News & Analysis as of

Home Health Agencies

OIG Evaluates Risks of Relying on Unverified Patient Lists in Home Health Surveys

by Reed Smith on

The Department of Health and Human Services, Office of Inspector General, has issued a new Risk Alert focusing on the home health agency (HHA) survey process. The alert specifically examined whether HHA-supplied patient...more

OIG Reports Reliance on HHA Patient Lists Creates Survey Vulnerabilities and Recommends CMS Action

by Arnall Golden Gregory LLP on

In March 2018, the Office of Inspector General (OIG) issued a Risk Alert, noting that some home health agencies (HHAs) provide Medicare surveyors with patient lists that are missing active Medicare beneficiaries at their...more

Certainty is on the Horizon for the New York Home Care Industry

by Littler on

The home care industry has faced collapse since a series of New York Appellate Division decisions invalidated New York Department of Labor (NY DOL) policy and held that home care attendants working 24-hour shifts who are...more

Sweeping Legislative Change for Florida Health Care Facilities

by Holland & Knight LLP on

The Florida Legislature passed a bill that makes significant changes to numerous provisions related to the regulation of various health care facilities by the Agency for Health Care Administration (AHCA). The following is a...more

Have You Properly Prepared for a WPA Audit?

by FordHarrison on

Audits of compliance with the Wage Parity Act ("WPA") are on the rise. The NYS Attorney General's Medicaid Fraud Unit, Medicaid Inspector General ("OMIG"), and Department of Labor ("DOL") are all auditing home care agencies....more

The Government’s Use of Data Analytics to Identify Healthcare Fraud

by Blank Rome LLP on

No one knows exactly how much fraudulent conduct costs the United States healthcare system. Some suggest it may cost Medicare, Medicaid, and private insurers $100 billion each year. Regardless of the exact amount, everyone...more

Trump Administration’s Proposed FY 2019 Budget Targets Medicare, Medicaid for Savings, Seeks (Again) to Repeal/Replace ACA

by Reed Smith on

The Trump Administration has released its fiscal year (FY) 2019 budget proposal, which includes extensive health policy provisions. While most of the President’s policy proposals for Department of Health and Human Services...more

Home Health Care Patients With Chronic Conditions Are Having Trouble Getting Medicare

Medicare is supposed to provide up to 35 hours a week of home care to those who qualify, but many Medicare patients with chronic conditions are being wrongly denied such care, according to Kaiser Health News. For a variety of...more

CMS Issues Temporary Enrollment Moratorium on Home Health Agencies and Non-Emergency Ambulances in Selected States

On January 29, 2017, the Centers for Medicare and Medicaid Services (CMS) announced a temporary moratorium on enrolling Part B non-emergency ambulance providers/suppliers and home health agencies, subunits and branch...more

Another Federal Court Holds Home Health Aides in NY are NOT Necessarily Entitled to Pay for Every Hour of a 24-Hour Shift, but...

by Littler on

A recent federal court decision has added to the confusion surrounding the application of the U.S. Department of Labor's (DOL) "home care" overtime rule and New York's "13-hour" rule regarding compensable work hours for...more

Workers’ Advocacy Group Seeks to Invalidate Emergency Regulation Relating to Live-In Aides

by Hodgson Russ LLP on

The Urban Justice Center, a not-for-profit advocacy group, has filed a petition with the New York State Industrial Board of Appeals, seeking to invalidate the Department of Labor’s emergency regulation regarding live-in...more

CMS Plans To Eliminate Home Health Agency Subunits in 2018

by Arnall Golden Gregory LLP on

On November 17, 2017, the Centers for Medicare and Medicaid Services (CMS) issued a Memorandum to State Survey Agency Directors outlining the process by which Medicare will eliminate existing Home Health Agency (HHA)...more

Court of Appeals Denies Motion for Leave to Appeal in a Live-In Case

by Hodgson Russ LLP on

On November 21, 2017, the New York Court of Appeals denied an application filed by Human Care LLC seeking leave to appeal the First Department’s April 11, 2017 decision that held that “live-in” aides must be paid for all 24...more

Medicare Home Health Payments to Drop by $80 Million under Final 2018 Rule

by Reed Smith on

The final CMS calendar year (CY) 2018 Medicare home health prospective payment system (HH PPS) rule cuts Medicare payments by 0.4% ($80 million) in 2018 compared to 2017 levels, but CMS did not adopt a more sweeping case mix...more

Home Health Payment Rule Published

by Baker Ober Health Law on

On November 1, 2017, CMS released the Final Rule for the 2018 home health prospective payment system rate update, including the CY 2019 case mix adjustment methodology refinements. CMS also made changes to the Value Based...more

New Home Health Rules Effective in January 2018—Some Traps for the Unwary

The Centers for Medicare & Medicaid Services (CMS) have issued new Conditions of Participation (CoP) for home health agencies (HHA) that are effective January 13, 2018. The CoP were originally scheduled to take effect on...more

House and Senate Tax Reform Bills May End Fringe Benefits Frequently Used to Satisfy Wage Parity Act Requirements

by Hodgson Russ LLP on

On November 9, 2017, the House Ways and Means Committee approved H.R. 1, the “Tax Cuts and Jobs Act”, which is anticipated to go before the House for a vote later this week. The same day, Senate Finance Committee Chairman...more

Final Home Health Rule Drops Controversial Proposed Payment Model

by Bass, Berry & Sims PLC on

Last week, home health agencies welcomed the Centers for Medicare & Medicaid Services' (CMS) decision to drop a controversial proposed payment model and leave largely unchanged the current payment system. Responding to...more

New York 13 Hour Rule

The New York State Department of Labor (DOL) adopted an emergency temporary regulation on October 6, 2017 to address home care aides who work shifts of 24 hours or more. This action comes amidst much anxiety in the industry...more

Draft Interpretive Guidelines for COPs for Home Health

The Centers for Medicare & Medicaid Services (CMS) has released a draft of interpretive guidelines (Guidelines) to the Home Health agency Conditions of Participation (the COPs). After having previously been delayed, the COPs...more

No Pay to Sleep or Eat on the Job: New York State Department of Labor Issues an Emergency Regulation for Home Care Workers

by Farrell Fritz, P.C. on

The New York State Department of Labor (the “DOL”) issued an emergency regulation clarifying its minimum-wage rules regarding home care employees. The emergency regulation provides that sleep and meal times for home care...more

DOH Releases Fiscal Intermediary Authorization Application

by Hodgson Russ LLP on

The Department of Health has released the long awaited Fiscal Intermediary (FI) Authorization Application (Application). Pursuant to legislative amendments enacted in the 2016-2017 NYS budget, all FIs currently operating in...more

NYDOL Issues Explanatory Statement on Recent Wage Order Amendment Codifying its Longstanding Interpretation of the "13-Hour Rule"

by Littler on

As we reported earlier this month, the New York State Department of Labor (“NYDOL”) issued an amendment, effective October 6, to its Minimum Wage Order for Miscellaneous Industries and Occupations to clarify that bona fide...more

New York Department Of Labor Issues Emergency Minimum Wage Regulations Regarding Home Healthcare Attendants, Controverting Recent...

by Jackson Lewis P.C. on

Citing the need “to preserve the status quo, prevent the collapse of the home healthcare industry, and avoid institutionalizing patients who could be cared for at home,” the New York Department of Labor (NYDOL) has issued...more

Return of the Living Dead: Could Unsuccessful California Bills Haunt Employers in 2018?

by Littler on

As discussed in our prior article, Governor Jerry Brown recently signed several significant labor and employment measures into law in California, including a statewide ban-the-box provision and an expansion of parental leave...more

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