June 2016

Medicare Home Health Pre-Claim Review Demonstration

By |2018-02-15T13:36:02-05:00June 8th, 2016|Billing, Industry Updates - Home Health, Lu's Blog|

Despite concerns from the home health industry about the burden of a prior authorization requirement and how it will restrict access to care, CMS will move forward with a three-year Medicare pre-claim review demonstration for home health agencies in five states as published to the rule posted in the Federal Register on June 8, 2016.

August 2015

New Service Intensity Add-On (SIA) in Hospice

By |2018-02-19T17:39:05-05:00August 7th, 2015|Billing, Ginger's Blog, Industry Updates - Hospice|

Based on the FY 2015 Final Rule released on 8/5/2015, CMS implemented changes as to how hospice agencies are paid for the Routine Home Care level of care. Known as a Service Intensity Add-On (SIA) Payment will apply if a visit is made on a RHC level of care day during the last 7 days of life (and the beneficiary is discharged dead), anddirect patient care is provided by an RN or a social worker that day.