CMS forum provides noteworthy updates about HEART and quality reporting training

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To address concerns raised during pilot testing for its planned comprehensive hospice assessment tool, CMS has decided to delay further testing phases.
But CMS is working diligently to retool the Hospice Evaluation and Assessment Reporting Tool (HEART) and plans to hold quarterly special open door forums beginning in September in an attempt to solicit public comments.
During its July 11 open door forum, CMS provided detailed updates about HEART and also …

Proposed Home Health PPS rule calls for $400-million payment increase, details new payment model

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Adjustments to Medicare’s home health payments under the 2019 proposed PPS rule would increase agencies’ total reimbursement by an estimated 2.1%, or $400 million.
By comparison, the 2018 PPS final rule included a 0.4%, or $80 million, payment reduction.
The proposed payment change reflects a 2.1% home health payment update percentage; a 0.1% increase due to decreasing the fixed-dollar-loss ratio in order to pay no more than 2.5% of total payments …

CMS to discuss proposed PPS rule during upcoming home health forum

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CMS has scheduled a home health, hospice and durable medical equipment open door forum for 2 p.m. to 3 p.m. EST July 11.
During the call, CMS officials will discuss the proposed 2019 PPS rule for home health and make announcements related to the home health and hospice CAHPS surveys. Officials also will discuss an MLN Matters article related to improvements in hospice billing and claims processing.

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

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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 …