Advantage Healthcare Consulting

09/18/2018

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Are you in the nearly 40% of hospices not reporting volunteer services coordination?

Medicare is getting serious about hospice cost reporting, and that focus is likely to translate into payment changes sooner than you might think.

In the 2019 hospice payment final rule, the Centers for Medicare & Medicaid Services notes that the new Level 1 and Level 2 edits for cost reports that it discussed in the proposed rule were implemented via a transmittal. “We appreciate support of the Level 1 edits to further address accuracy in cost reporting,” CMS says in the rule published in the Aug. 6 Federal Register.

Expected change: In the rule, CMS says “these changes are effective for cost reporting periods ending on or after December 31, 2017.”
Read more here:

https://advantagehcconsulting.com/blog/2018/08/15/finance-make-cost-report-changes-before-it-impacts-your-pay-rates/

07/16/2018

Data helps pinpoint winners, losers under new payment system.

Aside from budget neutrality, the PDGM payment reform model Medicare has proposed for 2020 may look basically the same as last year’s HHGM model. But there is one area of difference — the information the Centers for Medicare & Medicaid Services is providing about the change.

CMS is offering agency-specific impact files to providers, it says in the 2019 Home Health Prospective Payment System proposed rule released July 2. “To support an assessment of the effects of the proposed PDGM, CMS will provide, upon request, a Home Health Claims-OASIS Limited Data Set (LDS) file to accompany the CY 2019 HH PPS proposed and final rules,” CMS says in a fact sheet about the rule.
Read more here:


https://advantagehcconsulting.com/blog/2018/07/16/regulations-medicare-provides-more-info-on-pay-reform-this-time-around/

Regulations: Medicare Provides More Info On Pay Reform This Time Around By Sandy McCleve July 10, 2018 No Comments Data helps pinpoint winners, losers under new payment system. Aside from budget neutrality, the PDGM payment reform model Medicare has proposed for 2020 may look basically the same as ...

04/25/2018

providers does your staff understand the difference between ‘Partial/moderate’ and ‘Substantial/maximal’ assistance when scoring mobility?

In OASIS-D, the Centers for Medicare & Medicaid Services proposes that clinicians score the following abilities based on this scale for the newly expanded GG0170 (Mobility).
Read more here:

Do your staff understand the difference between ‘Partial/moderate’ and ‘Substantial/maximal’ assistance when scoring mobility? In OASIS-D, the Centers for Medicare & Medicaid Services proposes …

04/16/2018

New GG items should top your priority list. If you think the changes coming to OASIS in January are relatively minor because they involve lots of dropped items and only six new ones, think again. T…

04/11/2018

Will a decades-long prohibition on physician referrals and ownership get the ax?

Home care and other medical care providers have lived with Stark Law restrictions since the 1990s, but don’t assume they will last forever.

American Hospital Association President and CEO Rick Pollack had Centers for Medicare & Medicaid Services Administrator Seema Verma on an AHA town hall webcast in late January, where they discussed regulations in health care and moving toward a value-based payment system.

During the webcast, Verma acknowledged what hospitals and other healthcare entities consider challenges with Stark Law regulations, according to an AHA news release. “I think the Stark Law was developed a long time ago, and given where we’re going in terms of modernizing [Medicare] and the payment systems we are now operating under … we need to bring along some of those regulations,” Verma said.

Verma added that Congress might have to act to provide full relief from the Stark Law, according to the AHA.
Read more here:

Will a decades-long prohibition on physician referrals and ownership get the ax? Home care and other medical care providers have lived with Stark Law restrictions since the 1990s, but don’t assume …

04/10/2018

Key: Help show that aide services will ‘reduce avoidable emergency and healthcare utilization.’

Exactly how much a new broadening of the Medicare Advantage benefit rules will affect home care providers remains unclear, but it looks promising.

The change: The Centers for Medicare & Medicaid Services has finalized a February proposal to allow MA plans to cover aide services under their supplemental benefits, according to an April 2 Part D rate announcement and call letter for 2019.

Read more here:

Key: Help show that aide services will ‘reduce avoidable emergency and healthcare utilization.’ Exactly how much a new broadening of the Medicare Advantage benefit rules will affect home care provi…

03/29/2018

Number of providers climbed 4%.

Although spring is here, hospices are still feeling the chill as the Medicare Payment Advisory Commission once again urges Congress to freeze their payment rates.

Increases in key statistics ranging from profit margin to length of stay to live discharges may convince lawmakers to listen when the influential advisory body to Congress advocates eliminating any payment update for the industry. Those 2016 stats, included in MedPAC’s annual report to Congress released March 15, include:.........

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https://lnkd.in/gBCNJCW

Hospice: Rebounding Hospice Stats Underlie Rate Freeze Rec By Sandy McCleve March 23, 2018 No Comments Number of providers climbed 4%. Although spring is here, hospices are still feeling the chill as the Medicare Payment Advisory Commission once again urges Congress to freeze their payment rates. I....

03/22/2018

PROVIDERS. SHARE TIPS AND TOOLS WITH YOUR REFERRING DOCS.

You can boost your compliance — and reimbursement — by making sure your claims won’t fall prey to medical review denials based on certification and face-to-face encounter problems. Use the following resources to supercharge your policies and procedures surrounding documentation and billing accurately:
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https://advantagehcconsulting.com/blog/2018/03/22/77/

Documentation: Tap These Resources To Help Make Your Claims Bulletproof By Sandy McCleve March 22, 2018 No Comments Share tips and tools with your referring docs. You can boost your compliance — and reimbursement — by making sure your claims won’t fall prey to medical review denials based on ....

03/14/2018

https://www.linkedin.com/pulse/medicare-cost-report-submission-deadline-sandy-mccleve/

03/14/2018

http://advantagehcconsulting.com/

Our process is specialized for home health care agencies, hospice care providers, and skilled nursing facilities and allows our cost report preparation to be:

03/02/2018

http://www.advantagehealthcareconsulting.com/2018/02/medicare-cost-report-submission-deadline.html

"a blog about healthcare, cost reporting and reimbursement for Medicare and Medicaid providers."