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The Wrong Way to Use AI in Healthcare

Admin

by Tim Rowan | May 16, 2024 | Admin, Artificial Intelligence, CMS, Medicare Advantage, Regulatory

by Tim Rowan, Editor Emeritus Lawsuits are beginning to pile up against insurance companies participating in the Medicare Advantage program. The complaint? The wrong way to use AI in healthcare is with faulty algorithms to approve or deny claims. While AI can be...

Navigating the Home Care Revolution

Admin

by Kristin Rowan | May 10, 2024 | Admin, Caring for the Caregiver, Clinical, Marketing, Recruitment & Retention, Regulatory

by Kristin Rowan, Editor I was honored to have been a guest on Health Futures – Taking Stock in You Radio Show on Money Radio 1510 AM discussing navigating the home care revolution. Health Futures is hosted by HomeCare expert Bob Roth, owner of Cypress HomeCare...

Connecticut Senate and House Pass Home Care Worker Safety Bill

Admin

by Kristin Rowan | May 10, 2024 | Admin, Caring for the Caregiver, Clinical, Regulatory

by Kristin Rowan, Editor Last week, we reported on the proposed Bill in the Connecticut Senate and House to provide additional precautions for home care worker safety. In wake of the Joyce Grayson murder during a home health visit, leadership in Connecticut aimed to...

BREAKING NEWS: Home Care Agency Faulted in Death of Joyce Grayson

Clinical

by Kristin Rowan | May 2, 2024 | Clinical, Regulatory

by Kristin Rowan, Editor Home health agency failed to protect Joyce Grayson History We’ve been following the story of Joyce Grayson since her death in October of 2023. The news was first published in The Rowan Report here on November 8th, 2023.On April 14th, we...

UnitedHealth Grilled by Congress, Fired by Walmart

Admin

by Tim Rowan | May 2, 2024 | Admin, Privacy and Security, Regulatory, Telehealth

by Tim Rowan, Editor Emeritus You know the routine. Everyone does. You log into your bank, airline account, or health insurance web portal, enter the correct password, and are directed to look on your smartphone for a code to enter to fully authorize your login. The...

Understanding Differences in Medicare Policy and Conditions of Participation

Admin

by Rowan Report | Apr 26, 2024 | Admin, Clinical, CMS, Regulatory

by Johnathan Eaves, Senior Director of Communications, Axxess Treating Medicare patients comes with a level of nuance that is important to understand to ensure that organizations remain compliant and patients receive appropriate care. Standards for quality care and...

80/20 Finalized Rule

CMS

by Kristin Rowan | Apr 26, 2024 | CMS, Recruitment & Retention, Regulatory

by Kristin Rowan, Editor The Centers for Medicare and Medicaid Services (CMS) has finalized the “Ensuring Access to Medicaid Services” rule, more commonly known as the 80/20 rule. The 80/20 finalized rule requires at least 80% of Medicaid payments for home...

HOPE is on the Way: Part 3

CMS

by Rowan Report | Apr 26, 2024 | CMS, Medicare Advantage, Regulatory

By Beth Noyce, RN, BSJMC, BCHH-C, COQS CHAP-certified home health & hospice consultant This is part 3 of the 3 in the series, outlining the discussions and implications in adopting new outcome and process measures for Hospice care. The final segment addresses...

Private Duty Home Care in Fraud Enforcers’ Crosshairs

Clinical

by Elizabeth E. Hogue, Esq. | Apr 18, 2024 | Clinical, Regulatory

by Elizabeth E. Hogue, Esq. Some owners and managers of private duty home care agencies mistakenly think that fraud and abuse prohibitions apply only to services paid for by the Medicare Program. In fact, fraud and abuse prohibitions apply to providers if they accept...

HOPE is on the Way: Part 2 – Process Measures

Clinical

by Rowan Report | Apr 18, 2024 | Clinical, CMS, Regulatory

by Beth Noyce, RN, BSJMC, HCS-C, BCHH-C, COQS CHAP-certified home health & hospice consultant Process Measures The outcome measures being considered look at effectiveness of hospice clinical efforts to decrease pain and other symptoms. The process measures paired...

Home Care Worker Safety: Aftermath of Home Health Nurse Death

Caring for the Caregiver

by Kristin Rowan | Apr 18, 2024 | Caring for the Caregiver, Clinical, Regulatory

by Kristin Rowan, Editor In October of 2023, nurse Joyce Grayson went to the home (halfway house) of a released convict. She was later found dead in the basement of the house. In addition to adding focus to home care worker safety, the immediate response to this...

HIPAA: Access to Records

Clinical

by Elizabeth E. Hogue, Esq. | Apr 11, 2024 | Clinical, Regulatory

By Elizabeth E. Hogue, Esq. A key purpose of the Health Insurance Portability and Accountability Act (HIPAA) is certainly to protect patient information. Another is to help ensure that patients have access to their health information. In fact, the Office of Civil...

Adding Insult to Injury: Change Healthcare Attacked Again

Admin

by Kristin Rowan | Apr 11, 2024 | Admin, CMS, Regulatory

by Kristin Rowan, Editor For a few weeks now, we have been covering the Change Healthcare cyberattack by ALPHV/BlackCat and the subsequent updates from CMS. Pharmacy and medical orders have been delayed, providers and patients are suffering, and CMS has issued...

HOPE is on the Way: Part 1 – Outcome Measures

Clinical

by Rowan Report | Apr 11, 2024 | Clinical, CMS, Regulatory

By Beth Noyce, RN, BSJMC, HCS-C, BCHH-C, COQS Home health & hospice consultant The Hospice Outcome Patient Evaluation is a step closer to implementation. After four years of considering options, the Technical Expert Panel (TEP) has finished its work that will...

CMS Hospice Payment Rate FY 2025 Proposal

CMS

by Kristin Rowan | Apr 4, 2024 | CMS, Regulatory

By Kristin Rowan, Editor On March 28, CMS issued a new proposed rule to update Medicare hospice payments. Here’s what we know. The new proposed rule: Would change the existing hospice wage index Clarifies current policy related to the hospice “eletion...
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