Archive for 'Breaking News'

RACs: Watch Out for These Home Care Reviews in 2014

Posted on 17. Jun, 2014 by .

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Once the RACs start looking at your claim, they’ll check out everything including F2F documentation, technical items, and more.

Early in 2014, three of the four Medicare Recovery Audit Contractors (RACs) – CGI, Connolly and Healthdata Insights – announced two issues for home health agencies:

a)      Home health medical necessity and conditions to qualify for services

b)      Skilled Nurse Length of Stay.

Broad audit review could be challenging for HHAs

The issue of medical necessity taken up by the three MACs is very broad and could be a problem, according to experts. As many wonder how the RACs will go about determining how to select claims for ‘medical necessity’ review, you need to watch your steps because once the RACs start looking at your claim, they will review everything including face-to-face documentation, technical items, among others.

While checking medical necessity, the medical record will be reviewed to check that the home health services were both reasonable and medically necessary and that the patient met the conditions to qualify for home health services. (more…)

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Shortage of Quality Palliative Care Alarms Canadian Cancer Society

Posted on 09. Jun, 2010 by .

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The needs of patients who choose to die at home often ignored.

There is not enough quality palliative care available for dying cancer patients in Canada, according to a special report by the Canadian Cancer Society (CCS) on end-of-life care. This, despite cancer being the leading cause of death in the country (29 percent).

“Uniform, high-quality support for any person dying of cancer should be available no matter where they live,” says Heather Chappell, Director, Cancer Control Policy, CCS. Depending on where the person lives in Canada, the type and quality of care to ensure that (more…)

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Young White Adults Show Increased Incidence of Lower Stomach Cancer

Posted on 26. May, 2010 by .

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Study suggests new infection patterns may have been unmasked.

More whites ages 25 to 39 develop cancer of the lower stomach, said researchers from the National Cancer Institute (NCI) of the National Institutes of Health. They noted, however, that cases have lowered overall in American adults.

(more…)

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Health Reform Law to Boost Hospice Care Popularity Among Patients

Posted on 19. May, 2010 by .

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Medicare requires giving up all curative treatments, which turns people off.

Medicare offers hospice care to any terminally ill individual with only six months or less to live. But many people refuse to join the program, because of one simple requirement: give up curative treatment. (more…)

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Face-To-Face Encounters Affect Both HHAs And Hospices

Posted on 19. May, 2010 by .

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And HHAs may be on the hook retroactively.

If you were breathing a sigh of relief that your home health agency wouldn’t have to worry about face-to-face encounters after CMS’s announcement in the last Open Door Forum that they didn’t apply to agencies, suck that breath back in. (more…)

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Hospices Turn to Health Law for Hope

Posted on 12. May, 2010 by .

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Ten-million-dollar cut in Medicare reimbursements may trigger reduced services.

Despite the hard-hitting $10 million decrease in Medicare reimbursements this year, hospice and palliative care facilities clung to the recently passed health bill for some hope. The bill reduced the cut to $6.8 million, but health care experts cite some bad news.

(more…)

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Licensure & Accreditation Documentation Hits More Home Health Agencies

Posted on 05. May, 2010 by .

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Get the latest on add-on payments, diabetic supplies and more in this home health industry news round-up.

Home health agencies served by Palmetto GBA were first out of the chute for a new licensure and accreditation check, but Cahaba GBA agencies aren’t far behind. (more…)

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Sneak a Peek at New 2011 ICD-9 Codes for Home Care

Posted on 28. Apr, 2010 by .

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Welcome new pneumonia, fluencey disorder, and cystostomy complication codes.

It’s that time of year — the Centers for Medicare & Medicaid Services has unveiled the proposed changes to the hospital inpatient prospective payment systems, giving us the first look at the ICD-9 changes for 2011. So, what goodies are in store for home health coders?

Influenza with Pneumonia

Well, you’ll see a beefed up 488.0x (Influenza due to identified avian influenza virus) and 488.1x (Influenza due to identified novel H1N1 influenza virus). The co-operating parties found that these subcategories didn’t provide the level of detail that category 487 (Influenza) does, so they expanded the codes at 488.0 and 488.1. The result is 6 new influenza with pneumonia codes for the 2011 ICD-9 update: (more…)

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Older Cancer Patients Need More Attention

Posted on 21. Apr, 2010 by .

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Nurses play a key role on identifying issues for better treatment and management.

How do we best care for older cancer patients? The National Cancer Institute (NCI) reports in a bulletin that there are very few resources available today to help with these patients’ treatments. This despite the fact that people 65 years and older make up about 60 percent of cancer patients, and account for 70 percent of annual cancer death. (more…)

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Health Care Reform Brings Changes to Rural Add-on, Outlier Calculations

Posted on 21. Apr, 2010 by .

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Pay for performance is on the horizon.

The biggest home care cuts in the recently enacted health care reform package are years away, but other reductions and burdensome requirements will hit next year.

The good news: The 3 percent rural add-on takes effect this month, noted Lori Anderson with the Centers for Medicare & Medicaid Services at the National Association for Home Care & Hospice’s March on Washington annual meeting.

(more…)

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