When the “Ensuring Access to Medicaid Services” rule was finalized last week, the 80-20 provision stole the show, due to its unpopularity among home-based care leaders. But experts have pointed out that the rule is much more than just the 80-20 provision. “The rule, including the preamble, was over 1,000 pages, and I joke that […]
A senior Centers for Medicare & Medicaid Services (CMS) official stood behind the “80-20 rule” — which has drawn major pushback from the home-based care industry — during a congressional hearing Tuesday. Last week, the “Ensuring Access to Medicaid Services” rule was finalized. The impetus behind the rule is to strengthen access to home- and […]
Last summer, the National Association for Home Care & Hospice (NAHC) made waves when it filed a lawsuit against the Centers for Medicare & Medicaid Services (CMS) and the U.S. Department of Health and Human Services (HHS) over Medicare home health payment calculations. Last week, a federal court in Washington D.C., dismissed NAHC’s lawsuit against […]
Home health providers’ fight against cuts to fee-for-service Medicare payment has become a year-by-year battle. But the yearly cuts are compounding, which is exactly what industry advocates are trying to illustrate to Congress prior to the next payment rule proposal. Since the adoption of the Patient-Driven Groupings Model (PDGM) in 2020, the Centers for Medicare […]
On Tuesday, Centers for Medicare & Medicaid Services (CMS) officials vehemently backed the thought process behind the “80-20” wage mandate in home- and community-based services (HCBS). Providers and advocates, on the other hand, continued to argue that the policy could be disastrous. During a press call Tuesday, CMS stuck with the theme that, in general, […]
The White House teased the finalized Medicaid Access Rule early Monday, and the Centers for Medicare & Medicaid Services (CMS) later revealed more intricate details attached to the rule. Firstly, the timeline of the rule is now clear. Specifically: – In three years, states must “report on their readiness to collect data regarding the percentage […]
The White House on Monday announced that the nursing home minimum-staffing rule has been finalized. Effectively, the rule requires all nursing homes that receive Medicare and Medicaid funding to maintain a certain staffing threshold at all times. The U.S. Centers for Medicare & Medicaid Services (CMS) first proposed the minimum-staffing requirement last fall. “Medicare and […]
Every year, home health providers await the release of the U.S. Centers for Medicare & Medicaid Services’ (CMS) proposed payment rule. While home health providers are likely months away from seeing a proposal, it’s worth examining if what’s happening in other care settings could offer a clue of what to expect. CMS released the 2025 […]
Last week, the Centers for Medicare & Medicaid Services (CMS) Innovation Center announced a new proposed model that will undoubtedly affect home health providers, and also allow them the opportunity to get more involved in value-based care initiatives. The Transforming Episode Accountability Model (TEAM), which would eventually be mandatory if finalized, would have selected acute […]
The Centers for Medicare & Medicaid Services (CMS) finalized a rule that will result in a 3.7% positive payment adjustment for Medicare Advantage (MA) plans in 2025. According to an analysis done by the private investment banking company Stephens, rates are expected to remain virtually unchanged, with a slight decrease of 0.16%. This marks the […]
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