In these trying times, it is important to keep informed. We will be providing a summary of regulatory changes in this article. Please keep in mind that these changes are considered temporary and will be effective from 3/30/2020 through as long as the COVID-19 Public Health Emergency declaration remains in effect. Other legislation is being […]

You are already familiar with the Home Health Review Choice Demonstration and Home Health Pre-claim Review Submissions. Recently, PalmettoGBA (PGBA) released some important information regarding Pre-Claim Review (PCR) Non-Affirmations that pertains to home health agencies in Illinois and will soon apply to Ohio agencies as well. This is valuable insight into what PGBA is looking […]

This home health proposed rule’s 346 pages (reduced from last year’s 600) were published on July 18. Comments will be accepted from now until September 9, 2019. You can submit your comment by clicking on the “Submit a formal comment” link near the top of the article. You can also send your comments by regular […]

The Review Choice Demonstration (RCD) is a home health review program. It is planned for a 5-year period with initial implementation in Illinois scheduled for June 1, 2019 and expansion into Ohio, North Carolina, Florida and Texas soon after. This program is a continuation of CMS’s efforts to crack down on fraud, waste and abuse […]

The Patient-Driven Groupings Model (PDGM) is an alternative payment model that will replace the home health Prospective Payment System (PPS). The planned implementation date is January 1, 2020. Why the change? The Bipartisan Budget Act of 2018 (BiBA) requires reform of the current payment model to address several perceived problems in the PPS home health […]

As NAHC puts it, the “Patient-Driven Groupings Model (PDGM) was created by the Centers for Medicare and Medicaid Services and is slated to debut on January 1, 2020. PDGM will revolutionize the payment methodology for all Medicare Home Health Agencies (HHAs) in the United States.” We attended the PDGM summit in Chicagoorganized by NAHC and […]

So we’ve talked a lot about Quality Assessment and Performance Improvement (QAPI) in the last few articles and I wanted to give a quick note on each. Use this page as a guide to find past articles relating to QAPI. Are you prepared for QAPI? The first article in this series was Are you prepared […]

Infection control and prevention is fundamental to ensuring that a patient’s clinical condition improves without complications. There is very little official data to be found regarding home health infection numbers, probably because agencies are not required to submit annual infection statistics. There was a 2015 small sample study using OASIS responses M2310 and M2430 from […]

The Social Security Act’s section 1899B(b)(1)(B)(i) requires that post-acute care (PAC) providers submit standardized patient data for “Functional status, such as mobility and self care at admission to a PAC provider and before discharge from a PAC provider”. CMS tasked RTI to review existing PAC assessments, create the Continuity Assessment Record and Evaluation (CARE) Item […]