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Medicaid › Home Health Care

Medicaid is a partnership program between states and the federal government to provide healthcare coverage for lower income individuals, people with disabilities, older people, and certain families with... more +
Medicaid is a partnership program between states and the federal government to provide healthcare coverage for lower income individuals, people with disabilities, older people, and certain families with children.  less -
Husch Blackwell LLP

Hospice Insights Podcast: What’s the Latest on UPICs? Highlights from Recent Audit Activity, Part I

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UPIC activity is picking up, and the UPICs are reviving some old tactics. In this episode, Husch Blackwell’s Meg Pekarske and Bryan Nowicki discuss these trends which include extrapolation, Medicaid nursing home room and...more

Mandelbaum Barrett PC

Medicaid Final Agency Decision Reaffirms Criteria Necessary to Qualify for Caregiver Child Exception

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Certain Medicaid programs impose a transfer penalty on applicants who have transferred resources (assets) for less than fair market value within five (5) years preceding the Medicaid application. Simply stated, the transfer...more

The Volkov Law Group

Gentiva Pays $19.4 Million for False Claims Act Violations Involving Hospice Care

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Gentiva, the renamed former Kindred at Home, agreed to pay $19.4 million to resolve claims that its predecessor company, Kindred at Home and related companies, violated the False Claims Act by retaining overpayments for...more

Holland & Knight LLP

Fiscal Intermediaries Sue NYDOH Over CDPAP Reimbursement Changes

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A group of fiscal intermediaries (FIs) on July 22, 2024, filed a lawsuit against the New York State Department of Health (DOH) and its commissioner, Dr. James McDonald, alleging that the defendants disregarded established...more

Falcon Rappaport & Berkman LLP

Pooled Income Trusts for Medicaid Home Care

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One of the biggest misconceptions related to Community (Home Care) Medicaid is the idea that one thinks they and/or their loved one is not eligible for services because “they make too much money.” In New York State, for one...more

Parker Poe Adams & Bernstein LLP

Medicaid's 80/20 Rule: New Restrictions on Funding for Home and Community Based Services

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In spring 2024, the Centers for Medicare and Medicaid Services (CMS) finalized the Medicaid access rule, which includes a provision that requires that 80% of Medicaid payments for most Medicaid-funded home health aide,...more

McCarter & English, LLP

New Jersey Statutory Update Part II

McCarter & English, LLP on

Below is Part II of our New Jersey Statutory update. As you can see from the below, several statutes were passed imposing requirements on health insurance payers, including new requirements for prior authorization request and...more

Mandelbaum Barrett PC

Elder Law and Special Needs Newsletter: April 2024 Issue

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Check out our April Elder Law and Special Needs newsletter! Our legal team explores important topics including beneficiary designations and the recent updates to the Medicaid divisor, which came into effect this month....more

Bond Schoeneck & King PLLC

Enacted Budget Makes Major Changes to Consumer Directed Personal Assistance Program

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The Fiscal Year 2025 enacted budget will significantly change the Consumer Directed Personal Assistance Program (CDPAP), a program of self-directed home care that allows seniors and individuals with disabilities to hire their...more

McDermott+

Policy Update - CMS Releases Final Rule: Medicaid Program; Ensuring Access to Medicaid Services

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On April 22, 2024 the Centers for Medicare & Medicaid Services (CMS) published the Medicaid Program; Ensuring Access to Medicaid Services final rule. The rule has a particular focus on home- and community-based services...more

Polsinelli

The 80/20 Rule is Here: CMS Finalizes HCBS Care Worker Payment Requirements

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In May 2023, the Centers for Medicare and Medicaid Services (“CMS”) proposed a series of rule changes intended to help promote the availability of home and community-based services (“HCBS”) for Medicaid beneficiaries. Chief...more

Manatt, Phelps & Phillips, LLP

[Webinar] Final Medicaid Rules, Part Three: Home and Community Based Services - June 4th, 10:00 am - 11:00 am PT

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This program is part three of Manatt’s New Federal Rules on Medicaid Access and Managed Care webinar series. After releasing sweeping proposed rules on Medicaid access and managed care in spring 2023, the Centers for...more

Polsinelli

Health Care Fraud and Abuse 2023 Year in Review

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Introduction - Polsinelli proudly introduces the Health Care Fraud and Abuse 2023 Year in Review, a comprehensive examination of the evolving landscape surrounding the False Claims Act (“FCA”) and fraud & abuse enforcement...more

Chambliss, Bahner & Stophel, P.C.

Getting Help When Providing Care at Home for Aging Parents

Chambliss, Bahner & Stophel, P.C. on

As they grow older, your parents may prefer to continue living in their home rather than moving to a long-term care facility. They are not alone in this; more than three-quarters of adults over the age of 50 say they would...more

Falcon Rappaport & Berkman LLP

ELDER LAW LEGAL UPDATE: Important Changes to Social Security Income, Medicaid Resource and Income Allowances, and Regional Rates...

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The Elder Law Practice Group at Falcon Rappaport & Berkman would like to share some important Elder Law legal updates with our clients and professional partners that will impact Medicaid eligibility for applicants/recipients...more

Proskauer - Health Care Law Brief

The Key Health Care Initiatives Proposed in Governor Hochul’s Fiscal Year (FY) 2025 Executive Budget

Proskauer - Health Care Law Brief on

This year’s Health and Mental Hygiene Bill (“HMH Bill”) (part of the Governor’s FY 2025 Executive Budget, which proposes a $233 billion balanced budget), includes $35.5 billion to fund Medicaid, $4.8 billion to address...more

Lippes Mathias LLP

New York State Medicaid Updates for 2024

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Medicaid is a joint federal and state program that provides health coverage to millions of Americans. Federal law requires states to comply with certain minimum requirements, but New York is considered a maximum state in that...more

Bass, Berry & Sims PLC

Pushing a Balloon Into or Against the Jet Stream? Key Takeaways from the J.P. Morgan Healthcare Conference

Bass, Berry & Sims PLC on

The 42nd annual J.P. Morgan Healthcare Conference started with clear skies and overall optimism from investors. But with Jamie Dimon’s prediction of a recession in 2024 on Tuesday morning, the climate shifted to an on-again,...more

Harris Beach PLLC

New York OMIG Posts 2024 Work Plan

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On January 3, 2024, the New York State Office of the Medicaid Inspector General (“OMIG”) posted its 2024 Work Plan. This is the first update since its 2019 – 2020 Work Plan and OMIG notes that the Work Plan does not reflect...more

Littler

New York Department of Health Sets New Due Dates for Submission of Home Care Worker Wage Parity Compliance Certifications and...

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On September 21, 2023, the New York Department of Health (DOH) issued guidance addressing the due dates for Medicaid Managed Care Organizations (MMCOs), Certified Home Health Agencies (CHHAs), Licensed Home Care Services...more

Manatt, Phelps & Phillips, LLP

[Webinar] Proposed Rules to Enhance Access and Quality for Medicaid HCBS and Strengthen the HCBS Workforce - June 1st, 1:00 pm -...

Manatt, Phelps & Phillips, LLP on

On April 27, 2023, the Centers for Medicare & Medicaid Services (CMS) released proposed rules that, if finalized, would reshape Medicaid’s federal regulatory landscape in several ways, including with respect to home and...more

Nelson Mullins Riley & Scarborough LLP

CMS Continues Transparency Efforts for Home Health and Hospice

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The Centers for Medicare & Medicaid Services (CMS) announced on April 27, 2023, that it will publicly release all ownership information of home health and hospice agencies. This move is aimed at increasing transparency and...more

Robinson+Cole Health Law Diagnosis

CMS Proposes New Rule that Would Require 80% of Payment to Go Toward Home Care Worker Compensation

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On April 27, 2023, the Centers for Medicare & Medicaid Services (CMS) released a Notice of Proposed Rulemaking entitled Ensuring Access to Medicaid Services (Proposed Rule) which would, among other things, establish...more

Sheppard Mullin Richter & Hampton LLP

Tracking the Waivers: Implications of the Wind Down of the COVID-19 Public Health Emergency

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The White House recently announced that the COVID-19 national emergency and public health emergency (PHE) declarations will end on May 11, 2023. These declarations have been in place since the beginning of the COVID-19...more

King & Spalding

DOJ Announces False Claims Act Recoveries for FY 2022

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On February 7, 2023, the Department of Justice (DOJ) announced its annual False Claims Act (FCA) recoveries for fiscal year 2022. DOJ recovered $2.2 billion from a total of 351 settlements and judgments—the second-highest...more

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