Category: Home Health

Home Health, News, Payment/economy

MAC Palmetto GBA releases many claims that were ‘incorrectly suspended’

Brought to you by Home Health Line.
Many home health agencies were taken aback in early June after receiving what appeared to be additional documentation requests (ADRs) from SafeGuard Services LLC, a Unified Program Integrity Contractor (UPIC).
But it appears some claims were “incorrectly suspended,” according to a post on Medicare Administrative Contractor (MAC) Palmetto GBA’s website.
UPICs help address fraud, waste and abuse by performing regional Medicare and Medicaid data analysis, complaint resolution and investigative activities, according …

Home Health, News, Skilled Nursing Facility

CMS offers guidance for treating and funding better care for opioid addicts

On June 11, CMS released guidance aimed at partnering with states to ensure they have the necessary tools to address the opioid crisis. According to CMS:
This new guidance provides information to states on the tools available to them, describes the types of approaches they can use to combat this crisis, ensures states know what resources are available, and articulates promising practices for addressing the needs of beneficiaries facing opioid addiction. Notably, CMS released an Informational …

Home Health, News, Payment/economy, Skilled Nursing Facility

Reimbursement increased by 77% for brand-name Part D drugs

Brought to you by BALTC.
According to a report published by the OIG this month, total reimbursement for all brand-name drugs in Part D increased 77% from 2011 to 2015, despite a 17% decrease in the number of prescriptions for these drugs. After accounting for manufacturer rebates, reimbursement for brand-name drugs in Part D was found to have still increased 62% from 2011 to 2015.
The OIG conducted their review following concerns about the increase in …

Home Health, ICD-10, News

Breaking News: CDC releases final list of 2019 ICD-10-CM codes

Brought to you by Home Health Line.
Providers will have a total of 473 code changes beginning Oct. 1, including 279 new codes, 143 revised codes and 51 deactivated codes, according to the final list of changes issued June 11 by the Centers for Disease Control and Prevention.
The majority of the new codes added to the final update are codes describing exploitation of children and adults, such as T76.51xD (Adult forced sexual exploitation, suspected, subsequent encounter) …