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Medicaid/Medicare Enrollment and Regulatory Compliance

Deferred Covered Treatment SNF Stay Policy Updated


Posted on March 30, 2015 in Long-Term Care, Home Health & Hospice

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Subject to various exceptions, a covered skilled nursing facility (“SNF”) stay must initiate within 30 days of a qualifying hospital stay.  In some cases where it is medically predictable that an individual will require a covered level of SNF care within a determinable time frame, that same individual may also have a need for a covered... READ MORE

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Indiana Medicaid to Reimburse Home Health Agencies for Certain Telehealth Services


Posted on October 31, 2014 in Long-Term Care, Home Health & Hospice

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Senate Enrolled Act 554 from the 2013 legislative session set the stage for an upcoming change in Medicaid policy that will provide reimbursement for certain telehealth services provided by Home Health Agencies (“HHAs”).  The Indiana Health Coverage Programs (“IHCP”) released Bulletin BT201454 earlier this week outlining the policy change that will cover an HHA’s remote monitoring of data... READ MORE

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Caution – Pay No Mind to the Department of Labor’s Temporary Non-Enforcement Policy Relating to the Companion Services Exemption


Posted on October 31, 2014 in Long-Term Care, Home Health & Hospice

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In the October 9, 2014 Federal Register, the Department of Labor (“DOL”) indicated it will delay enforcement of the Companion Services Rule (“Rule”) until June 30, 2015 (the “Notice”). The DOL suggests this delayed enforcement is meant to assist the provider community with implementing changes in the Rule. In its commentary, the DOL suggests... READ MORE

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CMS Extends HHA Moratoria in Select Metro Areas


Posted on August 11, 2014 in Long-Term Care, Home Health & Hospice

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Since July 2013, CMS has instituted a moratorium on new home health agencies (“HHAs”) enrollments in Miami and Chicago areas.  Earlier this year in February, CMS added Fort Lauderdale, Detroit, Dallas and Houston to the moratorium.  This month, CMS has renewed the moratoria for all six locations for an additional six-month period, with the... READ MORE

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Senators Recommend Changes to Recovery Audit Contractor Payment System


Posted on July 15, 2014 in Long-Term Care, Home Health & Hospice

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At a recent roundtable, the Senate Special Committee on Aging criticized the Medicare claims review process, suggesting it unfairly burdened providers and failed to improve program integrity. The senators blamed the current payment system for the auditors and suggested moving from an arrangement that currently incentivizes recovery of overpayments to one that incentivizes reducing... READ MORE

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Obama Budget Contains Numerous Post-Acute Care Cuts


Posted on March 5, 2014 in Long-Term Care, Home Health & Hospice

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President Obama introduced his fiscal year (“FY”) 2015 budget yesterday, and there are many proposed cuts to post-acute care providers.  Some of the highlights include a number of bundled payment initiatives, a $100 co-pay for home health patients not discharged from a hospital and re-admission penalties for skilled nursing facilities (“SNFs”) with high hospital... READ MORE

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Report Suggests For-Profit Hospices Utilize Longer Periods of Service


Posted on February 27, 2014 in Long-Term Care, Home Health & Hospice

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Earlier this week, McKnight’s reported on a study from the Mount Sinai School of Medicine in New York relating to the length of stay at for-profit versus nonprofit hospice providers.  This study showed that, of the 600 Medicare certified hospices nationwide, for-profit hospices were more likely to have patients with a longer expected stay than... READ MORE

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CMS Extends and Expands Home Health Enrollment Moratoria


Posted on February 11, 2014 in Long-Term Care, Home Health & Hospice

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Effective January 31, 2014, the Centers for Medicare & Medicaid Services (“CMS”) has issued a temporary moratoria for the enrollment of home health agencies in Fort Lauderdale, Florida; Detroit, Michigan; Dallas, Texas; and Houston, Texas.  CMS also announced it is extending the current enrollment moratoria in Chicago, Illinois and Miami, Florida for another six... READ MORE

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CARES Act Introduced: Would Waive Three-Day Stay for Certain SNFs


Posted on November 21, 2013 in Long-Term Care, Home Health & Hospice

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The Creating Access to Rehabilitation for Every Senior Act of 2013 (“Bill”) was introduced this week by Representative James Renacci (R-OH) to the House.  This Bill proposes to waive the three-day qualifying stay requirement for admission to a skilled nursing facility (“SNF”) under Medicare.  


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CMS Revises Citation Guidelines for Facilities Working Towards Sprinkler Compliance


Posted on November 19, 2013 in Long-Term Care, Home Health & Hospice

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The Centers for Medicare & Medicaid Services (“CMS”) just released a revision to their August Survey and Certification letter concerning the August 13, 2013 deadline for the installation of automatic sprinkler systems in nursing facilities. Originally, facilities that did not meet the deadline were subject to deficiencies at scope and severity (“S&S”) levels of... READ MORE

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