Category: INDUSTRY NEWS

Updates on all the industry news you need to stay compliant!

Home Health LUPA Threshold: Bill Correctly

Posted in Home Care, INDUSTRY NEWS

Mary Madison, RN, RAC-CT, CDP Clinical Consultant – Briggs Healthcare In a recent report, the Office of Inspector General found that Medicare improperly paid some claims for home health services with 5–7 visits in a payment episode. Review the Medicare Home Health Benefit (PDF) and Home Health Prospective Payment System (PPS) (PDF) booklets to properly bill for services slightly above the…… Continue reading Home Health LUPA Threshold: Bill Correctly

Five-Star User’s Guide Updated – October 2021

Posted in INDUSTRY NEWS, Long-Term Care

Mary Madison, RN, RAC-CT, CDPClinical Consultant – Briggs Healthcare October 2021 Revisions Quality Measure Rating Changes: The “Rate of successful return to home and community from a SNF” measure will be updated in October, although the time period that the measure covers will continue to be October 1, 2017 through September 30, 2019. Due to…… Continue reading Five-Star User’s Guide Updated – October 2021

Appendix B – RAI User’s Manual Updated

Posted in INDUSTRY NEWS, Long-Term Care

Mary Madison, RN, RAC-CT, CDPClinical Consultant – Briggs Healthcare The October update of Appendix B to the RAI 3.0 User’s Manual contains changes to the list of State RAI Coordinators, MDS Automation Coordinators, RAI Panel members, and CMS locations and contacts.  The change document is found here; the change document here.  You can also locate both documents…… Continue reading Appendix B – RAI User’s Manual Updated

Upcoming Home Health, Hospice & DME Open Door Forum

Posted in Home Care, INDUSTRY NEWS

Mary Madison, RN, RAC-CT, CDPClinical Consultant – Briggs Healthcare The next Home Health, Hospice & DME Open Door Forum is scheduled for: Wednesday, November 10, 2021 PM at 2:00-3:00 PM Eastern Time (ET). Please call at least 15 minutes prior to the forum start time. **This Agenda is Subject to Change** Opening Remarks Chair –…… Continue reading Upcoming Home Health, Hospice & DME Open Door Forum

Quality Reporting Program: Non-Compliance Letters for CY2022 APU for Home Health Agencies

Posted in Home Care, INDUSTRY NEWS

Mary Madison, RN, RAC-CT, CDP Clinical Consultant – Briggs Healthcare CMS is providing notifications to home health agencies that were determined to be out of compliance with Quality Reporting Program (QRP) requirements for CY 2020, which will affect their CY 2022 Annual Payment Update (APU). Non-compliance notifications are being distributed by the Medicare Administrative Contractors (MACs)…… Continue reading Quality Reporting Program: Non-Compliance Letters for CY2022 APU for Home Health Agencies

Upcoming Rulemaking for Survey and Enforcement Requirements for Hospice Programs

Posted in Hospice, INDUSTRY NEWS

Mary Madison, RN, RAC-CT, CDP Clinical Consultant – Briggs Healthcare On October 20, 2021, CMS posted QSO-22-01-Hospice. Discussion: In current rulemaking, CMS outlines the statutory requirements and dates included in the CAA 2021. Given that some statutory timelines are effective prior to the effective date of the final rule, CMS’s ability to conduct compliance monitoring activities…… Continue reading Upcoming Rulemaking for Survey and Enforcement Requirements for Hospice Programs

PBJ Data Updated by CMS

Posted in INDUSTRY NEWS, Long-Term Care

Mary Madison, RN, RAC-CT, CDPClinical Consultant – Briggs Healthcare CMS has posted (October 14, 2021) 2 new PBJ datasets: Payroll Based Journal Daily Non-Nurse StaffingPayroll Based Journal Daily Nurse Staffing The Payroll Based Journal (PBJ) Nurse Staffing and Non-Nurse Staffing datasets provide information submitted by nursing homes including rehabilitation services on a quarterly basis. The…… Continue reading PBJ Data Updated by CMS