Lone Worker Safety. She is available to speak at state and national conferences as well as software user-group meetings.

Kristin also runs Girard Marketing Group, a multi-faceted boutique marketing firm specializing in content creation, social media management, and event marketing. She works with care at home software providers to create dynamic content that increases conversions for direct e-mail, social media, and websites. Connect with Kristin directly at kristin@girardmarketinggroup.com or www.girardmarketinggroup.com

©2026 by The Rowan Report, Peoria, AZ. All rights reserved. This article originally appeared in The Rowan Report. One copy may be printed for personal use: further reproduction by permission only. editor@therowanreport.com

VA in NM: An Interview from a Provider

by Kristin Rowan | Jun 19, 2026 | Advocacy, Veterans Affairs

by Kristin Rowan, Editor

VA in NM

An Inside Look from an Anonymous Provider

Effective January 1, 2026, the U.S. Department of Veterans Affairs made substantial rate cuts that impacted hundreds of veterans. None moreso than in rural areas of Texas and New Mexico. Reports from national and local news and associations reported a 43% rate cut in rural Texas and a 20% rate cut in rural New Mexico. On paper, those numbers are accurate. In practice, the situation looks much different. The Rowan Report spoke with a provider in New Mexico who asked to remain anonymous to preserve their relationship with both the U.S. VA and their local VA office.

Background and Experience

This anonymous source has worked in the home care space for 10 years. They opened the agency they now own about 3 years ago. The provider agency is strictly non-medical home care, operates in seven states, including their largest location in New Mexico, and has a patient population that is 90% VA.

What's Really Happening with VA in NM

Prior to the rate change, the home health aide (HHA) in New Mexico was $67 per hour. The new HHA rate for 2026 is $54 per hour. The source says if it were just the rate change, they could survive. But, the rate change is only one change impacting the agency.

HHA vs Homemaker

Prior to 2026, the average veteran received set hours of care almost exclusively at the HHA rate of $67 per hour. The rate change in New Mexico also include a split authorization requirement, capping the HHA hours at 60% of the total hours of care provided. The remaining 40% is now billed at the homemaker rate of $36.20 per hour.

Breaking Down the Math

In 2025, agencies billed 100% of care at HHA rates. In 2026, they are billing 60/40 homemaker to HHA rates. For an agency providing 10 hours of care per week, that is a difference of more than $200. The actual rate reduction is just over 30%.

More Hurdles

In addition to the rate cut and the HHA/Homemaker change, this agency and countless others are struggling to find caregivers for remote areas. Hours of drive time for one visit doesn’t pay enough to entice caregivers.

In most agencies, this one included, drive time and mileage are reimbursed between visits but not for the time to the first visit and after the last visit. This model doesn’t work for rural visits when the drive time is as long or longer than the visit and takes the whole day. Especially with the rate cut forcing lower hourly rates for caregivers, reimbursement for rural visits are necessary.

The Reality of VA in NM

My source described the grim reality over the last six months. What it means for agencies in New Mexico, what it means for caregivers, and especially what it means for veterans is disturbing and infuriating. Agencies in New Mexico, especially those whose client base is primarily veterans have few choices. They can stop serving veterans or they can operate at a loss. This agency knew the catastrophic consequences of no longer serving the veteran population and chose to operate at a loss. They are spending more on caregivers in rural areas than they make. The agency has onboarded more clients, more caregivers, and more staff in the last six months because so many agencies weren’t able to continue providing VA services.

Personal Plea

My source asked me to convey this personal message to agency owners in New Mexico and Texas, and to the industry:

“The Albuquerque VA team is exceptional. They are playing the cards that were dealt to them. These decisions were made above their heads. Support and be kind to your local VA offices. They’re not happy about this; they’re fighting this fight with us.”

When asked what agencies can do to support veterans and agencies, he said:

“The important thing for all of us to remember is what we do is important; we make a difference in the lives of veterans every day. It is important to advocate on behalf of providers and veterans.

Get in front of people who can influence. U.S. Reps, U.S. Senators. If enough people talk, they will have to listen. If they reach a threshold of calls, they have to answer.”

Final Thoughts

The thought of veterans, especially rural veterans, losing their in home care is devastating, as I hope it is for you. For some, this is the only human contact they have. For others, it is the only contact they can have. The consistency and familiarity that comes from having the same caregiver visit at the same time in a familiar setting is vital for veterans with PTSD or dementia. Disturbing that care and then claiming the rate change will not impact veteran care is ignorant and irresponsible. Whether you are operating in Texas and New Mexico or not, please consider writing to Secretary Collins and your local officials to ensure someone with decision-making authority is looking at the reality they have created.

# # #

Kristin Rowan is the owner and Editor-in-chief of The Rowan Report, the industry’s most trusted source for care at home news. She is also a sought-after speaker on Artificial Intelligence, Technology Adoption and Lone Worker Safety. She is available to speak at state and national conferences as well as software user-group meetings.

Kristin also runs Girard Marketing Group, a multi-faceted boutique marketing firm specializing in content creation, social media management, and event marketing. She works with care at home software providers to create dynamic content that increases conversions for direct e-mail, social media, and websites. Connect with Kristin directly at kristin@girardmarketinggroup.com or www.girardmarketinggroup.com

©2026 by The Rowan Report, Peoria, AZ. All rights reserved. This article originally appeared in The Rowan Report. One copy may be printed for personal use: further reproduction by permission only. editor@therowanreport.com

Justice Department’s Next Target

by Kristin Rowan | Jun 19, 2026 | Medicaid, Waste Fraud and Abuse

By Kristin Rowan, Editor

Justice Department's Next Target

New York Sued for Fraud

The past several months, Vice President JD Vance, Dr. Oz, and the anti-fraud task force have investigated home health and hospice agencies suspected of fraud. Much of the focus has been in Minnesota, Georgia, and California. Now, New York joins the list of targeted states, as the Justice Department suis the New York State Department of Health, the state’s Medicaid director, Public Partnerhsips, LLC (PPL), the company operating the $10 billion Consumer Directed Personal Assistance Program (CDPAP) for the state.

CDPAP Management

Prior to the fall of 2024, CDPAP was managed by hundreds of individual agencies. The state opted to consolidate management into one firm and selected PPL. At the time, CDPAP was one of the largest public health benefits programs in the state with more than 250,000 patients.

Justice Department Allegations

Skimming

In the lawsuit, the Justice Department alleges unauthorized profits going to PPL. These profits allegedly come from PPL skimming a percentage of each hour of care billed to Medicaid. The skimmed percentage, according to the suit, amounts to millions of dollars.

Favored Vendor

The Justice Department further alleges PPL was untruthful in its bid regarding its staffing plan, its financial readiness to handle the contract, and the quality of its software, among other aspects of the plan.

The Department of Justice is blaming New York Governor Kathy Hochul and her administration for allowing the fraud. The DOJ alleges PPL was “preselected” as the winner of the contract in a fixed bid process.

Misrepresentation

The lawsuit further alleges that PPL won the contract after a “sham bid” process. The Justice Department claims PPL intended to stray from the representations made in their bid, that the New York Department of Health learned of the deceit, and failed to hold PPL accountable.

JD Vance Speaks

At a recent campaign event, Vice President JD Vance spoke about the lawsuit.

“You do not want your government facilitating fraud; you want your government fighting against fraud. You know what these fraudsters are doing? They’re taking advantage of American generosity to enrich themselves.”
JD Vance
Vice President of the United States

Response

New York State Department of Health spokesperson Cadence Acquaviva called the lawsuit a “baseless complaint” and an attempt by Republicans to “score political points at the expense of vulnerable New Yorkers.” Acquaviva called the lawsuit “inexcusable and completely lacking in merit.”

The Rowan Report reached out to PPL for comment, but did not hear back as of the publication of this article. We will provide updated information as it becomes available.

# # #

Kristin Rowan is the owner and Editor-in-chief of The Rowan Report, the industry’s most trusted source for care at home news. She is also a sought-after speaker on Artificial Intelligence, Technology Adoption and Lone Worker Safety. She is available to speak at state and national conferences as well as software user-group meetings.

Kristin also runs Girard Marketing Group, a multi-faceted boutique marketing firm specializing in content creation, social media management, and event marketing. She works with care at home software providers to create dynamic content that increases conversions for direct e-mail, social media, and websites. Connect with Kristin directly at kristin@girardmarketinggroup.com or www.girardmarketinggroup.com

©2026 by The Rowan Report, Peoria, AZ. All rights reserved. This article originally appeared in The Rowan Report. One copy may be printed for personal use: further reproduction by permission only. editor@therowanreport.com

Solutions Provider Expands Home Health Footprint

by Kristin Rowan | May 29, 2026 | M&A

by Kristin Rowan, Editor

Solutions Provider Expands Home Health Footprint

An Interview with Mike Scarbrough

LivTech may not be a name with which you are familiar. I wasn’t. But, you are likely familiar with the brands this private equity firm has acquired. Worldview reduces document processing time for home health and hospice agencies. Qualis manages DME workflows for hospice agencies. Ally handles invoicing, payments, and record-keeping for 1099 caregivers while keeping registries aligned with regulations. And now, LivTech has acquired Alora, the cloud-based full workflow solution for home health, hospice, and home care.

Why Alora?

CEO Mike Scarbrough, who saw a lot of industry growth when working in the ambulatory space, got excited about the post acute market. LivTech has now been operating in the care at home space for a while with their acquisitions of Worldview and Thornberry. With that foothold, the company looked to have a significant presence in home health, tie all their care at home products together, and provide their customers with a migration path forward, Scarbrough said.

Alora is built for home health, hospice, and home care

“In home health and home care, a lot of our customers are or are contemplating doing both. We hear a lot that choosing different solutions for home health, home care, and hospice is difficult. We have a suite of products that will do all three after the integration, which will take months, not years,” Scarbrough said. “The Alora platform was very purpose-built, has a rich feature set, has consistently high NPS scores, and has very low churn. More importantly, Alora has a great personality and culture fit with LivTech.”

What to Expect

I asked Scarbrough what the future holds for LivTech as the integration finalizes and what LivTech and Alora customers should expect. He explained that LivTech offers solutions, not software. Their software platforms form the foundation, but their customers also get support, road maps, and best practices.

“The people we work with are care oriented, as they should be. We want to take the work they do and make it easier so they can focus on what matters, patient care.”
Mike Scarbrough
CEO, LivTech

The Path

To make the job easier for the caregivers, LivTech takes what they know as technologists and applies that to what they understand about home health. This involves ambient transcription, chart summaries, drift notification, audits and surveys, and information flow. They also use their understanding of home health to know where NOT to insert their technology: between the caregiver and the care. The solutions augment care and make suggestions, but never make decisions about care.

AI and the Future of LivTech

The question asked of every solution provider, technologist, and consultant recently is “What about AI?” Scarbrough noted the dramatic changes in the AI tool chain in the last six months, changing the pace of software development. He said these changes are going to make some things obsolete and push developers to focus less on how the tech works and more on the problem their trying to solve. We will rely more on expert problem solvers than on tech experts. Scarbrough predicts exponential growth in what software can do, real solutions that weren’t possible before.

When I asked how he felt about the future of LivTech after the acquisition of Alora, he said:

“I’m super excited and motivated to grow the business. The people we sell to and the people who work for us continue to amaze with their commitment and passion for the work they do.”

# # #

Kristin Rowan is the owner and Editor-in-chief of The Rowan Report, the industry’s most trusted source for care at home news. She is also a sought-after speaker on Artificial Intelligence, Technology Adoption and Lone Worker Safety. She is available to speak at state and national conferences as well as software user-group meetings.

Kristin also runs Girard Marketing Group, a multi-faceted boutique marketing firm specializing in content creation, social media management, and event marketing. She works with care at home software providers to create dynamic content that increases conversions for direct e-mail, social media, and websites. Connect with Kristin directly at kristin@girardmarketinggroup.com or www.girardmarketinggroup.com

©2026 by The Rowan Report, Peoria, AZ. All rights reserved. This article originally appeared in The Rowan Report. One copy may be printed for personal use: further reproduction by permission only. editor@therowanreport.com

Fight Loss of Rural Veteran Care: An Interview with Angelo Spinola

by Kristin Rowan | May 29, 2026 | Advocacy, Regulatory

by Kristin Rowan, Editor

Fight Against the Loss of Rural Veteran Care

Deep Cuts Impact All

Last November, the U.S. Department of Veterans Affairs (VA) announced the 2026 VA Fee schedule, which became effective January 1st. There were significant changes to the fee schedule compared with previous years. By far the most concerning, though, was the “rate restructuring” for Home Health Aide and Homemaker codes in Texas and New Mexico.

Rate Restructure

Prior to 2026, Texas VA had a tiered fee structure. The tiered structure applied different rates for geographical areas based on _____. The restructure for 2026 applied a single statewide rate. This gave a slight increase in rate for some urban and suburban areas. However, the change created a drastic drop in rates for rural areas. For most Texas rural areas, it is a 43% reduction for Home Health Aides. The restructing results in a 19% decrease in New Mexico.

Tiered Rates

2025 VAFS rates were as high as $67 per hour in some rural areas. The hourly rate covered the time spent in the home, greatly increased travel time compared to urban visits, and differential incentives to entice caregivers to take these shifts that are often short and spread apart. The new statewide rate is $38 per hour. For the highest paying rural areas, this is a 43% rate cut.

Hours per Veteran

In addition to the rate cut, the number of hours per veteran has also dropped to an average 3.4 hours per shift. Some veterans are seeing their monthly hours cut by more than 30%.

Advocating for Change

State and national associations and advocacy groups reached out to the VA. Six senators and congresspeople reached out Doug Collins, secretary of the VA, to express their concerns. The VA has largely not responded to inquiries about the validity of the rate reduction and has not provided the analysis used to decide the new rate.

Notice and Comment Period

Most rate changes like this require advanced notice for agencies to adjust as well as a comment period when interested and impacted parties can contact lawmakers to provide feedback and ask questions. The announcement about these rate changes came in December and went into effect in January. The VA provided almost no notice and did not entertain comments or questions.

Collins Responds

“[The rate reductions] reflect our assessment that prior rates for these areas significantly exceeded prevailing market rates. Aligning these rates with market conditions is not expected to affect veteran care.”
Doug Collins
Secretary, U.S. Department of Veterans Affairs

Defying His Objective

When Collins accepted the role of Secretary of the VA, he thanked President Trump for the assignment and asked him, “What would you like me to do?” The President answered, “Take care of my Veterans.” In a statement to the press, Collins outlined how he would accomplish that mission. Second on his list is to “put Veterans as the center of everything VA does, focusing relentlessly on customer service and convenience.”

Fail

Creating care deserts in rural areas and forcing veterans to travel up to an hour to get care is not convenient. Reducing home care hours and raising the probability of veterans having to move to care facilities is not service. Secretary Collins is failing in his objective and failing his directive from the President. More importantly, he is failing our veterans.

Coalition with Polsinelli

The Rowan Report spoke with Angelo Spinola and Heather Looby of Polsinelli. Polsinelli has been actively working on getting the rate changes reversed. Spinola, an employment litigator with a special interest in home care, explained the situation in more detail. According to Spinola there has been little information from the VA and what communication exists has been inconsistent. Many of the letters sent to the VA get no response at all. Spinola says there are legal remedies available, but they are challenging and expensive. In a letter to the VA, Polsinelli outlined the risks and consequences of these actions and gave the VA 30 days to respond.

Join the Fight

Next week, we will bring you real stories of agencies and veterans impacted by the changes in Texas and New Mexico. Their stories are powerful and moving. Even still, you may think this isn’t your fight because

A small enough percentage of your business is impacted

You have agencies in other states making up the difference

You don’t operate in Texas or New Mexico

Angelo cautions:

If they can do it in TX and NM, they can do it anywhere

“They” might be the VA changing rates that are unsubstantiated and contrary to the Administrative Procedure Act.

“They” might be CMS following suit and arbitrarily changing rates without analysis, notice, or comment.

“[Whether you are currently impacted by these changes or not,] the industry needs to get together to address this and join the fight before it’s too late; before it becomes the norm. “
Angelo Spinola
Home Health, Home Care & Hospice Chair, Polsinelli

How You Can Help

Write to your congressperson and senator and urge them to push Collins and the VA to reverse this change

Write to Collins and the VA directly with impact statements and concerns

Join the coalition with Polsinelli – PolsinelliHomeCare@polsinelli.com

Final Thoughts

We have interviews scheduled with providers and veterans to bring you real stories of how this is impacting our industry. We will also continue our discussions with Polsinelli to get additional information and keep you updated on the progress of the 30-day deadline and additional action the coalition will take.

Honor our Veterans

It was just a few days ago that our nation celebrated Memorial Day in honor of the ultimate sacrifice made by so many. There are too many service men and women who never came home. The ones who did risked everything for you, for me, for this country, and for the ideals that make the United States what it is. They deserve to come home after that service and age with dignity and grace in their homes for as long as they can. We owe them at least that. We all have our own stories and paths that led us to care at home, but at the core of each of those stories is care. Our veterans need that care now. Reach out, write, advocate, join. Whatever you are able to do, now is the time for action.

# # #

Kristin Rowan is the owner and Editor-in-chief of The Rowan Report, the industry’s most trusted source for care at home news. She is also a sought-after speaker on Artificial Intelligence, Technology Adoption and Lone Worker Safety. She is available to speak at state and national conferences as well as software user-group meetings.

Kristin also runs Girard Marketing Group, a multi-faceted boutique marketing firm specializing in content creation, social media management, and event marketing. She works with care at home software providers to create dynamic content that increases conversions for direct e-mail, social media, and websites. Connect with Kristin directly at kristin@girardmarketinggroup.com or www.girardmarketinggroup.com

©2026 by The Rowan Report, Peoria, AZ. All rights reserved. This article originally appeared in The Rowan Report. One copy may be printed for personal use: further reproduction by permission only. editor@therowanreport.com

Medicare Moratoria

by Kristin Rowan | May 14, 2026 | Breaking News, Medicare, Regulatory, Waste Fraud and Abuse

by Kristin Rowan, Editor

Medicare Moratoria

CMS Halts All New Home Health & Hospice Agencies

As part of it’s ongoing efforts to curb Medicare waste, fraud, and abuse, the Centers for Medicare and Medicaid Services (CMS) is taking a bold step. On Wednesday, May 13, 2026, CMS announced a 6-month moratoria on home health and hospice agency enrollment. Aimed at protecting Medicare beneficiaries and taxpayer dollars, the moratoria will temporarily stop new enrollment of providers in home health and hospice, which CMS calls “high-risk” categories and key sources of fraudulent activity. CMS states this effort builds on additional fraud prevention initiatives, including enhanced screening, site visits, and expanded oversight activities across the hospice and home health sectors

More Investigations

Together with Vice President JD Vance’s Anti-Fraud Task Force, CMS will increase its targeted investigations of hospice and home health agencies that are suspected of fraud. CMS promises to use advanced data analytics and to accelerate the removal of fraudulent hospice and home health agencies.

Skirting Authority

CMS investigations revealed that some agencies intent on committing fraud are closing their businesses and reopening under different names in different states to perpetrate additional fraud. The moratoria will prevent these agencies from skirting authority in this manner. Additionally, the moratoria applies to some changes in ownership, which is a common technique used to hide these “bad actors.”

What it Means for You

The moratoria do not apply to existing providers with current enrollments. You can continue to deliver services to Medicare beneficiaries as long as your enrollment is current and in good standing.

Statement from CMS

“We’ve seen systemic and deeply troubling fraud in the hospice and home health space, with bad actors exploiting some of our most vulnerable Medicare patients and stealing money from the American taxpayer. Today we’re shutting the door on fraud—preventing new bad actors from entering Medicare while we aggressively identify, investigate, and remove those already exploiting them. This is about protecting patients, restoring integrity, and safeguarding taxpayer dollars.”
Dr. Mehmet Oz
Administrator, Centers for Medicare and Medicaid Services

More Information

The administration’s anti- fraud, waste, and abuse efforts are ongoing.

Read the CMS Press Release

Full text of the Home Health Moratorium

Full text of the Hospice Moratorium

# # #

Kristin Rowan is the owner and Editor-in-chief of The Rowan Report, the industry’s most trusted source for care at home news. She is also a sought-after speaker on Artificial Intelligence, Technology Adoption and Lone Worker Safety. She is available to speak at state and national conferences as well as software user-group meetings.

Kristin also runs Girard Marketing Group, a multi-faceted boutique marketing firm specializing in content creation, social media management, and event marketing. She works with care at home software providers to create dynamic content that increases conversions for direct e-mail, social media, and websites. Connect with Kristin directly at kristin@girardmarketinggroup.com or www.girardmarketinggroup.com

©2026 by The Rowan Report, Peoria, AZ. All rights reserved. This article originally appeared in The Rowan Report. One copy may be printed for personal use: further reproduction by permission only. editor@therowanreport.com

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