CMS: Rethink Pre-Claim Review for Home Health Services
By Colin Roskey, Executive Vice President of Partnership for Quality Home Healthcare The Center for Medicare & Medicare Services recently proposed a pre-claim review demonstration for Medicare home health services, upon which approximately 3.5 million Medicare beneficiaries depend. The Partnership is echoing concerns expressed by more than 120 bipartisan lawmakers to a previously proposed,…
Five Reasons Prior Authorization Is Bad for Medicare Services
CMS is seeking comment on requiring prior authorization for Medicare home health, upon which approximately 3.5 million Medicare beneficiaries depend. Prior authorization means that a patient can’t receive the care her physician ordered unless and until a government official has reviewed that order (and a lot of other paperwork besides) and given it his blessing….
Preparing Home Health Patients for Natural Disasters
With the start of Hurricane season, we are reminded yet again of the importance of emergency preparedness for the home health sector. While hospitals and shelters help to protect many individuals in the event of a natural disaster, homebound patients often continue to rely on their home health providers to deliver the care they need…
Letter to President Obama: Support Program Integrity Reform Instead of Across-the-Board Cuts and Higher Costs for Seniors
The Partnership for Quality Home Healthcare supports program integrity reforms in the Medicare program specifically targeting fraud and abuse to prevent these behaviors before they can occur. As a member of the Fight Fraud First! coalition, the Partnership is working with others to ask policy makers to make every effort to eliminate waste, fraud…
CMMI Director Touts Value of Home Health
In a hearing before the Senate Finance Committee last week, CMS’ Center for Medicare and Medicaid Innovation (CMMI) Director, Dr. Richard Gilfillan, was the sole witness at a recent Senate Finance Committee hearing on ways to reform Medicare and Medicaid. In his written testimony and during the hearing, Dr. Gilfillan sited the value of home…
Fight Fraud First! to Protect Medicare and Seniors
Who is Fight Fraud First! Fight Fraud First! is a collaborative effort among advocates, seniors, persons with disabilities, military veterans, and minority communities. The coalition advocates that every effort should be taken to eliminate waste, fraud and abuse from the Medicare and Medicaid programs before any cuts are made to beneficiaries who rely on…
Bipartisan Group of Senators Call for Stronger Efforts to Fight Fraud
In a press statement last week, Senators Max Baucus (D-MT), Tom Carper (D-DE), Tom Coburn (R-OK), and Orrin Hatch (R-UT) called for Medicare program integrity improvements. Their statement was in response to a recent report by the Office of the Inspector General (OIG), which calls for more aggressive efforts to stop Medicare fraud and abuse…
Medicare and Medicaid Fraud: a Targeted Problem in Need of a Targeted Solution
We recently had the opportunity to attend the Alliance for Health Reform briefing on healthcare fraud and prevention. It’s an important and timely topic for the home healthcare community. Our community recognizes that program integrity and payment reforms are needed to strengthen the Medicare and Medicaid programs and secure seniors’ access to quality healthcare services….
Program Integrity Reforms Work
The Centers for Medicare and Medicaid Services (CMS) recently released data that backs up the Partnership’s position that program integrity reforms in Medicare can result in serious healthcare savings. In 2009, the home healthcare community proposed a 10 percent cap on outlier payments to Medicare home healthcare providers. The proposed policy was included in…