Home Health & Hospice

Home Health Prepayment Reviews are Increasing. Is Your Documentation Compliant?

Home Health & Hospice /

(January 30, 2013): Are the home health services you are currently providing compliant with applicable coverage, documentation and medical necessity requirements? Have you carefully reviewed your current caseload to ensure that each patient does, in fact, qualify as “homebound.” Do you have an effective Compliance Plan in place to assist you with your efforts? Now, […]

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ZPIC Home Health Audits are Slated for the Future

Home Health & Hospice /

(November 19, 2012): Zone Program Integrity Contractors, better known also as “ZPICs,” are continuing to focus on home health agencies (HHAs), hospice providers, and DME companies as the subject of their Medicare audits. Based on input from both the Office of Inspector General (OIG) and the Centers for Medicare & Medicaid Services (CMS), ZPIC audits

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Home Health Compliance Risks are a Significant Issue for Texas and Oklahoma Agencies

Home Health & Hospice /

(March 21, 2012): Over the past few weeks, several important events have occurred which should have home health agencies in Texas, Oklahoma and the rest of the country rethinking the adequacy of their existing compliance efforts. The home health compliance practices of many agencies have long been a concern of the Department of Health and

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Health Integrity Audits of Texas and Oklahoma Home Health Agencies are on the Rise.

Home Health & Hospice /

(August 14, 2011): Home health agencies in Texas and Oklahoma remain under considerable scrutiny by Medicare contractors tasked with identifying fraud and abuse perpetrated against the Medicare Trust Fund. As discussed below, these Medicare contractors have a number of tools at their disposal, many of which can effectively place a home health agency in financial

Health Integrity Audits of Texas and Oklahoma Home Health Agencies are on the Rise. Read More »

New Face-to-Face Requirements for Hospices and Home Health Agencies

Home Health & Hospice /

(May 8, 2011): Over the last year, both hospice and home health agencies have faced a number of regulatory challenges, including but not limited to the face-to-face issue. In many instances (including the new requirement discussed below), these regulatory changes have been implemented in an effort to better ensure that the services ordered are reasonable

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South Texas Home Health Fraud Case Results in Nurse Prosecution

Home Health & Hospice /

(October 9, 2010): The U.S. Attorney’s Office for the Southern District of Texas recently issued a Press Release announcing the conviction of a South Texas nurse who worked for a home health company. She allegedly admitted falsifying and forging encounter forms used when providing care for Medicare beneficiaries. This case is merely the latest example

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Existing Home Health Agencies Considered a Moderate Risk

Home Health & Hospice /

(October 5, 2010): Existing home health agencies are considered to be a Moderate Risk for screening purposes. Late last month, the Centers for Medicare & Medicaid Services (CMS) published a Proposed Rule entitled “Medicare, Medicaid, and Children’s Health Insurance Programs; Additional Screening Requirements, Application Fees, Temporary Enrollment Moratoria, Payment Suspensions and Compliance.” As set out

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MFCU Strike Force Teams are Taking Aim at Home Health Providers

Home Health & Hospice /

(July 19, 2010): Home health care providers are in the crosshairs again. On July 15, HHS granted Florida a waiver of the anti-data mining provisions of federal Medicaid program regulations that will allow its Medicaid Fraud Control Unit (MFCU) to begin seeking out reasons to investigate home health and other providers for fraud. While Florida

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RAC Audits of Physician Practices, Home Health, Hospice, and DME Providers, are Expected to Increase.

Home Health & Hospice /

(June 25, 2010): The purpose of this series of articles is to assess the Recovery Audit Contractor (RAC) Program from the perspective of physicians, home health, hospice, durable medical equipment (DME) providers, and other relatively small Medicare providers. As many non-hospital providers will acknowledge, early cries of wolf by law firms and consultants did a

RAC Audits of Physician Practices, Home Health, Hospice, and DME Providers, are Expected to Increase. Read More »