Appeals backlog slowly reduced, percentage of unfavorable rulings concerning

By Home Health Line.
While the backlog of home health appeals at the Administrative Law Judge level is steadily being chipped away, data show a low reversal rate for appeals.
In 2018, 54,875 home health appeals have been dismissed. That is compared to 958 dismissals in 2017 and 731 in 2016, according to an analysis from the National Association for Home Care & Hospice (NAHC).
The dramatic jump in dismissed appeals in 2018 is primarily because of large …

Yale studies approach to patient-centered care that involved a critical conversation with patients

Researchers at Yale, New York University School of Medicine, and Baylor College of Medicine recently studied an approach to patient-centered care that involves tailoring healthcare of seniors to senior’s desires.
The approach, which was studied and published in the Journal of American Geriatric Society, included a structured, 30-minute conversation with patients in primary care practices. The information focused on patient’s values, helath goals, what they consider helpful versus burdensome care, and one problem they consider most …

CMS publishes corrections to RUG-IV federal per diem rates & MDS item in SNF PPS final rule

By The Bottom Line.
The Centers for Medicare & Medicaid Services published the following summary of errors published in the FY2019 SNF PPS final rule:

In Tables 6 and 7 on pages 39170 through 39172, we made errors in copying values into the “total rate” column of the tables used in the final rule preamble, so the numbers in this column did not accurately reflect the total case-mix adjusted federal per diem rates.
On page 39222, we made …

CGS to hold webinar about RAPs

By Home Health Line.
Medicare Administrative Contractor (MAC) CGS is holding a webinar 1 p.m. to 2 p.m. EST Nov. 15 to discuss a transmittal that provides instructions to MACs about monitoring home health agencies’ misuse of requests for anticipated payment (RAPs).
“We will discuss the implications to you as a home health provider,” CGS’ calendar of events states. “Please plan to join us and alleviate some of your concerns about this new process as we approach …