Home Health Care

News & Analysis as of

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

11 Questions to Ask a Potential Caregiver

If you've decided to hire a caregiver for a person with special needs, you'll need to interview the candidates. Here are eleven important questions to ask...more

Health Law Insights Newsletter - Issue 9 - May 2016

NATIONAL - Medicare Proposes New Part B Payment System - The Center for Medicare and Medicaid Services (CMS) on April 27 proposed a new rule that would transform Medicare Part B reimbursement to practitioners into...more

Reforming Medicaid Could Become Toughest Job Ever for Baker Administration

Anyone who follows politics or government in Massachusetts has seen these numbers. They bear repeating: - ..Over the past seven years, spending on Medicaid (MassHealth) has increased 65%. ..Next year, total...more

MedPAC Publishes Report to Congress on 2017 Policies, Recommends Payment Reforms and Cuts to Part B Payments to Hospitals for 340B...

On March 15, 2016, MedPAC submitted its 2016 annual report to Congress on Medicare payment policies for 2017. In the Report, MedPAC makes a number of recommendations to Congress pertaining to payment under Medicare...more

Five Challenges Facing Employers in the Health Care Industry

Employers in the health care industry are facing a number of looming threats. Workplace violence is one of the most serious occupational hazards facing health care workers, while cyber-attacks pose a significant threat to the...more

February 2016 Independent Contractor Compliance and Misclassification News Update

In February 2016, two federal appellate courts ruled in favor of companies in IC misclassification cases: one where the NLRB was reversed in a decision where the agency had found stagehands to be employees and not ICs; the...more

Also In The News - Health Headlines - February 2016

CMS Extends Home Health and Ambulance Company Moratorium – Effective January 29, 2016, CMS is extending its temporary moratorium on the enrollment of new Medicare ground ambulance and home health agencies within designated...more

Health Alert (Australia) - February 15, 2016

In This Issue: -Judgments; Legislation; and Reports -Excerpt from Judgments JUDGMENTS Western Australia 8 February 2016 - Martin V Minister for Health [2016] WADC 15 Mr Martin...more

ALJ Upholds $239,800 In Civil Monetary Penalties For HIPAA Violations

Home health care provider Lincare, Inc. must pay $239,800 in civil monetary penalties for violations of the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) Privacy Rule, according to a February 3, 2016...more

Health Care E-Note - February 2016

The U.S. Department of Justice (“DOJ”) has a new view in cases involving corporate wrongdoing (including fraud and abuse, qui tam, and similar matters). And its gaze is focused squarely on rooting out and punishing the...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 Finalizes Medicaid Home Health and Medical Equipment Policy Changes, Including Face-to-Face Encounter Requirements

CMS published a final rule on February 2, 2016 to implement statutory requirements regarding documentation of face-to-face encounters with Medicaid beneficiaries within certain timeframes as a condition of Medicaid coverage...more

Latest OCR Enforcement Action: Underbed Storage is Not Appropriate for PHI

Recent enforcement actions by the U.S. Department of Health and Human Services (“HHS”) Office for Civil Rights (“OCR”) have highlighted that, not surprisingly, Covered Entities should not leave medical records in a...more

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