CMS Updates Home Health Compare Website

The Centers for Medicare & Medicaid Services has updated the Home Health Compare website, which shows a 1-percentage point improvement on the ambulation, transferring and medication management outcomes. It also shows a 1-percentage point deterioration on the dyspnea outcome.

Owner and Employee of Miami Home Health Agency Plead Guilty in $22 Million Fraud Scheme

By publishing announcements about home health fraud, HCAF demonstrates its commitment to honest providers throughout the state by shining a spotlight on the dishonest providers, eager to provide hope and validation to the good and send a message to the bad actors that their days are numbered.

The owner and an employee of a Miami health care agency pleaded guilty for their participation in a $22 million home health Medicare fraud scheme, the Department of Justice, the FBI and the Department of Health and Human Services announced today.

HCAF Publishes 2012 Legislative Toolkit

HCAF has published its 2012 Legislative Toolkit, which details the association’s legislative and regulatory goals for 2012. The toolkit includes a list of state legislation impacting the industry as well as relevant home care information and statistics that demonstrate the industry’s high quality, cost-effective services for Floridians.

NAHC, PDHCA Release Overtime Exemption National Survey Results

The National Association for Home Care & Hospice (NAHC) and its affiliate Private Duty Home Care Association (PDHCA) released the results of a national survey of home care agencies on the impact of the U.S. Department of Labor’s (DoL) proposed rule that effectively eliminates the companionship services overtime exemption in home care.

The survey was conducted in December as a joint project with the National Private Duty Home Care Association. Nearly 1,500 responses from home care companies in all 50 states, the District of Columbia, U.S. Virgin Islands, and Puerto Rico were received.

Calculation of Episodes Update for 2011-2012

The National Association for Home Care & Hospice received confirmation from CMS of the following information about the way 2012 home health PPS payment are being calculated.

The change is to the application of case mix weights (#4 below) based on episode ending date rather than M0090 date.

Miami Home Care Nurse Pleads Guilty in $25 Million Fraud Scheme

By publishing announcements about home health fraud, HCAF demonstrates its commitment to honest providers throughout the state by shining a spotlight on the dishonest providers, eager to provide hope and validation to the good and send a message to the bad actors that their days are numbered.

A Miami-area nurse pleaded guilty today for his participation in a $25 million home health Medicare fraud scheme, the Department of Justice, the FBI and the Department of Health and Human Services (HHS) announced today.

Palmetto GBA Alert: Medical Additional Documentation Requests

Palmetto GBA recently changed the process for mailing medical Additional Documentation Requests (ADRs). Previously, medical ADRs were mailed in yellow envelopes. ADRs are now mailed in white Palmetto GBA envelopes. It is possible that a provider may receive an ADR request prior to receiving their probe notification letter.

Florida Ranks Near Top in National Data for Medicare Home Health Utilization

Curious about how much each state utilizes home care services? The Remington Report has those numbers, based on provider data derived from bills for services performed in 2010 and recorded in Centers for Medicare & Medicaid Services central records of June 2011.

The data shows state-by-state reimbursement, number of patients, visits, average reimbursement and average visits per patients.

The national average:

Elizabeth Hogue’s Series on ACOs: Can Post-Acute Providers Participate in ACOs? (Part V)

ACOs seem to be the next “big thing.”  Doctors and hospitals clearly have a role to play in ACOs.  Many post-acute providers, however; including home health agencies, hospices, and HME companies; would like to know if they can also be part of ACOs.  Section 1899(a)(1)(A) of the Affordable Care Act defines ACOs as “groups of providers of services and suppliers” that work together to manage and coordinate care for Medicare fee-for-services beneficiaries.  The statute lists the following groups of providers of services and suppliers that are eligible to participate as an ACO:

FINAL REMINDER: Deadline for Exemption from Participating in HHCAHPS Survey is Tomorrow

All home health agencies that were exempted from participating in the HHCAHPS Survey for the 2012 APU must submit a new Participation Exemption Request form if the provider qualifies for and is seeking an exemption from participating in the HHCAHPS Survey for the 2013 APU. If the agency served more than 60 patients between April 1, 2010 and March 31, 2011 and you have already begun participating in the HHCAHPS Survey for the 2013 APU, ignore this message.

The deadline for submitting the exemption request is at 11:59 PM Eastern Time on Saturday, January 21, 2012. Click here to submit the form online.