Tag Archives: outlier
Clinicians Among 30 Arrested for Home Health Fraud
Posted on 15. Dec, 2009 by .
Home care benes falsely documented as blind diabetics.
Last week we told you about an OIG report that raised concerns over the high number of outlier payments for diabetic Medicare…
Continue Reading
Don’t Count On Outliers Forever
Posted on 09. Dec, 2009 by .
CMS still may eliminate the PPS payment option entirely.
Home health agencies smarting at the looming 10 percent cap on home health PPS outlier payments may face even bigger woes ahead. If abusive billing of the outlier option continues even under the 10 percent cap…
Continue Reading
OIG Report Links Miami-Dade Home Health Outlier Payments to Diabetes
Posted on 09. Dec, 2009 by .
Medicare officials suspect kickbacks to physicians, beneficiaries.
A new HHS Office of Inspector General report targets home health outlier payments in Miami-Dade County, and legitimate home care providers worry that the crackdown will hurt some of…
Continue Reading
2010 PPS: More Cuts for Case Mix Creep Hit Home Health
Posted on 18. Nov, 2009 by .
Just how much the feds will dock your HHA for perceived upcoding may depend on the health reform battle.
Your home health agency will getting 2.75 percent less in Medicare reimbursement next year thanks to so-called “case mix creep,” and that…
Continue Reading
Final 2010 Home Health Service Rates Available
Posted on 11. Nov, 2009 by .
Watch Out: Congressional action could cut rates in near future.
As we mentioned last week, CMS issued the final home health prospective payment system update on Oct. 30. This…
Continue Reading
Home Health PPS 2010 Final Rule: 2 Percent Market Basket Update
Posted on 04. Nov, 2009 by .
We’ve got the link that gives you a preview before the rule hits the Federal Register.
It’s that time of year again. The fall…
Continue Reading
Avoid These Hospice Eligibility Pitfalls
Posted on 28. May, 2009 by .
If your hospice hasn’t taken a good look at how it determines–and documents–patients’ eligibility for the Medicare hospice benefit, you’re fair game for everything from payment recoupments to fraud and abuse investigations.
There’s no shortage of reasons for hospices to…


