Author: Alora Home Health Software

On November 4, 2020 the Centers for Medicare and Medicaid Services (CMS) published the final rule for 2021. Overall the changes this year were minimal since this was the first year for the Patient-Driven Groupings Model (PDGM) and there is not enough data to support significant changes. Furthermore, the COVID pandemic affected industry operations which mitigated reform to the PDGM payment structure. Agencies should review the changes affecting their operations from the fifty-nine-page rule, but here is a quick glance at the updates:

States may be complicating non-physician certifications in home health care, as hospitalizations and homecare needs rise. In this edition of the Homecare Software blog...the CARES Act has made it possible for nurse practitioners, physician assistants, and clinical nurse specialists to certify eligibility for home health. This has facilitated movement in the home health care industry towards eliminating Medicare’s rigid physician certification requirements and policies. Congress first warmed to the idea of allowing non-physician certification in the early spring just as the COVID-19 pandemic was beginning to surge. At the end of the day, in spite of the federal government’s efforts, states by law have the final say when it comes to making these overtures into reality.

Following similar requirements born of the 21st Century Cures Act legislation, Electronic Visit Verification has been mandated in the state of Wisconsin. What is the official start date?  What care organizations does it apply to, and what are the unique requirements? Is Wisconsin an open model state in terms of the EVV system agencies must use? We will delve into all of these questions and then some as we hone in on EVV in the state of Wisconsin. 

Like many other states in 2019 and 2020, Electronic Visit Verification has come to Nebraska. When is its official start date?  What types of agencies does it apply to, and what are the specific requirements? Are home health care agencies free to choose whatever EVV software they desire? We answer all of these questions and more as we take a closer look at EVV in the state of Nebraska. 

The worldwide Coronavirus pandemic has caused ripple effects across numerous sectors of the global and local economies. A dramatic shift upwards in demand for homecare and medical care in general, has subsequently changed the way that healthcare is delivered and received on many fronts.

Can home health care agencies bill Medicare Part B for outpatient services? 

 

Outpatient Therapy Services BillingYes. According to CMS, outpatient therapy services may be provided by a home health agency to patients who are not homebound or otherwise are not receiving services under a home health plan of care (POC). These services are not paid under the Home Health Prospective Payment System (HH PPS). The reimbursement for the outpatient therapy services is calculated using the Medicare Physician’s Fee Schedule (MPFS).

Electronic Visit Verification (EVV) for Utah Medicaid

As an ongoing part of our commitment to keeping home health care professionals up to date with the latest regulatory information at the national and state level, in this edition of our homecare blog, we turn the spotlight on electronic visit verification in the state of UTAH. A good starting point is to look at the beginnings of how EVV requirements came to be, which brings us to the 21st Century Cures Act.

Choosing EVV Software

 

How do I choose EVV software?As the 21st Century Cures act moves to the forefront of home health agency staffs, many agencies find themselves trying to prepare for the inevitable. According to their official website www.medicaid.gov, all U.S states are required by law to implement an approved electronic visit verification system for all Medicaid-funded personal care services by January 1, 2020, and home health care services by January 1, 2023. Any non-compliant states will face financial penalties unless they have an authentic delay reason or burden which prevented their compliance.   To meet state requirements, when selecting a software vendor for EVV compliance, agencies performing personal care and home health services need to be sure to do their homework.