News & Analysis as of

Reimbursements Home Health Care

Dentons

Ep. 32 – An Easy Audit Tip to Help Avoid Overpayments

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Looking for a simple, easy-to-implement way to lower your risk of overpayments? We have one on this week’s podcast!...more

McCarter & English, LLP

New Jersey Statutory Update Part II

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

Segal McCambridge

Deciphering Reimbursement: Insights from the Central Home Health Care Servs Inc v. Progressive Mich Ins Co Decision

Segal McCambridge on

Introduction - The Michigan Court of Appeals has concluded that for purposes of MCL 500.3157, providers of in-home healthcare services are not subject to reimbursement based on their charge description master or other...more

Benesch

2024 Outlook: Behavioral Health Trends

Benesch on

Healthcare systems are facing significant challenges in recruiting and retaining talent within the burgeoning field of behavioral health services, primarily due to competition from telehealth providers and inconsistent...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

Arnall Golden Gregory LLP

AGG Talks: Home Health & Hospice - Reimbursement Audits and Appeals

In this episode, Jason Bring, AGG Healthcare partner and co-chair of the Post-Acute & Long-Term Care team, and Lanchi Nguyen Bombalier, AGG Healthcare partner and member of the Post-Acute & Long-Term Care, Hospitals & Health...more

Arnall Golden Gregory LLP

Community-Based Palliative Care Models and Trends

For too long, many have talked about the need for community-based palliative care programs as both a precursor to hospice care and even as a stand-alone service. Sure, some have given it a go, but for many others, without...more

Morrison & Foerster LLP

Quarterly Cartel Catch-Up: Recent Developments in Criminal Antitrust for Busy Corporate Counsel - Q1 2022

Since the last edition of the QCC, there has been a series of dramatic developments in the criminal antitrust enforcement space in the U.S. from the Department of Justice’s Antitrust Division (Division)....more

The Volkov Law Group

Antitrust Division Indicts Four Individuals for Wage Fixing in Labor Markets (Part III of III)

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Criminal antitrust is burning a path in prosecuting illegal wage-fixing agreements in labor markets.  The Justice Department warned companies over five years ago and now DOJ is executing on its warning.  Over the last two...more

Baker Donelson

Proposed CY 2022 Home Health PPS Rule Would Expand Value-Based Purchasing Model and Seeks to Gather Health Equity Data Through...

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On July 7, 2021, the Centers for Medicare & Medicaid Services (CMS) published its proposed rule to update the Calendar Year (CY) 2022 Home Health Prospective Payment System (HH PPS) and Value-Based Purchasing (HH VBP)...more

Foley & Lardner LLP

Home Health and Hospice Joint Ventures: An Accelerating Trend

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At the annual Home Care 100 Conference this past week, I had the pleasure of moderating a panel of top executives in the home health, hospice, palliative, and integrated primary care business models discuss leading trends in...more

Williams Mullen

A New Year and We Will “Ring In” Even Lower PCS Reimbursement Rates: Time for Litigation?

Williams Mullen on

I received an email today from an owner of a home care agency that reminded me that, especially during the holidays, many people are struggling. This home care agency owner, “we will call him Al,” informed me that he...more

Baker Donelson

CMS's Use of Contractors to Determine "Sustained or High Level of Payment Errors" Upheld

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In a decision handed down on July 23, 2013, the United States Court of Appeals for the D.C. Circuit upheld the use by CMS of outside contractors to determine whether a home health agency’s reimbursement claims had exhibited a...more

McDermott Will & Emery

CMS Releases Proposed Calendar Year 2014 Updates to Home Health Prospective Payment System

On June 27, 2013, the Centers for Medicare & Medicaid Services (CMS) released its proposed Calendar Year 2014 rate update to the Home Health Prospective Payment System. In addition to reducing reimbursement rates, CMS is...more

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