Opportunities for improvement exist
CMS
Agency green lights remote monitoring, new groupings model
WASHINGTON, D.C. (July 3, 2018)—To foster adoption of emerging technologies by home health agencies and to result in more effective care planning, the Centers for Medicare & Medicaid Services (CMS) proposed an updated home health prospective payment system (PPS), adding allowables for remote patient monitoring technology and implementing a new patient-driven groupings model (PDGM).
WASHINGTON, D.C. (June 27, 2018)—The Centers for Medicare & Medicaid Services (CMS) announced new and enhanced initiatives designed to improve Medicaid program integrity through greater transparency and accountability, strengthened data, and innovative and robust analytic tools.
WASHINGTON, D.C. (June 20, 2018)—The Centers for Medicare & Medicaid Services (CMS) issued a Request for Information (RFI) seeking recommendations and input from the public on how to address any undue impact and burden of the physician self-referral law (also known as the Stark Law), focusing in part on how the law may impede care coordination, a key aspect of systems that deliver value.
WASHINGTON, D.C. (June 18, 2018)—The June 15 release of MedPAC’s report to Congress on Medicare and the health care delivery system represents another missed opportunity by the Commission to address the serious problems with Medicare’s competitive bidding program for durable medical equipment (DME) as well as the disastrous application of bidding-derived pricing to rural and other less-populous communities, stated the American Association for Homecare (AAHomecare).
WASHINGTON, D.C. (June 7, 2018)—Since 2015, AAHomecare has been tracking the number of suppliers and their locations to monitor the impact of competitive bidding and other factors on the industry. The analysis has helped to bring these issues to the attention of Congressional offices and HHS to illustrate the need for more sustainable Medicare reimbursement rates and bidding program reforms.
Hospital-acquired condition rates falling with improved best practices.
WASHINGTON, D.C. (June 6, 2018)—Data released this week by the Agency for Healthcare Research and Quality (AHRQ) show continued progress in improving patient safety, a signal that initiatives led by the Centers for Medicare & Medicaid Services (CMS) are helping to make care safer.
What to consider when conducting a risk assessment
WASHINGTON, D.C. (June 4, 2018)—On Friday, June 1, 2018, CMS released CMS-6080-N, “Medicare Program; Update to the Required Prior Authorization List of Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Items That Require Prior Authorization as a Condition of Payment.”
SAN FRANCISCO (May 30, 2018)—ClearCare, a technology platform for homecare agencies, announced the nationwide availability of a new technology to seamlessly connect these agencies with insurance companies and hospitals.
Report does not adequately assess beneficiary access issues, CQRC says.
WASHINGTON, D.C. (May 29, 2018)—The Council on Quality Respiratory Care (CQRC) today warned a report released by the Department of Health and Human Services Office of Inspector General (OIG)—Round 2 Competitive Bidding for Oxygen: Continued Access For Vast Majority of Beneficiaries—underestimates the negative impact the Competitive Bidding Program for Durable Medicare Equipment (DME) continues to have on beneficiary access to home respiratory supplies and services.
Recent report recommends extending and renewing current programs.
By Kristin Easterling
(May 24, 2018)—Recently, the Government Accountability Office (GAO) conducted a study on Medicare prior authorization requirements. The requirements began in seven states for certain power mobility devices such as power wheelchairs in 2012. The categories later expanded to include DME, home health and others.
CMS Provider Compliance Group provides insight during keynote speech.
Tom Ryan (left) of AAHomecare presented Doug Coleman with the Mal Mixon Award
CMS releases new guidance for electronic visit verification
By Kristin Easterling
(May 17, 2018)—The Centers for Medicare & Medicaid Services (CMS) issued new guidance on electronic visit verification (EVV), in accordance with section 12006(b) of the Cures Act. This section requires the Secretary of the Department of Health and Human Services (HHS) to collect and disseminate best practices for the training people who provide personal care services (PCS), home health care services (HHCS) or both, on the operation of EVV systems.
Effective date of August 1 give providers time to adapt.
WASHINGTON, D.C. (May 14, 2018)—Effective August 1, 2018, the Centers for Medicare & Medicaid Services (CMS) will require suppliers to use KX, GA, GY and GZ modifiers on oxygen claims. The KX modifier will indicate when payment criteria is met, and the GA, GY and GZ modifiers provide more information for oxygen claims that do not meet payment criteria.
Fee increase and beneficiary cost sharing noted as points to watch.
By Kristin Easterling
(May 10, 2018)—After months of advocacy from AAHomecare and other industry stakeholders, the Office of Management and Budget (OMB) and CMS have cleared the Interim Final Rule related to HME (CMS-1687-IFC) to increase fee schedule rates for certain DME items and services through 2018. Language in the recent Omnibus bill also urged the Administration to release the rule and move on relief for rural providers.
Strategy seeks to ensure individuals in rural America have access to high quality, affordable care.
WASHINGTON, D.C. (May 8, 2018)—Today, the Centers for Medicare & Medicaid Services (CMS) released the agency’s first Rural Health Strategy intended to provide a proactive approach on health care issues to ensure that the nearly one in five individuals who live in rural America have access to high quality, affordable health care.
Q&A with Pardee Home Health's administrative director