Home Health
The Centers for Medicare and Medicaid Services (CMS) released the CY 2025 Home Health proposed rule, signaling that more significant cuts could be on the way for providers. The proposed…
New Edition of HHVBP Newsletter Focuses on Annual Performance Reports, Future Reporting Schedule
July 1, 2024The latest edition of the Expanded Home Health Value-Based Purchasing (HHVBP) Model newsletter is now available. CMS has announced that the preview CY 2024 Annual Performance Report (APR) will be…
The Center for Medicare & Medicaid Services (CMS) will host a virtual conference on August 7 and 8 from 12 – 4 p.m. for anyone who processes Medicare Part A…
The Centers for Medicare & Medicaid Services (CMS) has issued the Final April 2024 Interim Performance Reports (IPRs). These reports, which reflect updates to claims-based measure scores, are now available…
Medicare Provider Compliance Tips
June 3, 2024Looking for information on The Centers for Medicare & Medicaid Services (CMS) Provider Compliance Tips program? Plus, the new CMS tool provides high level guidance on how to prevent claim denials…
CMS Open Door Forum
June 3, 2024CMS held a Home Health, Hospice, and DME Open Door Forum (ODF) on Wednesday, May 22 to provide updates on the Hospice Quality Reporting Program. Members are encouraged to sign…
On May 3, 2024, The Centers for Medicare & Medicaid Services (CMS) released the following revisions to the State Operations Manual (SOM): These revisions are effective immediately; however, state survey agency…
House Labor and Industry Committee Holds Informational Hearing on the Nursing Workforce Crisis
May 13, 2024An informational hearing conducted by the House Labor and Industry Committee on the Nursing Workforce Crisis delved into the pressing challenges faced by the nursing workforce in Pennsylvania. Here are…
The Preliminary April 2024 Interim Performance Reports (IPRs) for the expanded HHVBP Model have been published on the Internet Quality Improvement and Evaluation System (iQIES). The quarterly IPRs provide HHAs…
CMS Issued Updates to Home Health Claims Processing
April 29, 2024The Centers for Medicare & Medicaid Services (CMS) has issued Change Request 14543, addressing critical aspects of home health care reporting, including county codes, notice of admission exceptions, telehealth service reporting,…
The latest MAAC Consumer Subcommittee Meeting provided an update on Shift Care Prior Authorization & Appeal Data. The presentation delved into HealthChoices through a series of insightful data sets. The…
Care Compare Quarterly Refresh – April 2024
April 29, 2024The April 2024 quarterly refresh for the Home Health Quality Reporting Program is now available on Care Compare. For this refresh, Home Health (HH) Outcome and Assessment Information Set (OASIS) will…
REMINDER: The Medicare Credit Balance Report for the quarter ending March 31 is due by April 30, 2024. CGS Administrators, LLC (CGS) will suspend all claim payments at 100% if a completed…
NEW Study: Costs and Benefits of Enhancing Private Duty/Shift Nursing Payment Rates in Pennsylvania’s Medicaid Program
April 22, 2024The Pennsylvania Homecare Association engaged The Menges Group to conduct a cost savings study for private duty nursing with a purpose of proving what an investment in increased reimbursement rates…
HHAs: Preview Reports, Star Rating Preview Reports for July Refresh Now Available in iQIES
April 8, 2024Home health providers can now access their Preview Reports and Star Rating Preview Reports for the July 2024 refresh in iQIES. For this refresh Home Health (HH) Outcome and Assessment…
With the April 15 tax deadline approaching, the Internal Revenue Service (IRS) reminds taxpayers there is still time to file their federal income tax return electronically and request direct deposit….
On March 27, CMS issued a release regarding the Biden-Harris Administration’s final rule aimed at enhancing the enrollment process and maintaining health coverage for millions of Americans under Medicaid, the Children’s Health…
How to Apply for VA Benefits
April 1, 2024PHA frequently hears from members who are supporting veterans who aren’t aware of the benefits they may be eligible for. You can support your patients and their spouses to access…
There will be a temporary pause in distributing CBRs and PEPPERs as CMS works to improve and update the program and reporting system, effective through the fall of 2024. For…
Aimed at bolstering support for caregivers of veterans, both the VA Caregiver Support Program (CSP) and Building Better Caregivers ®(BBC) have announced meaningful updates. These initiatives underscore the commitment to enhancing support networks and…
CMS Issues Revised Interpretive Guidelines for the Home Health Conditions of Participation (CoPs)
March 25, 2024The Centers for Medicare & Medicaid Services (CMS) has updated Appendix B of the State Operations Manual (SOM) to provide guidance for surveyors in assessing home health agencies (HHAs). These updates reflect…
New HHVBP Newsletter Highlights Quality Measures + PHA HHVBP Webinar Track Kicks Off March 25!
March 18, 2024Home health providers can access the March Home Health Value-Based Purchasing (HHVBP) Newsletter. This month’s edition includes information on interim performance reports, a look ahead in 2024, a review of the…
Claims Processing Issue: Claims Returning to Provider in Error Due to NOA Offline (Reason Code 19963)
March 18, 2024CGS continues to receive questions from home health providers regarding claims that were returned in error because the corresponding NOA is offline (reason code 19963). If you identify claims that…
On Friday, the Medicare Payment Advisory Commission (MedPAC) issued its March 2024 Report to the Congress: Medicare Payment Policy. As part of its annual report, MedPAC included the following home health and hospice recommendations: As a…
March is Fraud Prevention Month
March 18, 2024March is Fraud Prevention Month. Join PHA in recognizing the importance of combating fraud, waste, and abuse. We’ve compiled a list of tools and resources to assist you in staying…
On March 1, the Centers for Medicare and Medicaid Services (CMS) issued Change Request (CR) 13449 to establish and implement a new “stay of enrollment” status for Medicare-enrolled providers in an effort to…
Recently, the Centers for Medicare & Medicaid Services (CMS) Open Door Forums (ODFs) switched from phone to webinars and now include an online registration process. Last week, CMS shared the…
The Pennsylvania Office of Medical Assistance Programs (OMAP) held a Pediatric Shift Care Stakeholder Update Call on February 29, 2024 to review the refreshed Improving Pennsylvania’s Pediatric Shift Care Nursing Through Collaboration. The…
The deadline for home health agencies to submit a request for an exemption from participating in the Home Health CAHPS (HHCAHPS) Survey for the CY 2025 Annual Payment Update (APU)…
Recommendations Released to Improve Coordination of Care, Services for Children and Young Adults with Complex Needs
February 26, 2024The Shapiro Administration has unveiled a report containing recommendations aimed at enhancing the coordination of care and services for children and young adults facing complex needs. This initiative, led by the Pennsylvania Department of Human Services (DHS),…
Expanded HHVBP Model: January 2024 Interim Performance Reports (IPRs) Are Available on iQIES
February 19, 2024Home health agencies (HHAs) can now access their January Preliminary Interim Performance Reports (IPRs) for the expanded Home Health Value-Based Purchasing (HHVBP) Model in iQIES. The quarterly IPRs provide HHAs…
2021 Data Now Available for the Medicare Current Beneficiary Survey (MCBS) Chartbook
February 5, 2024CMS has added the annual update to the Medicare Current Beneficiary Survey (MCBS) Chartbook with data for 2021. The MCBS Chartbook provides the public with an interactive collection of charts and tables…
CGS: Avoid CERT No Documentation Errors
February 5, 2024CGS has identified an increase in the number of Comprehensive Error Rate Testing (CERT) reviews that receive No Documentation errors. The CERT Review Contractor assigns the No Documentation error category…
2024 HHCAHPS Survey Training Materials Have Been Posted
February 5, 2024The agenda and slides for the self-paced 2024 Introduction to the Home Health Care CAHPS (HHCAHPS) Survey training and the HHCAHPS Survey Vendor Update training are now posted under the…
PEPPER Distribution Paused
January 29, 2024The Centers for Medicare & Medicaid Services has announced a temporary pause in the distribution of the PEPPER (Program for Evaluating Payment Patterns Electronic Report) and CBRs (Comparative Billing Reports)…
MLN Matters: Refillable DMEPOS Documentation Requirements
January 29, 2024Last week, the Centers for Medicare and Medicaid Services issued an MLN Matters article on Refillable DMEPOS Documentation Requirements. Learn about the requirement to contact the patient (PDF) before you refill DMEPOS products.
CMS Home Health Cost Report Now Available
January 29, 2024The Centers for Medicaid and Medicare Services (CMS) has released a new Cost Report Public Use File (PUF) for Home Health, which includes data for 2020–2021. This report includes provider information such…
MedPAC Votes on 2024 Recommendations to Congress
January 22, 2024On January 11, the Medicare Payment Advisory Commission (MedPAC) unanimously voted to recommend cutting the home health base payment rate by seven percent in CY2025 and freezing the hospice update…
Home Health & Hospices: Medicare Credit Balance Reports Due
January 22, 2024As a reminder, the Medicare Credit Balance Report for the quarter ending December 31 is due by January 30, 2024. CGS will suspend all claim payments at 100% if a completed CMS-838…
Quarterly HHCAHPS Survey Results Reported on Care Compare
January 22, 2024Home health agencies (HHAs) are informed that Home Health Care CAHPS (HHCAHPS) Survey results from July 2022 to June 2023 are now accessible on the HHCAHPS website under the “Survey Preview Report”…
CMS Shares Updates OASIS Q&As
January 22, 2024The January 2024 CMS OASIS Quarterly Q&As are now available on the CMS QTSO webpage. In this addition, CMS addresses changes to OASIS as a result of the CY 2024 Home Health Final Rule.
Now Available: Updated Guide to Home Health Help Desks
January 22, 2024The updated guide to Home Health Help Desks is now available in the “Downloads” section of the Home Health Quality Reporting Program Help Desks webpage.
Reminder: Don’t Let Your Agency Credentials Expire!
January 15, 2024Don’t let license and credential expirations put a damper on your 2024 business plans! Take a moment this week to add a calendar reminder OR double check an existing calendar…
Now Available in iQIES – Preview Reports and Star Rating Preview Reports for the April 2024 Refresh
January 15, 2024For this refresh, Home Health (HH) Outcome and Assessment Information Set (OASIS) measures have been updated. For additional information, please see the HH Quality Reporting Training webpage and the Home Health Data Submission…
Home Health CAHPS Survey Exemption Request Due March 31
January 15, 2024The deadline for home health agencies to submit a request for an exemption from participating in the Home Health CAHPS (HH CAHPS) Survey for the CY 2025 Annual Payment Update (APU) is…
CMS has released the expanded Home Heath Value-Based Purchasing Technical Expert Panel (TEP) Report. This report provides a summary of the TEP’s input on health equity approaches, performance measures, measure weights, and…
CMS Releases Draft OASIS-E1 Instrument
January 8, 2024Last week, the Centers for Medicare & Medicaid Services (CMS) released the draft OASIS-E1 All Items instrument, scheduled for an effective date of January 1, 2025. The accompanying OASIS-E1 Manual is…
Home Health EVV Implementation Approaching – Here’s What You Need to Know for Jan. 1
December 18, 2023The January 1, 2024, implementation date for electronic visit verification (EVV) for home health care services (HHCS) is quickly approaching. As a reminder, the use of EVV applies to all providers…
Medicare Program Integrity Manual: CY 2024 Home Health Prospective Payment System Updates
December 18, 2023The Centers for Medicare and Medicaid Services (CMS) issued updates to Pub 100-08 Medicare Program Integrity Manual on December 7, 2023. The updates below are effective January 1, 2024. Medicare…
UPDATE: Changes to the Interstate Nurse Licensure Compact
December 4, 2023The Pennsylvania Department of Health (DOH) issued an important update to the multistate licensure (MSL) requirements regarding home care and hospice effective November 30, 2023. The Department will no longer require…