Regulatory Compliance
09/25/2017
The way Texas and Florida agencies reacted to the recent catastrophic hurricanes should serve as a valuable lesson learned for all agencies when preparing for similar events and for complying with pending emergency preparedness Conditions of Participation (CoP).
09/25/2017
Agencies that have struggled with probe-and-educate reviews or pre-claim reviews now have another weapon in their arsenal to ensure documentation they’re seeking to submit meets Medicare’s requirements.
09/25/2017
Examine how frequently the primary diagnoses you list will be deemed “questionable encounter” codes under the Home Health Groupings Model (HHGM). As needed, train staff to query physicians for more specific information so you can avoid red flags for auditors today that will lead to claims being bounced back under the HHGM.
09/25/2017
CMS has granted disaster-related exceptions under certain Medicare quality reporting and value-based purchasing programs to home health agencies, hospices and many other types of providers in areas affected by hurricanes Harvey and Irma.
09/18/2017
Following a recent DecisionHealth webinar about readiness for CMS’ Condition of Participation (CoP) involving patient rights, agencies asked questions of attorney Elizabeth Pearson of Pearson & Bernard in Edgewood, Ky. Here are some of Pearson’s answers.
09/18/2017
A new tool from CMS provides instruction to help agencies comply with rules for face-to-face encounters, plans of care, homebound status, the need for skilled care and certification requirements.
09/18/2017
A recent decision by a U.S. District Court in Texas has killed white collar exemption changes for now, meaning agencies won’t be required to pay overtime based on salary exemption levels more than double what they once were.
09/18/2017
Examine how frequently the primary diagnoses you list will be deemed “questionable encounter” codes under the Home Health Groupings Model (HHGM). As needed, train staff to query physicians for more specific information so you can avoid red flags for auditors today that will lead to claims being bounced back under the HHGM
09/07/2017
According to U.S. Immigration and Customs Enforcement (ICE), most common mistakes on I-9 forms can be avoided by ensuring the following.
09/04/2017
If you’re one of the agencies that had high denial rates in CMS’ probe-and-educate review, brace yourself. Some agencies will have 20 to 40 claims reviewed for face-to-face documentation among other things this fall as part of CMS’ next step in the probe-and-educate process.

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