At this year’s Annual Meeting, the path toward “NAHC 2.0” was laid out by its Interim President. We spoke to him about what comes next.

In what is sure to become a historic manifesto, 40-year home care veteran Dr. Bob Fazzi calls all of us to redefine our role in the US healthcare system. More than a naming exercise, this landmark declaration is a call to action…and a warning of what is to come if we remain passive.

"I have been in home health for 26 years and this is the most frustrating it has ever been!" Comments like this one permeated the responses to our survey asking readers whether they have noticed an increase in the number of payment denials. We reprint your comments here, with some background comment for perspective. The consensus among HCTR readers? A suspicion that MACs, ZPICs, UPICs and other Medicare contractors decide first what percentage of claims they want to deny and develop denial reasons later.

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The Department of Health and Human Services should never have allowed the Administrative Law Judge system to become overwhelmed by hundreds of thousands of appeals. They asked contractors to find more excuses to deny Medicare payments; they knew the number of appeals would climb; they should have been prepared. Home healthcare providers have no alternative but prevention. Better clinical documentation = fewer denials = reduced reason to appeal.

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In this article, HCTR editor Tim Rowan makes the case for Faulkner to consider making a determined focus on improving home healthcare software, and making a connection with software company Homecare Homebase which offers a full-featured, well-designed home health and hospice software system which Epic does not have. The many benefits of Faulkner’s doing so for the good of the home health industry are described.

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Analysis by Editor Tim Rowan
The Face-to-Face documentation rule is not achieving its intended goal, restraining Medicare fraud. It is doing nothing other than increasing the number of payment denials to honest agencies that cannot get their referring physicians to find the right wording. This is the message delivered in no uncertain terms this week to two PGBA educators, who may have known what kind of a lion’s den they were walking into but came prepared with no satisfying answers.

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We asked HCTR readers last week to tell us whether their recent change from paper documentation to a clinical point-of-care system improved documentation time, left it about the same or lengthened it. The numbers are interesting (37.5% said shorter time; 50% said longer time; 12.5% said about the same) but the details you offered in the questionnaire’s comments section tell the whole story. Here are your quotes, without comment, editing only for grammar and clarity.

For the first time in its 17-year history, Home Care Technology Report is making an endorsement for a Presidential election. The reason we have to do this is not that we are chasing the issues but the issues have moved decidedly in our direction. The future shape of Medicare will be a central issue in November. Election results will affect us all.

By Tim Rowan The six-year long, $375 million Medicare and Medicaid fraud fiasco that was revealed last month, allegedly perpetrated by Dr. Jacques Roy and 500 conspiring Texas home health care organizations, could have been prevented. Will Texas and other states and U.S. territories learn from the experience or will Roy-like racketeers continue to thrive […]

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As an advocate of technology in home care for the last 13 years, HCTR believes we should adopt an editorial position on the events of last week. The crime ring allegedly created by a Dallas-area physician could not have been successful had the state mandated the use of Electronic Visit Verification by home care agencies. Other states would be well-advised to take the six-year, $375 million fraud operation as a warning, not to merely step up investigation efforts but to put prevention measures in place. We have some measures to suggest.

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