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.
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.
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 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.
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.
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.
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.
The Centers for Medicare and Medicaid Services (CMS) recently filed its 2019 Medicare Inpatient Prospective Payment System (IPPS) proposed rule.
Sometimes things are not what they appear to be. Nevertheless, our legal system so often finds a way to deliver justice, even after someone has been accused and convicted of crimes. That is the case with a doctor and owner of a home health care business.
In the Old West, bounty hunters wore cowboy hats and spurs. They would pursue fugitives across plains, through valleys and over mountains in search of a payday. Today, bounty hunters wear business attire and might work for the federal government, suppliers of durable medical equipment, home health care companies or other providers.