Home Health Agencies

News & Analysis as of

A Fee Apart: The How, When, & Who in Awarding Attorney’s Fees

In a compensable claim, defendants were ordered to pay for prior attendant care services that were performed by plaintiff’s partner. The deputy commissioner approved an attorney fee of 25% of the award of the retroactive...more

Former Home Health Agency Owner Sentenced to 20 Years for $57MM Medicare Fraud

The US Department of Justice announced that Khaled Elbeblaswy, the former owner and manager three Miami-area home health agencies, was sentenced to 20 years in prison and ordered to pay $36.4 million in restitution for his...more

Ambulance and Home Health Moratorium Continued and Expanded

The Centers for Medicare and Medicaid Services (CMS) recently announced an extension of its temporary moratorium on enrolling new nonemergency ambulance suppliers in New Jersey, Pennsylvania and Texas and new home health...more

CMS Lifts Temporary Moratorium on Emergency Ground Ambulance Suppliers but Extends and Expands Other Moratoria

On July 29, 2016, CMS announced that it is lifting a temporary moratorium on Medicare Part B, Medicaid, and Children's Health Insurance Program (CHIP) emergency ambulance suppliers, but extending and expanding similar...more

CMS Announces Changes to HHA/Ambulance Supplier Enrollment Moratoria, New Exception Process Demo

CMS has announced a number of changes to its temporary Medicare enrollment moratoria for certain provider types in select geographic areas as a mechanism to address fraud, waste, and abuse. First, CMS is extending for six...more

CMS Extends and Expands Freezes on New Home Health Agencies in Four States

The Centers for Medicare and Medicaid Services (CMS) announced that, effective July 29, it extended and expanded temporary six-month moratoria on the enrollment of new Home Health Agencies (HHAs) statewide in Florida,...more

CMS Revises Enrollment-Related Provisions in the Medicare Program Integrity Manual

The Centers for Medicare & Medicaid Services (CMS) made changes to important written guidance to Medicare providers by issuing a Change Request on June 24, 2016, to Chapter 15 of its Program Integrity Manual (titled “Medicare...more

Also In The News - Health Headlines - July 2016

CMS Proposes Home Health Payment Reduction in 2017 – On June 27, 2016, CMS released a proposed rule that would decrease payments to home health providers by one percent, or $180 million, in calendar year 2017. Home health...more

OIG, CMS Focus New Scrutiny on Home Health Industry: Additional Investigative and Enforcement Activity Likely to Follow

On June 22, 2016, the Department of Health and Human Services Office of Inspector General (“OIG”) issued a comprehensive report detailing its nationwide analysis of common characteristics in home health fraud cases. In tandem...more

CMS Proposes CY 2017 Update to Medicare Home Health PPS Rates

CMS has released its proposed rule to update the Medicare home health prospective payment system (HH PPS) for 2017. CMS estimates that the policies in the proposed rule would reduce overall Medicare payments to home health...more

OIG Delivers Home Care a One – Two Punch: Release of Report and Alert on Home Health Fraud Highlights Increased OIG Scrutiny of...

On June 22, 2016, the Office of Inspector General (“OIG”) issued two communications that underscore its continued focus on fraud in home health care, along with the role of physicians as “gate keepers” in authorizing...more

CMS Announces Pre-Claim Review Demonstration for Medicare Home Health Services

CMS has announced a new three-year Medicare “pre-claim review” demonstration for home health services in five states — Illinois, Florida, Texas, Michigan, and Massachusetts — with “high incidences of fraud and improper...more

CMS Call on IMPACT ACT Standardized Patient Assessment – Patient/Family Perspective (May 12)

On May 12, 2016, CMS will host a conference call on “Understanding the IMPACT Act-Patient and Family Focused for Informed Decision Making.” The call is intended to allow patients, families, caregivers, advocacy groups, and...more

Health Law Insights Newsletter - Issue 8 - April 2016

McCarter & English, LLP’s Health Care Group presents Issue 8 of the Health Law Insights, which discusses the latest legal issues in the health care industry. NATIONAL - New Payment Model for Part B Drugs Proposed -...more

CMS Has Added a New Five-Star Ratings Tool to Help Patients Compare and Choose Among Home Health Agencies

On January 28, 2016, the Centers for Medicare & Medicaid Services (CMS) added a new and useful five-star ratings comparison tool to the Home Health Compare system. According to CMS, the new comparison tool will help patients...more

CMS Announces Extension of Moratoria on Enrollment of HHAs, Ambulance Suppliers in Designated Areas

CMS published a notice February 2, 2016 announcing an additional 6-month extension of its current temporary Medicare enrollment moratoria for new ground ambulance suppliers and home health agencies (HHAs), subunits, and...more

CMS Payment Initiatives Target Quality & Care Improvement - The Short Version

Like it or not, the Centers for Medicare & Medicaid Services (CMS) is expanding its strong commitment to focus on quality and care improvement as the basis for payment throughout the continuum of care. The final rule for the...more

10 Tips to Mitigate or Prevent Wage and Hour Litigation in the Post-Acute Industry

Wage and hour lawsuits are being filed against employers under federal and state wage and hour laws at a record rate. Most wage and hour claims allege the employer failed to pay employees for off-the-clock work, failed to pay...more

DOL Issues Guidance on Room and Board Deductions for Home Care Workers

On December 17, 2015, the U.S. Department of Labor’s (DOL) Wage and Hour Division issued guidance on permissible deductions for lodging under the Fair Labor Standards Act (FLSA), with particular emphasis on the law’s effect...more

Congressional Leaders Announce Spending/Tax Deal with Medicare and ACA Provisions; House Approves Tax Package

On December 15, 2015, Congressional leaders released sweeping spending and tax proposals, including a number of provisions impacting Medicare and the Affordable Care Act (ACA). The legislation is being considered on a fast...more

CMS Issues CY 2016 HHA PPS, Value-Based Purchasing and Quality Reporting Final Rule

On November 5th, CMS published the Final PPS Rule for Home Health Agencies (HHAs) for CY 2016. The rule implements annual changes to the PPS rates for HHAs and represents the third year in a four-year rebasing of the rates....more

CMS Call on Upcoming Home Health Value-Based Purchasing Model (Dec. 17)

On December 17, 2015, CMS is hosting an “Open Door Forum” on the Home Health Value-Based Purchasing Model (HHVBP), which begins January 1, 2016 in nine states. All Medicare-certified HHAs delivering services within these...more

OIG Work Plan Series Installment Two - Long Term Care - Nursing Homes, Hospice, and Home Health

In early November 2015, the Department of Health & Human Services’ Office of Inspector General (OIG) released its 2016 Work Plan, which includes projects specific to certain provider types. This alert will focus on the...more

Summary of CMS Proposed Rule for Discharge Planning Requirements

On November 3, the Centers for Medicare & Medicaid Services (CMS) issued a Proposed Rule that would revise the discharge planning conditions of participation (CoPs) for Hospitals, Critical Access Hospitals (CAHs), and Home...more

A New Headache for Home Care Agencies: The New York Domestic Workers’ Bill of Rights

Home care agencies in New York are acutely aware that the U.S. Department of Labor’s recent Final Rule eliminated the companionship exemption for home care agencies. But agencies may not be aware of another important—albeit...more

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