In December 2023, Performant, the designated Recovery Audit Contractor (RAC) for the Centers for Medicare and Medicaid Services (CMS), introduced a new issue, Issue 0221 – Hospice Care: Extended Length of Stay: Medical Necessity and Documentation Requirements, to its approved list.  This newly added issue centers on evaluating the “Extended Length of Stay” to verify medical…

The Elizabeth Dole Home and Community Based Services for Veterans and Caregivers Act of 2023, also known as the Elizabeth Dole Home Care Act of 2023, is a comprehensive bill focused on enhancing home care and caregiver programs provided by the Department of Veterans Affairs (VA). The legislation, passed on December 5, 2023 by the…

The issuance of the Home Health Final Rule brings with it the opportunity to re-evaluate the financial position of your agency. If your agency has not yet begun to analyze this data, in particular the updated comorbidity adjustments, let me help you with a brief update. According to the final rule, only those subgroups of…

In 2019, 37.3 million Americans had diabetes and another 96 million have prediabetes.  Of the 37 million Americans, 28.7 million were diagnosed and 8.5 million were undiagnosed.  The American Diabetes Association is calling it a nationwide epidemic. World Diabetes Day is celebrated each year on November 14th  to bring awareness to the disease and empower…

November is Diabetes Awareness Month.  In 2006, the United Nations officially designated November 14th as World Diabetes Day.  It is marked every year on Sir Frederick Banting’s birthday, who discovered insulin along with Charles Best in 1922.  Diabetes affects over 500 million people worldwide and about 37 million Americans.   For those with diabetes and their…

Due Now: Credit Balance Reporting now due for the Quarter ending 9/30/2023regardless of whether any credits need to be reported. What to Submit:  The one-page Credit Balance Report – Form CMS-838.  Ensure that it is signed by an authorized representative.  It may be necessary to submit additional Credit Balance Report Detail pages. When To Submit: …

Coding your home health claims is a multifaceted process fraught with complicated issues.  The October 1st, 2023, update including expanded Parkinson’s codes is just such an issue. Gone are the days of choose one code and go. Let’s look at this expansion.  The changes to these diagnosis codes began in September of 2021 with a…

The National Association for Home Care & Hospice (NAHC) expressed strong support for the Centers for Medicare & Medicaid Services (CMS) with the goal of the hospice Special Focus Program (SFP) as a means to “identify hospices as poor performers, based on defined quality indicators”.  But…NAHC in collaboration with other Home Health and Hospice State Associations submitted…

According to the CDC, an estimated 6.5 million adults over the age of 20 have a diagnosis of heart failure.  Certain conditions and unhealthy behaviors can increase the risk for heart failure.  Caring for the heart failure patient in the home can often be challenging and requires a thorough understanding of the disease and the…

Texas Health and Human Services published a Long-Term Care Regulation Provider Letter on May 22, 2023, for the Home and Community Support Services. This provider letter outlines new reporting requirements for Abuse, Neglect and Exploitation effective July 1, 2023. Suspected ANE for Medicaid consumers are to be reported to Department of Family and Protective Services…