WASHINGTON—The Centers for Medicare & Medicaid Services (CMS) unveiled a new payment model that will give states more flexibilities in how they manage health care, and could ultimately shift focus to home- and community-based services. The States Advancing All-Payer Health Equity Approaches and Development Model (“States Advancing AHEAD” or “AHEAD Model”) aims to better address chronic disease, behavioral health and other medical conditions.
CMS
The Centers for Medicare & Medicaid Services (CMS) released an announcement on efforts to support Florida’s emergency response to Hurricane Idalia, including resources and flexibi
WASHINGTON—The methodology chosen to determine future home health payment rates "will eventually destroy the value of the home health services benefit," the National Association for Homecare and Hospice (NAHC) said in a letter sent to the Centers for Medicare & Medicaid Services (CMS).
MINNEAPOLIS, Minnesota—Reprise Biomedical, Inc., an innovator in medical biotechnology for wound care, announced the Centers for Medicare and Medicaid Services (CMS) has assigned a Level II Healthcare Common Procedure Coding System (HCPCS) code to its Miro3D wound matrix, effective Oct. 1, 2023.
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WASHINGTON—The Centers for Medicare & Medicaid Services (CMS) released updated guidance that will extend COVID-19 public health emergency (PHE) flexibilities approved in the states' section 1915(c) home- and community-based services (HCBS) waiver Appendix K amendments.
WASHINGTON—The Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) have responded to a May 2023 data breach in Progress Software’s MOVEit Transfer software on the corporate network of Maximus Federal Services, Inc. (Maximus), a contractor to the Medicare program, that involved Medicare beneficiaries’ personally identifiable information (PII) and/or protected health information (PHI). No HHS or CMS systems were impacted.
WATERLOO, Iowa—U.S. Representatives Judy Chu (D-CA) and Mariannette Miller-Meeks (R-IA) have reintroduced the bipartisan H.R. 4779: Breast Cancer Patient Equity Act, which would provide Medicare coverage of custom breast prostheses to breast cancer survivors. Since most private insurance companies follow Medicare coverage standards, passage of this legislation would allow hundreds of thousands of women each year to choose a custom prosthesis after a mastectomy.
BOSTON – The owner of Conclave Media (Conclave) and Nationwide Health Advocates (Nationwide) has been charged and has agreed to plead guilty in connection with a $44 million telemedicine fraud scheme involving medically unnecessary durable medical equipment (DME), including orthotics such as back and knee braces and genetic tests.
Reps. Terry Sewell (D-AL) and Adrian Smith (R-NE) are leading an effort to help maintain strong access to home oxygen for individuals with respiratory challenges.
PurposeCare, a provider of coordinated homecare and home health services in the Midwest, announced its acquisition of three Midwest homecare agencies in the Indiana and Ohio markets.
DALLAS—Homecare Homebase (HCHB), a software for home-based care, has released an updated HCHB Analytics Home Health Impact Report Model, less than two weeks following the Centers for Medicare & Medicaid Services (CMS) publication of the 2024 Home Health Proposed Rule. The tool helps customers quickly and accurately identify the potential impact of proposed and final Medicare reimbursement changes on their unique agencies.
WASHINGTON—The Centers for Medicare & Medicaid’s (CMS) proposed rate reductions for home health could be devastating for agencies if they are codified, said Bill Dombi, president of the National Association for Home Care & Hospice (NAHC). Even worse, CMS has left a door open to demand some $3 billion in clawbacks for prior years of what it interprets as over-payments.
Broader Medicare coverage is now available for Biogen and Eisai’s Leqembi (the brand name for lecanemab) following the Food and Drug Administration’s (FDA) move to grant traditional approval to the drug that treats individuals with Alzheimer’s disease. The Centers for Medicare & Medicaid Services had previously announced this would be the case and released more details on coverage.
WASHINGTON—The Center for Medicare & Medicaid Services' proposed 2024 rule for the home health payment system includes a slew of hospice-specific provisions, many of them designed to reduce fraud and so-called "hospice flipping." Here's a look at what's included, according to the National Association for Homecare and Hospice.
BOSTON—Myomo, Inc. (NYSE American: MYO), a wearable medical robotics company that offers increased functionality for those suffering from neurological disorders and upper-limb paralysis, announced that its request to the Centers for Medicare and Medicaid Services (CMS) to classify the company’s MyoPro as a brace has been published for public comment.
NEWARK, New Jersey—An Ocean County, New Jersey, man admitted his role in a durable medical equipment (DME) kickback scheme, U.S. Attorney Philip R. Sellinger announced.
Alexander Schleider, 57, of Lakewood, New Jersey, pleaded guilty before U.S. District Judge Michael A. Shipp in Trenton federal court to an information charging him with one count of conspiracy to commit health care fraud and one count of wire fraud.
Washington, D.C.—The National Association for Home Care and Hospice (NAHC) filed a lawsuit against the Centers for Medicare and Medicaid Services (CMS) and the United States Department of Health and Human Services (HHS) challenging the validity of a change in Medicare home health payment that reduced rates by 3.925% in 2023 with significant additio
LOS ANGELES—A South Bay woman was found guilty on Tuesday, June 27 of nearly two dozen felonies for billing Medicare more than $24 million by submitting fraudulent claims for medically unnecessary durable medical equipment—mostly power wheelchairs (PWC)—and PWC repairs, many of which were never performed.
The National Association for Home Care & Hospice (NAHC) and the Partnership for Quality Home Healthcare (the Partnership) commended Senators Debbie Stabenow (D-MI) and Susan Collins (R-ME) for introducing the Preserving Access to Home Health Act of 2023 to safeguard access to essential home-based, clinically advanced health care services by preventing the Centers for Medicare & Medicaid Services (CMS) from implementing dire cuts of negative -7.85% to the Medicare Home Health