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The eighth of the 10 risks facing home health agencies today, highlighted by the Texas Association for Home Care and Hospice and Liles Parker PLLC, is HIPAA Privacy Breach Liability. HIPAA, the Health Insurance Portability and Accountability Act, was passed by Congress in 1996 and, among other things requires the protection... Keep Reading
Home Health Value-Based Purchasing (HHVBP) began this year in Arizona, Florida, Iowa, Maryland, Massachusetts, Nebraska, North Carolina, Tennessee, and Washington. As selected HHVBP states, all Medicare-certified home health agencies in these states are required to participate in the model, which studies the effects of incentives to improve quality and delivery... Keep Reading
One of the biggest changes in CMS’ Home Health 2017 Final Rule involves the outlier payment methodology, and these changes will certainly impact many agencies. Current Methodology Outlier payments are made for episodes whose estimated costs exceed a threshold amount for each Home Health Resource Group (HHRG). Currently, the episode’s estimated cost... Keep Reading
  One of the top ten risks highlighted by the Texas Association for Home Care and Hospice and Liles Parker PLLC is fraud in government-funded healthcare programs that lead to criminal liability. The Office of Investigations conducts criminal, civil and administrative investigations of fraud and misconduct related to U.S. Department of Health... Keep Reading
As in prior years, the Home Health Prospective Payment System (HHPPS) had several revisions in this year’s Final Rule update.  These changes will likely impact your agency’s bottom line, so you will want to familiarize yourself with them so you know what to expect in 2017. This is the last year... Keep Reading
  The recently published 2017 Home Health Final Rule outlines changes to the Home Health Prospective Payment System (HHPPS), Home Health Value Based Purchasing Model (HHVBP), and Home Health Quality Reporting Requirements. This blog gives a basic overview of the changes, while subsequent blogs will detail these changes further per topic. The... Keep Reading
One of the top ten risks highlighted by the Texas Association for Home Care and Hospice and Liles Parker PLLC is fraud in government-funded healthcare programs, an issue addressed by the False Claims Act (FCA). With recent escalation of fraud resurfacing, the FCA acts as the government’s primary enforcement for attacking... Keep Reading
The Medicare appeals process is experiencing a sustained increase in the number of appeals, as highlighted earlier this year by the Texas Association for Home Care and Hospice and Liles Parker PLLC.  This increase, coupled with only modest increases in funding, has created a significant backlog of appeals at the... Keep Reading
In November, the home care and hospice community honors the millions of nurses, how care aides, therapists, and social workers who make a remarkable difference for the patients and families they serve. Caregivers are an integral part of home healthcare and provide millions of Americans several freedoms that may not... Keep Reading
Today we’ll take a look at the issue of Prepayment Reviews, Suspension Actions and Postpayment Audits and how it has unfolded. CMS continues to move away from “pay and chase” strategies and are taking a more proactive approach to enforcement, as seen with the Pre-Claim Review demonstration begun in... Keep Reading
The word wellness has become a buzzword in today’s culture and organizations are seeking platforms that provide wellness opportunities for employees, but what does that mean to you exactly? According to the Centers for Disease Control (CDC), workplace programs are created to address the rising trends of chronic disease. The... Keep Reading
Today we’ll take a look at the issue of Regulatory Pressure on Contractors and how it has unfolded.  The Health and Human Services –Office of Inspector General (HHS-OIG) was created to protect the integrity of HHS programs and operations and the well-being of beneficiaries by detecting and preventing fraud, waste,... Keep Reading