An indictment was unsealed on Wednesday in Brooklyn, New York, charging eight defendants with allegedly scheming to defraud Medicaid of approximately $68 million. This was done through the operation of two social adult day care organizations and a home care financial intermediary that paid kickbacks and bribes for services not provided. According to court documents, […]
Category: Medicaid
Electronic Visit Verification (EVV) was established as law in 2016 under the 21st Century Cures Act to address fraud and abuse in home-based care delivery. The law provides federal guidelines, but individual states can determine which service codes are included. However, years after nationwide implementation, EVV still remains a burden for home care providers. Simply […]
Public Partnerships LLC (PPL) — an Alpharetta, Georgia-based financial management services company — has been awarded the fiscal intermediary contract in New York. PPL will take over as the sole administrator of the state’s Consumer Directed Personal Assistance Program (CDPAP). “We are excited to have the opportunity to serve CDPAP consumers and personal assistants,” Maria […]
The Centers for Medicare & Medicaid Services (CMS) has released additional information around continuity of coverage for home- and community-based services (HCBS) beneficiaries. The agency issued an informational bulletin last month reminding states of federal renewal requirements and available flexibilities to ensure continued coverage for individuals eligible for HCBS through Medicaid. This bulletin continues CMS’ […]
For seniors looking to gain access to home- and community-based services (HCBS), wait times can be a major roadblock. Policy aimed at reducing those wait times could also have a positive effect on providers. In a recent MACPAC meeting, Tamara Huson, a senior analyst and contracting officer at the organization, presented early findings on the […]
U.S. Sens. Bob Casey (D-Penn.) and Marsha Blackburn (R-Tenn.) have set their sights on lifting age-based restrictions in the Medicaid buy-in program. Their proposed legislation has the potential to widen the addressable market for home care providers. On Wednesday, the policymakers introduced the Ensuring Access to Medicaid Buy-In Programs Act. If enacted, the legislation would […]
Public Partnerships LLC, also known as PPL, is competing to become the exclusive administrator of New York’s Consumer Directed Personal Assistance Program (CDPAP). This program enables seniors and individuals with disabilities to choose their own caregivers, with payment coming from the state’s Medicaid program. New York’s CDPAP has been in the headlines for months. Gov. […]
There might be some recourse for home-based care providers that aren’t able to meet the requirements of the “Ensuring Access to Medicaid Services” rule’s 80-20 provision. “We heard, consistently, that there were concerns about the applicability of the 80% threshold to small providers,” Melissa Harris, the deputy director of the Medicaid and benefits health programs […]
Medicaid home- and community-based services (HCBS) vary by state, in many ways. And while it makes the space a complex one for providers to navigate, a greater understanding of the complexities allows for more success. Broadly, Medicaid is a state and federal partnership. The federal government sets rules and parameters. The state takes those parameters […]
How Personal Care In Acute Care Settings Could Become Popularized, Benefiting Patients And Providers
In March, the U.S. Centers for Medicare & Medicaid Services (CMS) approved a request from one state to allow more personal care service delivery within acute care facilities. Though not yet widespread, the amendment could open doors for providers and patients needing personal care in alternative settings in the future. One change to a Medicaid […]
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