Home Health Care

News & Analysis as of

CMS Postpones Pre-Claim Review Demonstration for Home Health Services

The Centers for Medicare & Medicaid Services (CMS) announced that it would postpone the initiation of the CMS Pre-Claim Review Demonstration for Home Health Services (the “Demonstration”) in Florida, which was scheduled to...more

Morristown, New Jersey, Passes Paid Sick Leave Ordinance

Private-sector employees who work at least 80 hours during a calendar year in Morristown, New Jersey, will be entitled to paid sick leave under Ordinance No. 35-2016, passed by the Morristown Town Council on September 13,...more

Hope for Employers: Court Says Home Health Aides Can’t Bring Collective Action

Courts have been quick to allow one employee claiming to be due overtime to sue on behalf of others in the same job category by certifying a collective action, allowing that employee to represent the class and requiring the...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

Taking a Bite Out of Crime…and Maybe the Employer? OSHA Fines Company Following Criminal Assault on Employee

The Occupational Safety and Health Administration (OSHA) recently reminded us that every employer needs a violence in the workplace policy or risk citation for third party criminal actions. The OSH Act’s general duty clause...more

FLSA Conditional Certification Denied in NYS for 5,000 Home Care Workers

In a case with far reaching implications, Cowell v. Utopia Home Care, Inc., 2:14-cv-00736-LDW-SIL, Magistrate Judge Steven Locke of the Eastern District of New York (covering Brooklyn, Queens and Long island) ruled that...more

Client Alert: Medicare Home Health Payment Update: Florida and Other States are Required to Submit Their Home Health Claims for...

The Centers for Medicare and Medicaid Services ("CMS") is implementing a new pre-claim review process for home health claims in five (5) states, including Florida. Other affected states are Illinois, Texas, Michigan, and...more

Medicaid Coverage of Social Interventions: A Roadmap for States

Editor's Note: Faced with mounting evidence about the impact of social factors—such as income, access to food and housing, and employment status—on health outcomes, Medicaid agencies are looking for ways to integrate social...more

Individuals, Families, and Households and Those Who Jointly Employ Home Care Workers With Them are All Liable for Unpaid Overtime

Claims by home care workers for unpaid overtime have risen steadily since the U.S. Department of Labor, in 2015, eliminated the federal overtime exemptions that allowed agency employers essentially to pay no overtime wage...more

Health Care Market Intelligence: Post-Acute Care Summary Report - Q2 2016

Key Findings - - CMS proposed an $800-million Medicare payment increase for SNFs in FY 2017, a 2.1% increase from this year, while hospice payments would rise by $330 million, or 2%. Home healthcare agencies may see a...more

CMS Proposes CY 2017 Home Health PPS Rate, Updates to ValueBased Purchasing Model and Quality Reporting

The US Department of Health and Human Services (HHS) Centers for Medicare & Medicaid Services (CMS) released proposed updates to its Calendar Year (CY) 2017 Home Health Prospective Payment System (HH PPS) in the July 5, 2016,...more

NIOSH Offers Free Training Program to Help Employers Address Safety Risks Faced by Home Healthcare Workers

Seyfarth Synopsis: NIOSH releases a comprehensive training curriculum that home healthcare employers can use to minimize safety risks and prevent OSHA citations. We had blogged previously about OSHA’s “Strategies and...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

OSHA Hits Employer with Hefty Fine for Failing to Protect Employee from Assault by Client

A national home health care provider, doing business in York Pennsylvania as Epic Health Services, was recently issued a citation and significant fine by The Occupational Safety and Health Administration (OSHA) in connection...more

Home Health PPS CY 2017 Proposed Rule: Payments Rebased, Quality Measures Updated

Downward adjustments to home health episode payments arising from rebasing of the national payment rates, case mix adjustments, and an increase to the fixed dollar loss ratio for calculating outliers will result in an overall...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

Physical security still an issue: Pruitt Health suffers breach in break-in

The importance of physical security and the risk associated with the unauthorized access to or loss of paper records is clear from recent experiences of Pruitt Health in South Carolina. On March 2, 2016, an intruder...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 2017 Proposal Reduces Home Health Reimbursements by $180 Million

On June 27, CMS issued a proposal for the 2017 Medicare home health prospective payment system (HH PPS). CMS is proposing a $180 million reduction in 2017. This equates to a 1% drop in reimbursements for home health...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

Supreme Court Declines Review of D.C. Circuit’s Decision Upholding DOL Home Care Rule as Regulatory and Litigation Focus on Home...

On June 27, 2016, the U.S. Supreme Court denied the plaintiffs’ petition for a writ of certiorari in Home Care Association of America v. Weil, leaving the U.S. Department of Labor’s (“DOL”) Home Care Rule intact. The Home...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

Medicare Launches Home Health Pre-Claim Review Demonstration in Five States

The Centers for Medicare and Medicaid Services (CMS) recently announced it will implement a pre-claim review demonstration for home health services. The three-year demonstration will apply to home health services performed in...more

Tenth Circuit Rebukes CMS for Applying Wrong Regulations in Overpayment Action

The United States Court of Appeals for the Tenth Circuit shot down CMS’s overpayment recoupment related to physical therapy and skilled nursing services, citing multiple errors in CMS’s appeal briefing and concluding that “an...more

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