The Centers for Medicare & Medicaid Services reported the Targeted Probe and Educate program (TPE) program resumed after being suspended in March 2020 due to the COVID-19 public health emergency (PHE). Here's what your agency need to know.
In the 2020 Patient-Driven Groupings Model (PDGM) environment, LUPAs will become even more complicated with the introduction of the multifaceted structure of visit requirement variables. Like so many other aspects of PDGM, this change in calculation requires your attention.
The Patient-Driven Groupings Model (PDGM) is the most significant change to the home health payment reform in the past two decades. The impact from PDGM is expected to significantly shift service delivery and will change the structure of home health reimbursements. A key component for calculating payment under PDGM...
The Office of Inspector General (OIG) is reviewing payments under the Post Acute Transfer (PACT) policy again. Why? The OIG wants to ensure claims are properly paid by the MACs with the controls they have put into place through claim editing. The OIGs follow-up will determine whether
The Patient-Driven Groupings Model (PDGM), is the most significant change to the home health payment reform in the past 20 years. PDGM completely alters the methodology for calculating payments, and an example of this is the removal of therapy utilization as a component and the payment periods have been reduced from 60 to 30-days...
Although the January 1, 2019 implementation date has come and gone, agencies should not lessen their focus on accurate OASIS-D data set collection. Just like any new process, agencies need to provide support through this OASIS-D learning curve. In addition to developing new assessment practices, clinicians are learning guidance that often conflict between items that assess the same functional activity.
Cash flow maintenance is paramount to sustaining any health care provider, especially through this era of rapid policy change and regulation. Organizations attempting to go through transitional phases such as process realignment and systems implementation are especially susceptible to reduced cash flow, both during and following these transitions...
The home care provider was experiencing a high LUPA rates that consistently exceeded 15%. A staffing shortage, particularly with nurses, combined with communication challenges throughout made it difficult to achieve positive patient outcomes.
Wayne, Pa. (October 9, 2018) – McBee Senior Clinical Consulting Manager, Dawn Cheek, RN, BSN, will present, “Are You Paying Attention to ADRs and Denials? Tips for Addressing ZPIC Issues,” during the 2018 Clinical Conference for Hospice & Home Care, hosted by the Home Care & Hospice Association of NJ (NJHCH). The conference will take place November 13 [...]
