Nov 1st, 2018
Learn what’s in store for facilities billing under the Home Health Prospective Payment System in the coming years. For 2019, the Centers for Medicare & Medicaid Services (CMS) will recalibrate scores for the case-mix adjustment variables, clinical and functional thresholds, payment regression model, and case-mix weights using 2017 claims data. The 2019 market basket update ...
In Billing
Aug 24th, 2018
Effective Jan. 1, 2019, providers who are participating in Next Generation Accountable Care Organizations (NGACOs) are gaining a new covered benefit enhancement to offer their patients who are not otherwise covered by original fee-for-service (FFS) Medicare. Benefit enhancements are conditional waivers of certain Medicare payment requirements. For 2018, benefit enhancements include: Three-Day Sk...
In Billing
May 23rd, 2018
Starting Oct. 1, hospital discharges to hospice care qualify as a post-acute care transfer and may have payment adjustments for Medicare patients. According to the Centers for Medicare & Medicaid Services (CMS) Transmittal 2055, change request 10602, under the policy regulations § 412.4: * When a patient is transferred to another hospital and their stay ...
In Billing
Jan 29th, 2018
Continuing the effort to prevent and combat healthcare fraud, waste, and abuse where it occurs most, the Centers for Medicare & Medicaid Services (CMS) has extended the statewide temporary moratoria on the enrollment of new Medicare Part B, Medicaid, and Children’s Health Insurance Program (CHIP) non-emergency ground ambulance providers and suppliers and home health agencies, sub-units, and ...
In CMS
Aug 1st, 2017
A proposed rule would update the 2018 Medicare payment rates and the wage index for home health agencies (HHA) serving Medicare beneficiaries, as well as revise the Home Health Prospective Payment System (HH PPS) case-mix adjustment methodology. Payment Update is Down In the proposed rule, published July 28 in the Federal Register, the Centers for ...