New Survey and Enforcement Requirements

Home health agencies, hospices, hospitals, physician practices and other providers have been under increased government and government contractor scrutiny.  They have dealt with increased claim audits by RACs, ZPICs, and CERTs.  These contractors are bounty hunters, meaning they get paid based on the number of claims they deny.  Many of the denials have been labeled as questionable by providers and physicians.  The MACs (Medicare Administrative Contractors) have supported these denials in the lower level appeal process forcing appeals to the Administrative Law Judge.  This has overwhelmed the Administrative Law Judge system.  Appeals that were required to be heard within 90 days may not be resolved for many years.    Hospitals have obtained a potential settlement offer from CMS to pay for 68% of claims that have been denied for patient admitted prior to October 1, 2013.  CMS has not made this proposal to home health, hospices or physicians. This settlement may reduce the potential ALJ backlog, but will not eliminate the backlog. Now home health agencies are facing more stringent surveys with enhanced penalties.  Look for this to be the next arrow from CMS's quiver to reduce the number of home health agencies.  I have personally had more calls about survey problems this year than my last 5 years in business.  Home health agencies must ensure they are complying with all the conditions of participation and to document this compliance.  If your agency does have a survey with deficiencies you will be required to write a plan of correction. J'non Griffin a 26 year veteran of home care will present a session titled Home Health Intermediate Sanctions in our "Exploring Trends and Routes for Success" a comprehensive seminar for Home Health which will be held in Las Vegas, NV on January 2015. The session will explain and identify intermediate sanctions.  It will also show how to develop a suitable corrective action plans.  This timely session will provide information that is crucial for all home health agencies. There is more information about the seminar below.   **********************************************

Exploring Trends & Routes for Success

Four Great Seminars presented by Dixon Healthcare Solutions, Inc. Home Health Agencies - January 28-30, 2015 Physicians Practices - January 28-30, 2015 Hospices - February 2-4, 2015 Private Duty - February 2-4, 2015 Location is the Monte Carlo in Fabulous Las Vegas, NV It is important to register early, because the rates go up as the date gets closer and their is limited seating. Registrations Forms Home Health Physician Practices Hospice Private Duty The speakers include: Richard Dixon, J-non Griffin Robert Liles Richard Martin Cheri Martin Robert Floyd Donna Floyd Adam Bird (Physician Practice Only) Program Outlines Home Health Physician Practice Hospice Private Duty The program is great for each and we hope to see you in Las Vegas at the Monte Carlo ***********************************