Home Health Proposed Payment Rule CY2021

CMS released the CY 2021 Home Health Proposed Payment Rule in June 2020. The proposed rule contains several updates and changes. These changes include PDGM Rates, Wage Index, Telehealth, Quality Reporting Program, and Billing RAPS. The RAP issue alone is enough to warrant EVERY agency in the nation sending in comments and requesting that this be changed! We must stand together.

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COVID-19: Interim Final Rule & What It Means for Home Health

There have been two Interim Final Rules, the most recent on May 1, that have been issued by CMS during this historic pandemic of the century. This Public Health Emergency (PHE) has taken the full focus of national officials and in the process, there have been sweeping concessions for healthcare, some permanent and others temporary.

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COVID-19: Imperative Home Health and Hospice Updates

This article was last updated on May 7, 2020.

As we are facing the pandemic of the century, home health and hospices are on the frontline of this Public Health Emergency (PHE) along with hospitals, physicians and all other healthcare workers. We at Healthcare Provider Solutions, Inc. would like to take this moment to thank each and every one of you for your true dedication to treating patients and helping the world to be a healthier place. HPS is dedicated to providing the Home Health and Hospice industries with the education and resources necessary to keep you performing at the highest level of success.

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PDGM Series: The 2020 Proposed Rule Update

January 1, 2020 will bring many new beginnings, including the Patient Driven Groupings Model (PDGM). No doubt the largest reimbursement system overhaul in home health since October 2000.
CMS continues to tweak the model and updates to the Claims Processing Manuals have begun.

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OASIS-D1 Update & PDGM Impact

CMS has announced that the revised OASIS-D1 instruments will be effective January 1, 2020. Changes to the OASIS-D data set and data collection guidance were finalized in the Calendar Year (CY) 2019 HH Final Rule, CMS 1689-FC.

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Are You Prepared? The Patient Driven Groupings Model (PDGM) Is Coming Soon

Home health agencies may find many of the changes to OASIS-D daunting, but there are several modifications that have helped make assessments easier than ever before. The Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act) is the primary driving force behind the OASIS changes.

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OASIS-D: ARE YOU READY FOR 2019?

OASIS has indeed changed again and quite dramatically this time. While there are 28 M items that have been deleted from the data set and only 6 new ones added, don’t be fooled into believing that this will be a breeze.

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2019 Value Based Purchasing Proposed Changes (UPDATED)

The Centers for Medicare and Medicaid Service (CMS) finalized all of the proposed changes to the Value-Based Purchasing (VBP) Model for implementation January 1, 2019. One of the refinements of VBP removed five measures, while adding two new composite measures.

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2019 Home Health Proposed Payment Rule – PDGM 2020

The Centers for Medicare and Medicaid Service (CMS) released the CY2019 Medicare Home Health payment rule July 12, 2018. This proposed rule is voluminous and carries an immense number of proposed changes. HPS will continue analyzing and updating the proposed elements of this rule.

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CAHPS – Home Health & Hospice

Are you monitoring the agency’s CAHPS results? There are numerous questions on the survey that the patients must complete, but only selected ones go into the outcome measure calculations. Home Health CAHPS results have been reported on the Home Health Compare website for quite some time, while the results for the CAHPS Hospice Survey just began being public reported on Hospice Compare 02/22/18. One of the lowest scoring…

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2018 Home Health Final Rule

The Breaking News that has every one full of excitement and hope is that the 2018 Home Health Final Rule does NOT include finalizing HHGM, at this time, which was set for implementation in 2019! The battle has been won, BUT the war has just begun! Some form of payment reform will occur in home health. It is not…

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2018 Home Health Proposed Rule – HH QRP

The 2018 Home Health Proposed Rule was released 07/28/17. The 2018 Home Health Proposed Payment Rule – Including Intro to HHGM regarding this rule primarily discussed the proposed reimbursement changes for 2018 as well as the massive changes to the Prospective Payment System in the form of HHGM. The following is a recap of the proposed changes to the Home Health Quality Reporting Program (HH QRP).

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2018 Home Health Proposed Payment Rule – Including Intro to HHGM

The Centers for Medicare and Medicaid Service (CMS) released the CY2018 Medicare Home Health payment rule last week. This proposed rule is voluminous and carries an immense number of proposed changes.  HPS will continue analyzing and updating on the proposed elements of this rule.

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Delayed Implementation of Home Health CoPs

Last week CMS issued a Final Rule that changed the new Home Health CoPs rule implementation date to January 13, 2018. HPS announced the proposed rule a few months ago. NAHC and the Forum of State Associations spearheaded this effort to postpone the rule because of the extensive changes that are…

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Home Health PEPPER is HOT!

One of the Hot Topics surrounding the medical review contractors and Medicare MACs is Home Health PEPPER (Program for Evaluating Payment Patterns Electronic Report)! Pepper is an accumulation and calculation of certain statistics that result from claims data. These Medicare claims data statistics are calculated for areas that may be at risk for improper Medicare payments such as…

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HHCAHPS – Improvement in Specific Care Issues

Are you monitoring the agency’s HHCAHPS Star Ratings? There are numerous questions on the survey that the patients must complete, but only selected ones go into the outcome calculation and eventual star rating. The Composite Measure – Specific Care Issues, seems to be one that most agencies struggle with. The specific questions from the survey…

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Negative Pressure Wound Therapy with a Disposable Device Billing Specifics (NPWT)

The 2017 Final Home Care Rule included clarification that payment for the NPWT device is when a HHA “furnishes NPWT using a disposable device” to mean when the HHA provider is either initially applying an entirely new disposable NPWT device, or removing a disposable NPWT device and replacing it with an entirely new one.

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Home Health COPs Delayed

CMS just issued a proposed rule that will change the new Home Health CoP rule effective date to January 13, 2018. NAHC and the Forum of State Associations spearheaded an effort to postpone the rule because of the extensive changes that are required and the absence of needed interpretive guidance to properly comply.

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Are You Thriving?

The constant additions of new programs and new methods, updates and consideration of changes is almost unbearable for some agencies.  Home Health has been hit really hard since 2008 and no relief seems to be coming.   Value-Based Purchasing, Pre-Claim Review, New CoPs, OASIS-C2, ICD-10 CM and now possibly major changes to the Prospective Payment System in regard to reimbursement.

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BREAKING NEWS – PRE-CLAIM REVIEW DELAYED

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Pressure Ulcer Unlearning!

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HHCAHPS – Is There Room for Improvement?

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The Continued Culture Change to Quality

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Culture of Quality

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Can You Afford to Ignore?

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Value Based Purchasing: What We Weren’t Sure of!

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Are You Overwhelmed by it All?

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