HHS Secretary Kathleen Sebelius announced the formation and approval of 106 new Accountable Care Organizations. As many as 4 million more Medicare beneficiaries now have access to coordinated care.

Comments Off

  by Liz Seegert If there is anyone who knows what it takes to lower the cost of health care, it is former Department of Health and Human Services Secretary Donna Shalala. As someone steeped in policy for 30 years, one thing she says she knows for sure is that home health care needs to […]

Comments Off

by Liz Seegert Last week, staff writer Liz Seegert examined the Republican Party Platform in terms of its impact on home health care. (http://homecaretechreport.com/article.asp?id=1589) In part two, she takes the same close look at the just-released Democratic platform. It was a bit of a surprise that home health care and home health technology are not […]

Comments Off

Attorney General Eric Holder and HHS Secretary Kathleen Sebelius announced Wednesday that a nationwide takedown by Medicare Fraud Strike Force operations in eight cities has resulted in charges against 91 defendants, including doctors, nurses, and other medical professionals, for their alleged participation in Medicare fraud schemes involving approximately $295 million in false billing.

Comments Off

HHS Secretary Kathleen Sebelius revealed on February 17 that the H.E.A.T. Strike Force effort has returned $6.80 for every taxpayer dollar spent. Two new cities will open H.E.A.T. offices this month.

Comments Off

Have you spoken with your software vendor yet about their plans for the HIPAA 5010 claims transaction sets? Testing begins in January, with implementation one year later. After that, CMS claims, ICD-10 will arrive on time in 2013, and it will be obligatory for all HIPAA covered entities, not just those that submit claims to Medicare and Medicaid.

Comments Off

If home health care providers sometimes feel that government agencies treat the industry like a pre-ball Cinderella when it comes to payment rates, a new report from the Office of Inspector General (OIG) will not make them feel any better. Though CMS continues to look for reasons to reduce payment rates to home care agencies, […]

Comments Off

Amidst all the news this month about PPS rate cuts, do not forget your regular opportunity to hear directly from CMS. Here is the phone number and code for their August 25 Open Door Forum.

Comments Off

Though the deadline has been pushed back a few months, RHHIs will soon deny payment for home health care claims if the physician authorizing Medicare services was not registered in the Medicare Provider Enrollment, Chain and Ownership System ( PECOS) or opted out of Medicare by the date services began. Wouldn’t it be handy if your referral intake software included a direct link to the PECOS database? We have found two such services so far.

Comments Off

At the top of three regulatory stories this week is one that appeared on the news wires just before this issue went to press. The Federal H.E.A.T. strike force, a joint effort of HHS, the FBI, the federal Department of Justice and the DEA, arrested 94 people so far in Miami, Baton Rouge, Detroit and Brooklyn. The number is expected to grow as more arrests are announced throughout the weekend.

In a related announcement, Secretary Kathleen Sebelius said that health care fraud fighters in the state of Florida will now have additional funding to help find potential fraud and abuse in the state’s Medicaid program through use of Medicaid claims data.

Comments Off