Archives: Home Health Agencies

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Providing Patient Written Plan of Care Eliminated from The Joint Commission’s Standards for Deemed Home Health Agencies

The Joint Commission announced that it will eliminate a requirement of deemed home health organizations to provide the personalized written plan of care to patients. The announcement follows a communication from CMS that it will no longer require that the individualized written plan of care be given to the patients, as written in §484.60 of the Home Health Services Conditions of Participation.   Effective April  30, 2018, the Joint Commission will no longer score organizations on whether they fail to give their patients a written individualized plan of care.…

Private Equity Firm Named as Defendant in False Claims Act Case Targeting A Portfolio Company

A recent complaint filed by the United States Department of Justice against a private equity firms regarding an alleged kickback further illustrates new concerns private equity should be aware of in the healthcare arena and working with counsel to mitigate such concerns.  A February 23, 2018 press release from the DOJ regarding United States ex rel. Medrano and Lopez v. Diabetic Care Rx, LLC dba Patient Care America, et al., No. 15-CV-62617 (S.D. Fla.), available here, describes how the complaint was made against a pharmacy, several of its executives …

CMS Issues Temporary Enrollment Moratorium on Home Health Agencies and Non-Emergency Ambulances in Selected States

On January 29, 2017, the Centers for Medicare and Medicaid Services (CMS) announced a temporary moratorium on enrolling Part B non-emergency ambulance providers/suppliers and home health agencies, subunits and branch locations in Florida, Illinois, Michigan, Texas, Pennsylvania and New Jersey.  CMS is taking this measure “to prevent and combat fraud, waste and abuse.”  The moratorium also extends to the Medicaid and Children’s Health Insurance Programs (CHIP).  According to CMS, the action is taken pursuant to Sections 1866(j)(7), 1902(kk)(4), and 2107(e)(1)(D) of the Social Security Act and CMS regulations at 42 …

CMS Announces First Advanced Alternative Payment Model Under MACRA: Bundled Payments for Care Improvement Advanced

On January 9, 2018, the Centers for Medicare & Medicaid (CMS) Center for Medicare and Medicaid Innovation announced a new voluntary bundled payment model called Bundled Payments for Care Improvement Advanced (BPCI Advanced).  BPCI Advanced is the first Advanced Alternative Payment Model (Advanced APM) launched under the Quality Payment Program that was implemented as part of the Medicare Access and Chip Reauthorization Act (MACRA). …

Draft Interpretive Guidelines for COPs for Home Health

The Centers for Medicare & Medicaid Services (CMS) has released a draft of interpretive guidelines (Guidelines) to the Home Health agency Conditions of Participation (the COPs).  After having previously been delayed, the COPs are set to be implemented January 13, 2018.  While feedback is being solicited on the draft and final guidelines have yet to be released, agencies should begin preparing in the event that no further delay is provided.

While information is provided on all of the COPs, examples of the topics guidelines are provided for include OASIS, patient …

New York 13 Hour Rule

The New York State Department of Labor (DOL) adopted an emergency temporary regulation on October 6, 2017 to address home care aides who work shifts of 24 hours or more.  This action comes amidst much anxiety in the industry caused by recent case law which called into question a prior DOL opinion letter as not being a proper interpretation of existing laws and regulations.  In the DOL’s own words, the reason for this emergency temporary regulation is as follows:

This emergency regulation is needed to preserve the status quo, prevent …

CMS Proposes Delay of Home Health Agency Conditions of Participation

The Centers for Medicare & Medicaid Services (CMS) is proposing to delay the effective date for the revised Conditions of Participation (CoPs) for Home Health Agencies (HHAs).  The original effective date was July 13, 2017.  The proposed delay would extend the effective date for an additional six months, until January 13, 2018.  In a previously published post, we discussed the HHA CoPs.…

CMS Revises Process for Reporting Stark Law Violations and Posts New SRDP Forms

On March 28, the Centers for Medicare & Medicaid Services (CMS) revised the procedures and posted new forms for its Voluntary Self-Referral Disclosure Protocol (SRDP).  The SRDP is a mechanism established pursuant to the Affordable Care Act for health care providers and suppliers to facilitate settlement of violations of the physician self-referral law (Stark Law).

Under the Stark Law, physicians (or their immediate family members) who have a financial relationship with an entity are prohibited from making referrals to that entity for certain designated health services (DHS) that are payable …

CMS Updates Home Health Agency Conditions of Participation

On January 13, 2017, the Centers for Medicare and Medicaid Services (CMS) published a Final Rule updating the home health agency (HHA) Conditions of Participation (CoPs).  HHAs only have until July 13, 2017 to implement these extensive changes. CMS revised the CoPs to focus on a “patient-centered, data-driven, outcome-oriented process that promotes high quality patient care at all times for all patients.”

Below are some of the most significant changes to the CoPs for home health agencies (HHAs) — the Final Rule:…

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