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Understanding Place of Service Requirements Under Medicare Part B

Medicare Part A covers nursing home care for a beneficiary’s stay of up to 100 days in a skilled nursing facility (SNF). If nursing home care is still needed after the 100 days or the beneficiary did not qualify for a Part A SNF stay, Medicare Part B may provide coverage for certain medical and other health care services. However, Part B does not …

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Why Home Care Can Still Define Medicare Advantage in 2020

In November, the Better Medicare Alliance and actuarial consulting firm Milliman dropped their latest report detailing how Medicare Advantage (MA) plans were acting on the expanded supplemental benefits rules federal policymakers established over the past couple of years. Home care executives devoured the report, but came away feeling somewhat …

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Physician, NAHC Make Case for Home Care Coverage Under Medicare

Over the past few years, non-medical home care has become a pillar service within the broader health care continuum for its ability to improve outcomes and increase patient satisfaction. Due to that success, some believe home care should be covered under Medicare, just like home health or hospice care. Dr. Laurie Archbald, an associate professor … …

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ResMed Resolves False Claim Act Allegations

BIRMINGAHAM, Ala. (January 15, 2020)—The Department of Justice announced Wednesday, Jan. 15, 2020 that ResMed Corp. agreed to pay more than $37.5 million to resolve alleged False Claims Act violations. The company was accused of paying kickbacks to durable medical equipment (DME) suppliers, sleep labs and other health care suppliers.

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The Top Home Health Trends of 2020

In all likelihood, 2019 will go down as one of the most important years in Medicare-certified home health care history. While many industry-shaping changes didn’t officially begin last year, 2019 did set the stage for several new regulatory and business trends in 2020. Almost all of those trends are somehow linked to the Patient-Driven Groupings … …

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Home Health Insiders Hearing About Agency Exits Less Than 10 Days into PDGM

We’re less than 10 days into the Patient-Driven Groupings Model (PDGM), but already some industry experts are hearing about the forthcoming shutdown of home health agencies. PDGM — the biggest home health reimbursement overhaul in two decades — began on Jan.1. “Right now, it’s really early to see some of these scenarios,” Mike Dordick, president … …

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CMS Proposal Takes Home Health Agency Closure Estimates and 'Lights Them on Fire'

After federal health care policymakers fine-tuned the Patient-Driven Groupings Model (PDGM) last October with a 6.42% cut based on certain behavioral assumptions, some industry experts predicted there would be a modest uptick in home health bankruptcies in 2020. “The last time the industry went through this kind of major change was in the late …

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Lifesprk Partnership Helps North Memorial Lower Its ReHospitalization Rate by 47% -

Minneapolis-based North Memorial Health has partnered with Lifesprk, a holistic home care provider also based in Minneapolis, to help serve the health system’s rapidly aging patient population. And the partnership is already seeing some impressive results in terms of lowering re-hospitalization rates and ER utilization The goal of the partnership — …

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The Digital Evolution of Clinical Care

Baton Rouge and Lafayette, Louisiana, may not rival Silicon Valley when you think about technological breakthroughs or digital innovation in health care. But, thanks to investments by home health care giants headquartered in the Bayou State, meaningful change in clinical care is moving forward across the industry.   Indeed, the financial …

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Hospice Rebrands as Community Healthcare of Texas

Community Hospice of Texas, the largest nonprofit hospice provider in the Lone Star State, has rebranded as Community Healthcare of Texas, reflecting a growing trend of hospices updating their brands to reflect an expanding scope of services in anticipation of value-based payment models.  The Community Healthcare of Texas rebranding reflects the …

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