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Home Health Agencies Archives

Can home health care centers survive the challenges of 2020?

2020 is a year that has tested businesses in every marketplace. The home health system is no exception. This niche area of health care has had to navigate many issues throughout the year, some novel, some that have been building over the years. Two of the most notable include dealing with the decision by the Centers for Medicare and Medicaid Services (CMS) to eliminate home health pre-payments and addressing the current coronavirus pandemic.

Couple accused of health care fraud, face lifetime imprisonment

The government recently accused two business owners of working together on an elaborate health care fraud scheme that cost the government millions. According to the prosecution, the two business owners, a married couple, put together a health care business to defraud the government.

DOJ charges 30 in "patients for cash" health care fraud scheme

The Department of Justice (DOJ) recently charged 30 in a "patients for cash" health care fraud scheme. According to the indictment, a home health organization illegally paid doctors, nurses, and at least one social worker along with other medical professionals in violation of the Anti-Kickback Statute (AKS) for referral of patients to a home health organization.

Can the home health care industry handle growing need for PCAs?

Every day in the United States, approximately 10,000 people turn 65. Within this group, the majority hope to receive long-term care within their own home. Instead of going to a nursing home or other long-term care facility, these individuals may look to hire medical professionals to help them remain within their homes.

Home health company sues HHS and federal contractor

Home health companies often rely on payments from Medicare to continue operations. Even a brief suspension in these payments can be detrimental to patient care and business. In this case, a home health company alleges a federal contractor wrongly continued a suspension of Medicare payments for months, ultimately leading the home health business to shut down.

Home health care providers may see changes to payment structure

The American population is aging. As the Baby Boomers begin to transition into a new phase of life, there will likely be a greater demand for home health care services. In an effort to help address this need, lawmakers passed the Patient-Driven Groupings Model (PDGM). The Centers for Medicare and Medicaid Services (CMS) touted this new model as a means to improve reimbursement for home health care services.

Six health care startups named on list of 50 'unicorns'

This month, The New York Times teamed up with the research firm CB Insights to select 50 startup businesses that they think will eventually be valued at $1 billion or more. Six of the startups, which they refer to as "unicorns," are part of the health care industry.

New York City officials' crackdown on home health care agencies

The New York City Department of Consumer Affairs (DCA) is following the recent practices of the United States Department of Labor. The federal government recently identified a prevalence of labor law violations within the home health care agency industry. As such, the DCA put together a group to investigate for local offenders.

Important Notice for Medicare Providers: Medicare Beneficiaries Identifier is replacing Social Security number

The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 mandates removal of Social Security Number (SSN)-based HIC numbers from Medicare cards to address current risk of beneficiary medical identity theft. CMS will use a new MBI generator to assign over 150 Million MBIs beginning April 1, 2018, and continuing through December 31, 2019, for full implementation January 1, 2020. While CMS will continue to process transactions utilizing a beneficiary's current HIC number during the transition period, Medicare fee for service entities must modify their current processes and systems to be ready to submit or exchange the MBI by April 1, 2018. The current system requires a 9-byte SSN plus 1 or 2-byte BIC. The MBI system will require an 11-byte alpha numeric numeration system. All Medicare fee for services entities are advised to check all of their internal billing systems to be certain the software they are currently using will accommodate the new MBIs. During the transition period, Medicare entities will be allowed to enter either the MBI or HIC number. If you use vendors to bill Medicare, ask them about their MBI practice management system changes and make sure they are ready for the change.

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