by Kristin Rowan | Sep 12, 2024 | Admin, CMS, Hospice, Regulatory
by Kristin Rowan, Editor CMS Oversight in Fraud-Ridden States In 2023, The Centers for Medicare and Medicaid Services (CMS) cited research suggesting that hospices profit from fraud far too often. CMS has identified cases of hospices certifying benficiaries who are...
by Kristin Rowan | Aug 23, 2024 | Admin, CMS, Regulatory
by Kristin Rowan, Editor Background on the HHVBP Model The Home Health Value Based Purchasing (HHVBP) Model, implemented by CMS in 2016, began in nine states. The goal is “to provide incentives for better quality care, to study new quality and efficiency...
by Kristin Rowan | Aug 16, 2024 | CMS, Editorial, Marketing, Medicare Advantage, Regulatory
by Kristin Rowan, Editor Leading Associations Attempt to Curb Medicare Advantage Marketing Practices that Prey on the Unsuspecting For some time now, we’ve been reporting on the marketing practices that Medicare Advantage uses to lure new members. And,...
by Kristin Rowan | Aug 9, 2024 | Advocacy, CMS, Hospice, Medicare Advantage, Regulatory
by Kristin Rowan, Editor The Alliance On June 18, 2024, the National Association for Home Care & Hospice (NAHC) and the National Hospice and Palliative Care Organization (NHPCO) announced they had met in Washington D.C. to formally sign an affiliation agreement...
by Kristin Rowan | Aug 1, 2024 | CMS, Hospice, Regulatory
by Kristin Rowan, Editor 2025 Hospice Final Rule Update On July 30, 2024, CMS issued its final rule for the 2025 Hospice Final Rule Update (CMS-1810-F), with updates to HQRP and HOPE. The rule also finalizes a proposal to change the statistical area delineations. This...
by Tim Rowan | Jul 26, 2024 | CMS, Editorial, Medicare Advantage, Regulatory
by Tim Rowan, Editor Emeritus Past For at least the last five years, every Home Health conference this reporter has attended has featured at least one keynote speaker or expert panelist complaining about sparse and shrinking payments from Medicare Advantage plans. As...
by Tim Rowan | Jul 19, 2024 | Admin, Editorial, Medicare Advantage
by Tim Rowan, Editor Emeritus UnitedHealth Making Home Health Visits Payer or Competitor…that is the question. According to a report in the Wall Street Journal, and questioned by the insurance industry’s lobbying arm, AHIP, UnitedHealth Group has increased...
by Kristin Rowan | Jul 12, 2024 | Advocacy, CMS, Regulatory
by Kristin Rowan, Editor Chevron Deference “A government agency must conform to any clear legislative statements when interpreting and applying a law, but courts will give the agency deference in ambiguous situations as long as its interpretation is...
by Tim Rowan | Jun 27, 2024 | CMS, Medicare Advantage
by Tim Rowan, Editor Emeritus We have been keeping an eye on the Medicare Advantage business as the number of beneficiaries who switch exceeds fifty percent. In past reports, we have described the federal lawsuits that accuse MA insurance companies of illicitly...
by Kristin Rowan | Jun 27, 2024 | CMS, Regulatory
by Kristin Rowan, Editor CMS Proposed Rule for 2025 Citing “budget neutrality adjustments”, the Centers for Medicare & Medicaid Services (CMS) June 26 issued its proposed rule for 2025 for the home health prospective payment system. Here are the...
