Treatment in Place from Emergency Medical Services
Clinical by Elizabeth E. Hogue, Esq. Treatment in Place Providers of services to patients in their homes are anecdotally familiar with situations in which patients need help at home, but do not qualify for home health services and have not arranged for or are unable to afford...Medicare Advantage Lowers Home Health Care Use
Hospice by Kristin Rowan, Editor End-of-Life Care in Medicare Advantage vs Traditional Medicare Using research from CMS, researchers from Mt. Sinai in New York and Brown University in Rhode Island studied the data of adults aged 66 and older who passed away and had Medicare...Medicare Advantage Increase for Payers, not Providers
Artificial Intelligence by Kristin Rowan, Editor CMS Announces Medicare Advantage Pay Hike On January 13, 2025, CMS announced its plans to increase payments to Medicare Advantage plans by 4.33%. Policy changes for Medicare Advantage and Part D include changes in how the agency calculates...Whistleblower Case Impedes Lawsuits
CMS by Kristin Rowan, Editor Whistleblower Action A United States District Court in Tampa, Florida ruled against a whistleblower action under the False Claims Act (FCA) against her former employer. In 2019, a family care physician filed a whistleblower, or qui tam, action...Congress Allows Medicare Advantage to Deny Coverage
Advocacy by Kristin Rowan, Editor Medicare Advantage Bill Dies in Congress The 118th United States Congress, ran from January 3, 2023 to January 3, 2025. This Congress’s first law was passed on March 20, 2023, much later than most previous congressional sessions. In its...Proposal to Update HIPAA Security Rule
CMS HHS OCR Proposes Updates to the HIPAA Security Rule to Respond to Emerging Threats by Paul F. Schmeltzer and John F. Howard, Clark Hill PLC HHS Proposal On Dec. 27, the Department of Health and Human Services (HHS) issued proposed updates to the HIPAA Security Rule to...Updates on UnitedHealthcare CEO Shooting
Breaking News by Kristin Rowan, Editor Last Week As most of the U.S. now knows, last week, UnitedHealthcare CEO Brian Thompson was shot and killed outside a hotel in Manhattan just hours before the UnitedHealth Group Investor Event. The Rowan Report provided the breaking news story...Health Insurance Impact after Thompson’s Death
Advocacy by Kristin Rowan, Editor Will Thompson's death change healthcare? It's all Relative On the same day that Brian Thompson died, Blue Cross Blue Shield announced a reversal of an earlier planned policy change. In November, the insurance giant announced it would change...Meet the CMS Administrator Nominee
Admin by Tim Rowan, Editor Emeritus Mehmet Oz, MD, MBA is the CMS Administrator nominee in the new administration that assumes power on January 20. A popular TV personality and former gubernatorial candidate, the public side of Dr. Oz is well known, but the details of his...Survive Medicare Advantage
Admin by Alexandria Nelson, Communications Specialist, Axxess How to Survive Medicare Advantage in Home Health Navigating the complexities of Medicare Advantage continues to be a sticking point for organizations trying to scale their business. In an education session at the...UnitedHealth Group Acquisition of Amedisys Under Fire by DOJ
CMS by Kristin Rowan, Editor Justice Department Sues In September of 2023, UnitedHealth Group made a bid to purchase Amedysis. That acquisition has been under scrutiny since last year. When the bid was announced, the Department of Justice began an inquiry, asking for...Here We Go Again
Clinical by Tim Rowan, Editor Emeritus OIG Accuses Medicare Advantage Providers of Padding Patient Assessments...Again “Hello, this is your Medicare Advantage company calling. I am one of their clinicians and it is time for us to update your health assessment. If you...2025 Final Rule
Advocacy by Kristin Rowan, Editor CMS Releases Home Health Final Rule 2025 Last week, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2025 Home Health Prospective Payment System (HH PPS) final rule. Included in the final rule are updates...End of an Era
Advocacy by Kristin Rowan, Editor NAHC President Bill Dombi Retires Earlier this year, with the announcement of the merging of NAHC and NHPCO, Bill Dombi announced his retirement from his position as President of the Association. Shortly after that announcement, The Rowan...
