While it’s common knowledge that therapy services are essential in improving patient outcomes and maximizing independence, it’s critical to understand how to document therapy treatment in a manner which demonstrates that value. We covered some of this before in our Therapy Documentation 101 article. Here, we’ll dive into documenting interventions performed and progress toward goals. […]

In these trying times, it is important to keep informed. We will be providing a summary of regulatory changes in this article. Please keep in mind that these changes are considered temporary and will be effective from 3/30/2020 through as long as the COVID-19 Public Health Emergency declaration remains in effect. Other legislation is being […]

We asked via Facebook for topics to write about and a reader requested an article on therapy documentation. It’s a very timely subject considering all of the scrutiny by CMS review contractors such as MACs, RACs, ZPICs, UPICs, etc. and the review choice demonstrations that started in Illinois on June 1st, Ohio on September 30th […]

You are already familiar with the Home Health Review Choice Demonstration and Home Health Pre-claim Review Submissions. Recently, PalmettoGBA (PGBA) released some important information regarding Pre-Claim Review (PCR) Non-Affirmations that pertains to home health agencies in Illinois and will soon apply to Ohio agencies as well. This is valuable insight into what PGBA is looking […]

This home health proposed rule’s 346 pages (reduced from last year’s 600) were published on July 18. Comments will be accepted from now until September 9, 2019. You can submit your comment by clicking on the “Submit a formal comment” link near the top of the article. You can also send your comments by regular […]

From time to time, we receive inquires from our users with clinical questions. Though our team possesses a treasure trove of knowledge in different aspects of home health, including Medicare home health care, early intervention (EI), pediatric therapy, outpatient therapy and more, we are not clinicians. However, we do want to give our users the […]

The Merit-based Incentive Payment System (MIPS) is a Quality Payment Program (QPP) developed by CMS to get providers to focus on performance improvement by paying bonuses to providers who perform well in certain measures. There are four domains that clinicians report on with each accounting for a percentage of your overall score: Quality, Improvement Activities, […]

The Review Choice Demonstration (RCD) is a home health review program. It is planned for a 5-year period with initial implementation in Illinois scheduled for June 1, 2019 and expansion into Ohio, North Carolina, Florida and Texas soon after. This program is a continuation of CMS’s efforts to crack down on fraud, waste and abuse […]

The Patient-Driven Groupings Model (PDGM) is an alternative payment model that will replace the home health Prospective Payment System (PPS). The planned implementation date is January 1, 2020. Why the change? The Bipartisan Budget Act of 2018 (BiBA) requires reform of the current payment model to address several perceived problems in the PPS home health […]