Regulatory Compliance
11/14/2018
Agencies should make it a top priority to improve coding specificity and assess the use of codes that do — and do not — drive clinical groups under the Patient-Driven Groupings Model (PDGM).
11/14/2018
Reducing the number of patient hospitalizations will take on even greater importance for agencies in value-based purchasing states starting in 2019.
11/14/2018
Agencies will continue to receive one point for a patient with a secondary diagnosis of diabetes in the first equation, according to the case-mix table discussed in the 2019 PPS final rule.
11/14/2018
CMS has decided — for now — against moving forward with a plan to reduce the frequency with which it updates the Grouper software used to assign the appropriate HIPPS code used for case-mix adjustment onto claims.
11/14/2018
Most employers are required by Title VII of the Civil Rights Act and state law to guard against and respond to claims that an employee was sexually harassed by a coworker or manager. But employers also can be liable for sexual harassment of an employee by non-employees, such as sales representatives, patients or referral sources.
11/09/2018
The following OASIS items will be optional at follow-up in 2020.
11/07/2018
Agencies that wait until the last minute to prepare for the Patient-Driven Groupings Model (PDGM) may put themselves in huge financial trouble when it launches, industry experts say.
11/07/2018
Adjustments to Medicare’s home health payments under the 2019 PPS final rule will increase agencies’ total reimbursement by $420 million in 2019.
11/07/2018
by: J'non Griffin
CMS will use specific, individual patient characteristics to determine payments for home health agencies under the Patient-Driven Groupings Model (PDGM). Understanding how the revised payment system will work is crucial to understanding its potential impact on your bottom line.
11/07/2018
Based on stakeholder feedback, CMS under the final PPS rule has agreed to include inpatient psychiatric facility (IPF) stays in the institutional category for the payment system under the Patient-Driven Groupings Model (PDGM).

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