Author: Amy Ross

Home Health Value Based Purchasing

As you have probably heard, the Home Health Value Based Purchasing (HHVBP) model has been finalized in the Home Health Final Rule for next year and includes all home health Medicare-certified agencies across the United States, territories, and District of Columbia.  However, a change in the full enactment of the program was a happy announcement…

Home Health & Hospice Regulatory Updates

The first week of November has been newsworthy for the home health and hospice care sectors.  The Home Health Final Rule, CMS-1747-F, was released on Tuesday afternoon.   If that wasn’t enough to digest, both OSHA and CMS released rules on COVID-19 vaccination.  There’s a lot of information to be processed in the coming days.  However…

Home Health Final Rule

The home health final rule from CMS is expected to be released today.  Will it be full of tricks or treats for the home health industry?  No one knows for sure.  The expected treats are increases in the payment for agencies who submit quality data.  CMS is also establishing a permanent rule in which certain…

International Classification of Functioning (ICF)

Clinical documentation is a constant struggle as clinicians deal with tight time schedules due to increased responsibilities.  One effective way to justify and individualize patients’ information on homebound criteria and medical necessity, in particular, is through the use of ICF language.  ICF stands for International Classification of Functioning.  When examining the exact reason a patient…

Breast Cancer Awareness Month

October has long been designated as breast cancer awareness month.  This particular cancer is especially significant to the MAC Legacy organization as we have many friends and family who have been affected by this disease.  As we all reflect on breast cancer this month, we want to remind you to get screened.  A report from…

Hospice Election Statement Addendum

October 1st marked the beginning of the hospice fiscal year and implementation date of some changes detailed in CMS’ Hospice Final Rule.  One particular modification has to do with the Hospice Election Statement Addendum.  Hospices are now required to include a “date furnished” on the addendum and this date must also be recorded in the…

Coding Changes Go Into Effect Today

Today is the day!!  The new ICD-10 codes that were released are now effective!! Do not let your billing be delayed due to a coding glitch.  Remember that every episode that has an encounter date of 10/01/2021 and after will have to be reviewed for any new code updates. The code that will probably create…

COVID-19 Employee Tracking

An important aspect of your COVID-19 Plan is maintaining a log of COVID-19 positive employees.  This document details all your employees who have a confirmed infection regardless of the source (work-related or otherwise).  Remember that this log must be consistent with your OSHA 300, 300A, and 301 forms and be maintained in the confidential medical…

COVID-19 Compliance

Much confusion and angst has been brought about in the recent announcement of President Biden’s new COVID mandate.  This along with changes to the OSHA ETS have left many home health and hospice providers wondering what to do.  First of all, neither of these new regulations have been implemented yet—so take a deep breath.  The…

Medical Necessity

One of the most common reasons for home health claims denials revolve around medical necessity for skilled nursing services—denial code 5HN18.  During the first quarter of 2021, the Medicare Administrative Contractors identified this denial reason among the top five.  The solution boils down to a good understanding of skilled nursing services and documentation, documentation, documentation. …