The proposed rule includes a 2.6% payment rate update, regulatory text changes and a proposed implementation of the Hospice Outcomes & Patient Evaluation (HOPE) tool.

WASHINGTON—On March 28, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule (CMS-1810-P) that would update Medicare hospice payments and the aggregate cap amount for fiscal year (FY) 2025 in accordance with existing statutory and regulatory requirements.

This implementation facilitates statewide aggregation of critical health care data aligned with the 21st Century Cures Act

VERLAND PARK, Kansas—Netsmart, a provider of software and services for payers, providers and state Medicaid Agencies, announced the deployment of the Netsmart electronic visit verification (EVV) system for the Montana Department of Public Health & Human Services (DPHHS). This implementation facilitates statewide aggregation of critical health care data aligned with the 21st Century Cures Act.

Findings reveal current audit process’ shortcomings

WASHINTON and ALEXANDRIA, Virginia—Following a series of meetings with the Centers for Medicare & Medicaid Services (CMS) and Members of Congress on efforts to improve and protect hospice program integrity, four national hospice organizations—LeadingAge, the National Association for Home Care & Hospice (NAHC), the National Hospice and Palliative Care Organization (NHPCO) and the 

Fees for codes L8701 and L8702 are effective as of April 1, 2024

BOSTON—Myomo, Inc. (Myomo or the Company), a wearable medical robotics company that offers increased functionality for those suffering from neurological disorders and upper-limb paralysis, today announced that on February 29, 2024, the Centers for Medicare & Medicaid Services (CMS) posted the final Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) fee schedule payment rates for the MyoPro.

HHS & CMS are looking for comments related to all aspects of the MA program including access to care, PA, care quality and more

WASHINGTON—The U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), released a Request for Information (RFI) to solicit feedback from the public on how best to enhance Medicare Advantage (MA) data capabilities and increase public transparency. 

Jeffrey Brooks was charged with conspiring to submit or cause to be submitted false and fraudulent claims to Medicare

GREENVILLE, South Carolina—Jeffrey Brooks, 40, of Clarence Center, New York, was sentenced to more than seven years in federal prison after pleading guilty to one count of conspiracy to commit health care fraud. In addition to Brooks’ criminal conviction, last year, Brooks paid $850,000 in a civil settlement to resolve allegations that he provided kickbacks and caused false claims to be submitted in violation of the federal False Claims Act.

NAHC President Bill Dombi said the recommendation would "destroy the primary Medicare benefit"

WASHINGTON—The Medicare Payment Advisory Commission (MedPAC) voted on Jan. 11 to recommend that Congress reduce 2025 home health payment rates by 7%.

While the move was expected, advocates and the National Association for Home Care & Hospice (NAHC) still voiced their disappointment at the guidance. 

The effective date of this change is Jan. 1, 2024

WASHINGTON— In what was called a "big win" by the American Association for Homecare (AAHomecare) the Centers for Medicare & Medicaid Services (CMS) published a change request (CR) directing DME MACs to adjust their local edits to allow for 90-day billing for continuous glucose monitor (CGM) supplies to align with blood glucose monitor supplies.

Friday, Oct. 6 was the last day the National Supplier Clearinghouse accepted appeals and rebuttals.

WASHINGTON—The Centers for Medicare & Medicaid Services (CMS) announced that beginning Monday, Oct. 9, 2023, all durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) provider enrollment appeals and rebuttals should be sent to 

David Santana pleaded guilty to one count of conspiracy to commit health care fraud

BOSTON—The owner of Conclave Media (Conclave) and Nationwide Health Advocates (Nationwide) pleaded guilty in connection with a $44 million telemedicine fraud scheme involving medically unnecessary durable medical equipment (DME), including orthotics such as back and knee braces and genetic tests. 

New Rule Reduces Red Tape and Simplifies Medicare Savings Program Enrollment, Helping Millions of Older Adults and People with Disabilities Afford Coverage

WASHINGTON—The Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), finalized a rule to streamline enrollment in the Medicare Savings Programs (MSPs), making coverage more affordable for an estimated 860,000 people. CMS estimates the improvements will save older adults and people with disabilities nearly 19 million hours in paperwork each year and reduce state administrative burden by more than 2 million hours annually.

Model is designed to give states flexibilities in Medicaid, Medicare approaches

WASHINGTON—The Centers for Medicare & Medicaid Services (CMS) unveiled a new payment model that will give states  more flexibilities in how they manage health care, and could ultimately shift focus to home- and community-based services. The States Advancing All-Payer Health Equity Approaches and Development Model (“States Advancing AHEAD” or “AHEAD Model”) aims to better address chronic disease, behavioral health and other medical conditions.