Home Health Value-Based Purchasing

The Home Health Value-Based Purchasing Model has been in effect since 2016 for nine select states.  As expected, the proposed home health final rule for CY 2022 has made plans to expand the model to all 50 states, territories, and District of Columbia next year.  This program will be applicable to Medicare-certified home health agencies…

Review Choice Demonstration

The Review Choice Demonstration continues for Medicare home health services in selected states–specifically, Illinois, Ohio, Texas, Florida, and North Carolina.  Here’s some of the latest news of RCD: Due to the lingering public health emergency, CMS has extended the phased-in participation for Florida and North Carolina until July 31, 2021.  This allows the agencies in…

CMS Emergency Preparedness Testing Clarification

CMS continues to make clarifications to the Emergency Preparedness regulation.  A revision to QSO-20-41-ALL was released on June 21, 2021 and was directed to State Surveyors.  As previously established, outpatient providers of services, such as home health and home hospice, are required to test their program annually.  In 2019, CMS changed the testing requirement for…

New Codes Added to ICD-10 Code Set

The coding addenda for fiscal year 2022 was posted on the CDC website on June 23rd.  There are 159 new codes that were finalized and will be added to the ICD-10 code set on October 1st.  One code that is included but was absent from the proposed code update is U09.9 (Post COVID-19 condition, unspecified). …

Emergency Preparedness Readiness

Hurricane season officially kicked off June 1st. With the formation of a Potential Tropical Cyclone system, designated by the National Hurricane Center, agencies and residents should prepare now for high winds and flooding rain. Utilize your emergency preparedness risk mitigation to put action steps into place in the event you should need to implement your…

Home Health RCD Top 5 Non-Affirmation and Claim Denial Reasons

Review Choice Demonstration (RCD) did not add any new requirements, but home health agencies are still struggling with the Face-to-Face (F2F) and getting an affirmation. Agencies need to remember that the F2F documentation must be “related” to the primary diagnosis (the primary reason for home care) and must be timely. This means that the encounter…

Hospice Survey Reform

The HOSPICE Act passed out of the House on December 8, 2020. In the version of the bill that will pass as part of the Consolidated Appropriations Act, 2021, routine hospice survey frequency will remain permanently at 36 months (as opposed to 24 months as proposed by the House). The OIG made the following recommendations related…

Hospice Outcomes & Patient Evaluation (HOPE)

The Hospice Outcomes & Patient Evaluation (HOPE) Cheat Sheet outlines CMS’ design for a new assessment tool for all hospice agencies. Although still in the developmental stages, the assessment strives to be patient-centered to create a  more positive end of life experience.

Home Health Certification and Recertification Signatures

On May 7th, CMS issued Change Request 12218 to clarify who is allowed to sign plans of care.  The January 1, 2021 benefit policy manual update erroneously included language limiting who was allowed to sign the plan of care when the certifying physician or certifying allowed practitioner (nurse practitioner, physician assistants, and clinical nurse specialists)…

Proposed Hospice Final Rule Change

CMS proposes to make some of the waiver changes permanent. One of these modifications is regarding hospice aide training.  The current CoP, 418.76 (c)(1) specifies aides must be evaluated by observation of their performance of the task with a live patient.  The proposed change would affect CoP 418.3 by allowing evaluation of aide competency to…