CMS/Medicare

WASHINGTON—The U.S. Department of Human Services Office of the Inspector General (OIG) released a review of Medicare Part B payment trends for wound care products known as skin substitutes that the office said “raises major concerns about fraud, waste and abuse.”

In March 2023, OIG issued a report that identified significant gaps in manufacturer compliance with new average sales price (ASP) reporting requirements for skin substitutes. 

ALEXANDRIA, Virginia & WASHINGTON—At its September public meeting, the Medicaid and CHIP Payment and Access Commission (MACPAC) released draft recommendations for Medicaid payment policies intended to support the home- and community-based services (HCBS) workforce.

BURKBURNETT, Texas—HomeWell Care Services, a non-medical in-home care franchises, has announced a national strategic partnership with PocketRN, a virtual nursing provider, to expand its dementia care support for seniors and their families as part of the Centers for Medicare & Medicaid Services’s (CMS) Guiding an Improved Dementia Experience (GUIDE) Model.

WASHINGTON—A national poll by Fabrizio Ward, commissioned by the National Alliance for Care at Home (the Alliance), found that seven in 10 Americans oppose the Centers for Medicare & Medicaid Services’ (CMS) 2026 Medicare home health proposed rule, which is expected to cut Medicare home health funding by an additional 9%, or $1.1 billion, next year.

WASHINGTON—Representatives Kevin Hern (OK-01) and Terri Sewell (AL-07) introduced the Home Health Stabilization Act of 2025 (HR 7027). The legislation aims to ensure patients have access to rehabilitative care by pausing the payment cuts proposed in the Centers for Medicare & Medicaid Services’ (CMS) Calendar Year 2026 Home Health Prospective Payment System proposed rule. The legislation also looks to create a more sustainable payment system for Medicare Home Health Agencies (HHAs).

WASHINGTON—The Centers for Medicare & Medicaid Services (CMS) is retracting its recent guidance regarding Outcome and Assessment Information Set (OASIS) data collection, according to the National Alliance for Care at Home.

FORT SMITH, Arkansas—Mercy Home Health-Fort Smith has been awarded a five-star rating from the Centers for Medicare & Medicaid Services (CMS) for both Quality of Patient Care and Patient Survey Satisfaction, making it the only home health provider in Arkansas to receive five stars in both categories.

MIDDLETOWN, Connecticut—Habroon Habib, 29, a citizen of Pakistan and lawful permanent resident of the U.S. residing in Middletown, has been charged by federal criminal complaint with offenses stemming from an alleged health care fraud scheme involving durable medical equipment (DME).

WASHINGTON—The Centers for Medicare & Medicaid Services (CMS) announced a new prior authorization pilot program that will require recipients of Medicare to receive prior approval before obtaining access to certain medical services. 

PALO ALTO, California—PocketRN, a provider of virtual nursing, and Caring Senior Service, a homecare company, announced they will form a partnership to test the Centers for Medicare & Medicaid Services (CMS) alternative payment model designed to support people living with dementia and their caregivers. 

WASHINGTON—ATA Action, the advocacy arm of the American Telemedicine Association, released a co-led letter to Congressional leadership signed by more than 350 stakeholder organizations, urging both the House and Senate to act swiftly to make Medicare telehealth flexibilities permanent, or to approve the longest possible extension. 

WASHINGTON—The Durable Medical Equipment Medicare Administrative Contractors (DME MACs) announced they will host a virtual public meeting to solicit stakeholder comments on Aug. 27. The purpose of the meeting is to discuss the expansion of coverage and to clarify the coverage criteria for blinatumomab, an immunotherapy drug used to treat B-cell acute lymphoblastic leukemia (ALL). 

The American Association for Homecare (AAHomecare) encouraged members of the HME industry to submit final comments on a proposed rule from the Centers for Medicare & Medi

WASHINGTON—The Centers for Medicare & Medicaid Services (CMS) launched an oversight initiative to ensure that enrollees in Medicaid and the Children’s Health Insurance Program (CHIP) are United States citizens, U.S. nationals or have a satisfactory immigration status. 

MIAMI—The United States has filed civil forfeiture complaints in the Southern District of Florida against two purported durable medical equipment (DME) companies accused of fraudulently billing Medicare more than $33 million combined.

According to allegations in the complaints, Vida Med Center LLC and Med-Union Medical Center, Inc., both enrolled Medicare providers, submitted false and fraudulent claims for DME that were medically unnecessary and not provided as represented.

ARLINGTON, Virginia—American Association for Homecare (AAHomecare) announced that it has launched a new End User CBP Activation Toolkit to help the HME industry submit its comments in opposition to the Centers for Medicare & Medicaid Services's (CMS) proposed rule to revive the competitive bidding program (CBP).