Monitor Mondays

CMS Proposes to Implement Home Health Pre-Claim Review Demonstration

October 01, 2018 Chuck Buck | Ronald Hirsch, MD | Nancy Beckley | David Glaser, Esq. | Ellen Fink-Samnick | Marvin D. Mitchell, RN | Duane Abbey, PhD | William A. Dombi, Esq.
Monitor Mondays
CMS Proposes to Implement Home Health Pre-Claim Review Demonstration
Show Notes
Home health providers are now on alert following an announcement on Wednesday that the Centers for Medicare and Medicaid Services (CMS) intends to implement in December its Home Health Pre-Claim Review demonstration in Illinois, Ohio, North Carolina, Florida, and Texas.

In its announcement, CMS issued a notice for a 30-day public comment period. Reporting this developing story during this edition of Monitor Mondays will be William A. Dombi, president of the National Association for Home Care and Hospice.

The broadcast rundown also will include:

  • Monday Focus: The newest compliance issue to gain national attention involves the T codes. As of Oct. 1, providers are required to document clients who might be at risk of sex and labor exploitation. Reporting on this story is nationally recognized authority on the social determinants of health (SdoH), Ellen Fink-Samnick.
  • Monday Rounds: Ronald Hirsch, MD, vice president of R1 Physician Advisory Services, makes his Monday Rounds with another installment of his popular segment.
  • Hot Topics: Monitor Mondays senior correspondent Nancy Beckley, president and CEO of Nancy Beckley and Associates, reports on the latest hot topics.
  • Risky Business: Healthcare attorney David Glaser with Fredrikson & Byron reports on another example of a potentially troublesome issue that could pose a risk to your facility.
  • Medicare Payment Report: Are small, independent providers being forced by CMS to increase their size so that there is enough activity to have the averaged national payments break even, or be profitable? Author, educator, and consultant Duane Abbey, president of Abbey and Abbey Consultants, Inc., reports on this timely issue.
  • The Hospice Report: Are referrals to hospice frequently the result of misunderstandings of the purpose of hospice? And why the rush to hospice if death is imminent? Marvin D. Mitchell, director of case management and social services at San Gorgonio Memorial Hospital in California, reports on this critically important subject.