MIAMI—A federal jury in Miami convicted a Florida man and woman for their roles in a conspiracy to defraud Medicare by billing more than $93 million for home health therapy services that were never rendered.
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
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.
MIAMI—A defendant, who was previously convicted of money laundering, was sentenced to a total of 90 months in federal prison for his recent money laundering conviction.
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.
WASHINGTON—Home health agencies didn’t report more than half of the falls that Medicare home health patients hospitalized for falls with major injury experienced, according to a new study by the Department of Health and Human Services Office of the Inspector General (OIG).
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.
The Centers for Medicare & Medicaid Services (CMS) released an announcement on efforts to support Florida’s emergency response to Hurricane Idalia, including resources and flexibi
WASHINGTON—The methodology chosen to determine future home health payment rates "will eventually destroy the value of the home health services benefit," the National Association for Homecare and Hospice (NAHC) said in a letter sent to the Centers for Medicare & Medicaid Services (CMS).
MINNEAPOLIS, Minnesota—Reprise Biomedical, Inc., an innovator in medical biotechnology for wound care, announced the Centers for Medicare and Medicaid Services (CMS) has assigned a Level II Healthcare Common Procedure Coding System (HCPCS) code to its Miro3D wound matrix, effective Oct. 1, 2023.
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WASHINGTON—The Centers for Medicare & Medicaid Services (CMS) released updated guidance that will extend COVID-19 public health emergency (PHE) flexibilities approved in the states' section 1915(c) home- and community-based services (HCBS) waiver Appendix K amendments.
WASHINGTON—The Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) have responded to a May 2023 data breach in Progress Software’s MOVEit Transfer software on the corporate network of Maximus Federal Services, Inc. (Maximus), a contractor to the Medicare program, that involved Medicare beneficiaries’ personally identifiable information (PII) and/or protected health information (PHI). No HHS or CMS systems were impacted.
WATERLOO, Iowa—U.S. Representatives Judy Chu (D-CA) and Mariannette Miller-Meeks (R-IA) have reintroduced the bipartisan H.R. 4779: Breast Cancer Patient Equity Act, which would provide Medicare coverage of custom breast prostheses to breast cancer survivors. Since most private insurance companies follow Medicare coverage standards, passage of this legislation would allow hundreds of thousands of women each year to choose a custom prosthesis after a mastectomy.
BOSTON – The owner of Conclave Media (Conclave) and Nationwide Health Advocates (Nationwide) has been charged and has agreed to plead 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.
Reps. Terry Sewell (D-AL) and Adrian Smith (R-NE) are leading an effort to help maintain strong access to home oxygen for individuals with respiratory challenges.
BOSTON—Senator Edward J.
PurposeCare, a provider of coordinated homecare and home health services in the Midwest, announced its acquisition of three Midwest homecare agencies in the Indiana and Ohio markets.
DALLAS—Homecare Homebase (HCHB), a software for home-based care, has released an updated HCHB Analytics Home Health Impact Report Model, less than two weeks following the Centers for Medicare & Medicaid Services (CMS) publication of the 2024 Home Health Proposed Rule. The tool helps customers quickly and accurately identify the potential impact of proposed and final Medicare reimbursement changes on their unique agencies.
WASHINGTON—The Centers for Medicare & Medicaid’s (CMS) proposed rate reductions for home health could be devastating for agencies if they are codified, said Bill Dombi, president of the National Association for Home Care & Hospice (NAHC). Even worse, CMS has left a door open to demand some $3 billion in clawbacks for prior years of what it interprets as over-payments.
Broader Medicare coverage is now available for Biogen and Eisai’s Leqembi (the brand name for lecanemab) following the Food and Drug Administration’s (FDA) move to grant traditional approval to the drug that treats individuals with Alzheimer’s disease. The Centers for Medicare & Medicaid Services had previously announced this would be the case and released more details on coverage.
WASHINGTON—The Center for Medicare & Medicaid Services' proposed 2024 rule for the home health payment system includes a slew of hospice-specific provisions, many of them designed to reduce fraud and so-called "hospice flipping." Here's a look at what's included, according to the National Association for Homecare and Hospice.
