Latest News

Below are some recent news articles from throughout the industry.

Why Medicare Advantage Isn't an 'Instant Home Run' for Home Care

With only a few short months to go in 2019, the year is rapidly winding down. As home care leaders take stock of their 2020 priorities, many remain focused on contracting with Medicare Advantage (MA) plans, some of which still lack a basic understanding of what home care services actually look like.
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Rogers: PDGM's 8% Cut 'A Double Slap in the Face' to Home Health Providers

While home health advocacy efforts are routinely focused on national policies, state-level organizations often help pave the way. Among them is the Association for Home & Hospice Care of North Carolina (AHHC-NC), led by industry veteran Tim Rogers, its president and CEO.
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Medicare AdvantageCMS: Hundreds of Medicare Advantage Plans Preparing to Roll Out New Home Care Benefits in 2020

As more Medicare Advantage (MA) plans prepare to roll out new home care benefits in 2020, premiums are expected to drop 23% next year, the Trump administration announced Tuesday.
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Amazon Rolls Out In-Home Care Offering 'Amazon Care'

Amazon (Nasdaq: AMZN) has launched a new virtual care clinic, which will give employees access to telehealth and in-home care, according to CNBC. While public details are relatively sparse, the move potentially sets Amazon up for a broader expansion down the road.
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Walmart Health, Amedisys Partner to Expand Home Health Access Nationwide

Amedisys Inc. (Nasdaq: AMED) and Walmart (NYSE: WMT) have entered into a new partnership to expand home health care access nationwide, according to an analyst report from William Blair. The global investment and wealth management firm has learned that Baton Rouge, Louisiana-based Amedisys is part of the retail giant's new health care initiative, dubbed "Walmart Health."
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State Home Health Leaders Go on the PDGM Offensive

On a federal level, the National Association for Home Care & Hospice (NAHC), LeadingAge and the Partnership for Quality Home Healthcare (PQHH) have all ramped up their home health advocacy efforts this summer and in early fall.
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Congress: Support bipartisan solutions to protect Medicare home health

As members of Congress return to Washington following their August recess, we might be tempted to assume the nation is in for more of the same: partisan disagreements, frustrating distractions, and slow progress on critically important policy issues. Assumptions, however, don't always pan out. And blindly depending on them can be dangerous.
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Uber Health Eyes Meal Delivery, Caregiver-Driving Partnerships

When ride-hailing companies first came on the scene nearly 10 years ago, they were rarely - if ever - associated with health care. But today, both industry giants Uber (NYSE: UBER) and Lyft (Nasdaq: LYFT) have growing health care divisions that are frequent partners of home-based care providers.
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Home health aides care for the elderly. Who will care for them?

When the alarm clock went off at 7 am, Angelica Rios had barely gotten four hours of sleep. She rolled out of bed anyway and slipped into her Winnie the Pooh scrubs. "I have a lot of trouble sleeping," Angelica said as she combed mousse through her thick brown curls. She picked up two silver hoop earrings and clasped one onto each ear. Then she laced up her sneakers and grabbed a bottle of Gatorade on her way out the door.
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Senior Helpers Telemedicine Pilot Helps Cut Costs, Reduce ER Trips

Telemedicine has the potential to more regularly and affordably connect older adults to their doctors, but several barriers still exist preventing its widespread adoption. Perhaps the biggest: seniors' own embrace of technology.
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Home health care for seniors at risk unless Congress acts

By Jane Kelly. Aging isn't easy. And leaving home when healthcare needs require extra attention makes it even harder. But thanks to progress and innovations in the delivery of home health, more older Americans are able to stay safely at home while receiving home healthcare services.
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Amedisys Goes After Home Care, Medicare Advantage with New Partnership

Amedisys Inc. has locked in an agreement with ClearCare Inc. that will expand its personal care services and could open the door for future Medicare Advantage (MA) opportunities. The deal could also be good news for home care providers hoping to work with the home health giant.
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Game On: PDGM Encourages Home Health Agencies to 'Game the System'

When the Center for Medicare & Medicaid Services (CMS) developed the Patient-Driven Groupings Model (PDGM), part of the goal was to fix problems that exist with the currently used Prospective Payment System (PPS).
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Opinion: Texas lawmakers should protect home health for older Americans

By Rachel Hammon - With recent debate surrounding Medicare For All and other big-ticket healthcare proposals, changes to the current Medicare system that affect millions of Americans are going unnoticed. Including one that stands to affect Texas seniors who rely on life-saving home health services.
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With Data Breaches on the Rise, Home Health Providers Especially Vulnerable

Data breaches are on the rise across the health care industry at large, with the number of cyber attacks targeting health data reaching record highs in 2018. And due to the mobile nature of home health care, the sector is especially vulnerable to attacks.
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Why CMS's Final PACE Rule Spells Opportunity for At-Home Care Providers

Programs for All-Inclusive Care for the Elderly (PACE) organizations were given much-needed operational clarity on Tuesday, as the Centers for Medicare & Medicaid Services (CMS) finally announced a new rule to update and modernize program requirements.
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Personal Care Services Projected to Dominate Home Care's 2020 Medicare Advantage Involvement

The Medicare Advantage (MA) expansions that the Centers for Medicare & Medicaid Services (CMS) announced this year and in early 2018 open the door to creative applications of non-medical home care services designed to proactively improve individuals' health.
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Congress: Support legislation to defend Medicare home health

By Tim Rogers. Since the start of the 116th Congress, reducing prescription drug-pricing has been a focal point for many lawmakers on Capitol Hill–and rightfully so. Legislative initiatives that strive to lower the cost of care should be applauded. Yet as many policymakers and the wider public continue to focus on lowering the high costs of drugs, it's easy to let other health care access issues fly under the radar. Case in point, a recently proposed reform to the Medicare program's home health benefit that threatens the health care needs of millions of vulnerable seniors across the country.
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Encompass Health's April Anthony: PDGM Is an 'Overcorrection' to Therapy

As currently structured, the Patient-Driven Groupings Model (PDGM) will completely change how and when home health providers deliver therapy services. It will do so in multiple ways, most notably by eliminating the use of therapy service thresholds as a factor in payment determinations. It's a move the Medicare Payment Advisory Commission (MedPAC) has long recommended.

Home Care Industry Turnover Reaches All-Time High of 82%

The home care industry's biggest problem - turnover - is only getting worse. Already cited as the No. 1 challenge plaguing home care agencies across the country, the median caregiver turnover rate skyrocketed to 82% in 2018, according to this year's Home Care Benchmarking Study by market research and education firm Home Care Pulse.
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CMS Finalizes In-Home Medicare Advantage Telehealth Policies

The Centers for Medicare & Medicaid Services (CMS) announced Friday that the agency has finalized a set of policies designed to expand the use of telehealth benefits under the Medicare Advantage program. Originally proposed in October 2018 for the 2020 plan year, the new policies from CMS are meant to expand access to telehealth services by giving Medicare Advantage (MA) plans more flexibility to cover them in the home setting. Traditionally, CMS has largely restricted telehealth reimbursement to clinical settings in rural areas, apart from certain expectations in Alaska and Hawaii.
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Home Care Providers Look Ahead as Medicare Advantage Evolution Continues

Home care providers slow to chase Medicare Advantage business opportunities may now be motivated to speed up their pursuits. Last week, the Centers for Medicare and Medicaid Services (CMS) announced it was broadening the range of supplemental benefits Medicare Advantage (MA) plans can offer in 2020. Starting next year, health care policymakers will allow MA plans to cover any benefits that "have a reasonable expectation of improving or maintaining the health or overall function" of beneficiaries with chronic conditions.
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How Telehealth Can Solve Home Health Agencies' PDGM Therapy Problems

ne of the most anxiously awaited aspects of the Patient-Driven Groupings Model (PDGM) is the elimination of therapy visit volume as a determining factor in calculating reimbursements. Despite reassurance from industry leaders that PDGM isn't a 'death knell' for therapy services, therapy-heavy agencies will have to become more cost effective to ensure they don't take a hit when the new payment model takes effect.
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MedPAC Pushes 5% Home Health Payment Cut, Says Program Integrity Remains a Challenge

The Medicare Payment Advisory Commission (MedPAC) submitted its Medicare payment policy report to Congress on Friday, again recommending a 5% home health payment rate reduction for the coming year and maintaining its view that program integrity remains problematic.
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CMS Official: Final Medicaid Managed Care Rule Expected This Fall

The senior counselor to CMS Administrator Seema Verma on Tuesday (Feb. 26) touted the agency's proposed changes to the Medicaid managed care rule and told stakeholders they can expect the final rule to be out this fall. CMS is reviewing the 275 comments it received on the proposed rule, which the agency released in November. The rule seeks to modify the landmark Medicaid managed care regulations adopted by the Obama administration in 2016.
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Hospice workers find peace in helping patients find comfort at the end of life

It is 7:30 on a summer morning in a room overlooking the slate-gray, lapping waters of Lake Erie. Ten or so people, some just arriving at work, some finishing a night shift, sit silently on benches and in armchairs below stained-glass windows. A plump golden retriever named Linus, a therapy dog, wanders from one person to another, gratefully accepting their caresses.
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Humana Highlights Home Health's Value in Reducing Hospital Readmissions

Insurance giant Humana, Inc. (NYSE: HUM) is touting the value of its home health business - and its ability to prevent costly hospital readmissions and streamline transitions of care.
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CMS issues final rule allowing states to pick essential health benefits

The CMS issued a final rule late Monday aimed at giving states and health insurers more flexibility and reducing regulatory burdens in the individual and small group health insurance markets. read more

U.S. Immigration Policy Threatens Shake-Up In Home Health Business

On a rare rainy night in Albuquerque, two dozen students are learning the proper way to care for older people. Teacher Liliana Reyes is reviewing the systems of the body - circulatory, respiratory and so on - to prepare them for an upcoming exam. read more

What the Hospitals of the Future Look Like

The days of the hospital as we know it may be numbered. In a shift away from their traditional inpatient facilities, health-care providers are investing in outpatient clinics, same-day surgery centers, free-standing emergency rooms and microhospitals, which offer as few as eight beds for overnight stays. They are setting up programs that monitor people 24/7 in their own homes. And they are turning to digital technology to treat and keep tabs on patients remotely from a high-tech hub.
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Report of EVV 'Firestorm' Draws Home Care Industry Pushback

The rollout of electronic visit verification (EVV) for home care has created a "firestorm" of complaints in Ohio, according to a recent article in the Columbus Dispatch. However, that news story painted an incomplete picture, some home care providers and EVV vendors have told Home Health Care News.
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Big Year Coming for Electronic Visit Verification in Home Care

Coming guidance from the Centers for Medicare & Medicaid Services (CMS) could settle some big questions regarding electronic visit verification (EVV) in home care, setting the stage for a lot of activity throughout 2018. read more

Kentucky becomes the first state allowed to impose Medicaid work requirement

A day after the Trump administration announced that it would allow states to compel poor people on Medicaid to work or get ready for jobs, federal health officials on Friday granted Kentucky permission to impose those requirements.
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Trump Administration Says States May Impose Work Requirements for Medicaid

The Trump administration said on Thursday that it would allow states to impose work requirements in Medicaid, a major policy shift that moves toward fulfilling a conservative vision for one of the nation's largest social insurance programs for low-income people.
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Health Care Just Became the U.S.'s Largest Employer

This moment was inevitable. It just wasn't supposed to happen so soon. Due to the inexorable aging of the country - and equally unstoppable growth in medical spending - it was long obvious that health-care jobs would slowly take up more and more of the economy. But in the last quarter, for the first time in history, health care has surpassed manufacturing and retail, the most significant job engines of the 20th century, to become the largest source of jobs in the U.S.
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CMS Introduces New Bundled Payment Model

The Centers for Medicare & Medicaid Services (CMS) on Tuesday introduced a new alternative payment model, the Bundled Payments for Care Improvement Advanced (BPCI Advanced). Home health services would be eligible to be reimbursed under this program.
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Golden Girls-Inspired Housing Offers Home Care, Affordability

Seniors in Nashville, Tennessee, seeking a manageable home environment could live out their golden years in a rental housing program that combines affordable housing with home care services.
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Net Neutrality Repeal Raises Questions for Home Health Tech

Thursday marked a major change for the future of the internet and possibly for some home health technologies. The Federal Communications Commission voted 3-2 to repeal "net neutrality" rules that had implemented in 2015.
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Alexa Pilot Explores Benefits of Voice-Activated Home Health

"Hey, Alexa, what time should I take my medication today?" This exchange with Amazon's digital personal service assistant, Alexa, may soon be commonplace for older adults who wish to age in place, thanks to a pilot study conducted by Dublin, Ireland-based Accenture (NYSE: ACN), a global management consulting firm that provides services in technology, strategy and operations. read more

Honor Expands Caregiver Pool with New Partner Network

Building on its momentum of creating partnerships with other health care providers, San Francisco-based Honor has launched a new program with the aim of further expanding those types of arrangements. Honor, which has raised $65 million in funding, currently has partnerships with senior living providers, independent home care agencies and continuing care systems, among others. read more

CMS Finalizes Home Health Payment Rule Without HHGM

The home health groupings model (HHGM) has been defeated - for now. The Centers for Medicare & Medicaid Services (CMS) released its final rule for the home health care prospective payment system (PPS) 2018 update without finalizing HHGM, which was proposed to be implemented in 2019.

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Untested proposals will cut Medicare and hurt seniors

By Dr. Steven Landers

As a family and geriatric medicine doctor, I am incredibly passionate about home health care, visiting nurse services and their incredible impact on America's seniors and family caregivers. For more than a decade I have been professionally immersed in home health care as a doctor making thousands of house calls to homebound seniors.

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NEWS RELEASE: National Home Health Leaders Host Policy Summit in DC to Advocate forPolicies to Protect Medicare Home Health Benefit

With policy changes on the horizon that could significantly harm Medicare's home health benefit through significant payment cuts, nearly 150 representatives from home health, hospice and homecare agencies across the country gathered in Washington today to ask lawmakers to support efforts to protect the approximately 3.5 million Medicare beneficiaries who depend on home health.

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Why Seniors are Hesitant to Embrace Home Care

Home care should be an attractive solution for seniors who want to age in place-—but, all too often, that's not the case.

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HomeHero Closure Casts Shadow Over Home Care 'Disrupters'

Millions of dollars in backing from seasoned venture funds and investors. Technology built to improve efficiencies and lower costs. And plenty of ambition.

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Senators Ask for Halt to Pre-Claim Before Florida Start Date

Lawmakers in Florida have teamed up to ask Department of Health and Human Services (HHS) Secretary Tom Price to delay the implementation of the Pre-Claim Review Demonstration (PCRD) in the state.

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Gov. Pat McCrory signs waiver request to feds for Medicaid changes

Hours before submitting a waiver request to the federal government, North Carolina on Wednesday unveiled its finalized Medicaid overhaul proposal to lawmakers, with key provisions including privatizing the majority of services.

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Federal prosecution and fines didn't stop pain-pill prescribing

A January report to Virginia's House of Delegates said the state's Medicaid program spent $26 million on opioid use and misuse in 2013 and at least 40,000 adults in Virginia's Medicaid program have a substance abuse disorder.

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Couple sentenced to prison in $80 million Medicaid fraud in nation's capital

A federal judge on Wednesday sentenced a Bowie, Md., wife and husband to 10 and seven years in prison, respectively, for orchestrating a multiyear campaign to defraud D.C. Medicaid of more than $80 million between 2009 and 2014, the largest local health-care fraud scheme ever prosecuted in the city.

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Partnership for Medicaid Home-Based Care Announces Additional Founding Members and Board of Directors

The Partnership for Medicaid Home-Based Care (Medicaid Partnership), a group of national homecare provider organizations formed to advance the integrity and delivery of high-quality, cost-effective Medicaid home-based care through proactive and constructive engagement with government leaders and across the Medicaid homebased care stakeholder community, is pleased to announce that All Metro and Centene have joined as Founding Members of the Medicaid Partnership.

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Council of State Home Care Associations Praises U.S. House Lawmakers forAsking CMS to Stop Proposed Home Health Cuts

The Council of State Home Care Associations - an organization of the associations representing homecare and hospice provider communities across the United States - today praised 133 bipartisan members of the U.S. House of Representatives for signing a letter to the Centers for Medicare & Medicaid Services (CMS) asking the agency to revise proposed changes to the Medicare home health benefit, which would cut an additional $350 million in funding from the program in 2016.

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Partnership for Medicaid Home-Based Care Forms to Protect the Delivery of Home-Based Care Services to America's Medicaid Beneficiaries

WASHINGTON, Sept. 23, 2015 /PRNewswire-USNewswire/ - A group of national home care provider organizations has formed a new coalition - the Partnership for Medicaid Home-Based Care (Medicaid Partnership) - to advance the integrity and delivery of high-quality, cost-effective Medicaid home-based care through proactive and constructive engagement with government leaders and across the Medicaid home-based care stakeholder community.

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Medicare to Start Paying Doctors Who Coordinate Needs of Chronically Ill Patients

August 16 - In a policy change, the Obama administration is planning to pay doctors to coordinate the care of Medicare beneficiaries, amid growing evidence that patients with chronic illnesses suffer from disjointed, fragmented care.

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Report Discusses Consequences of Not Expanding Medicaid

August 15, 2014 - The Robert Wood Johnson Foundation and the Urban Institute released a brief highlighting the financial repercussions for the 24 states that have not expanded Medicaid. Deciding not to expand Medicaid, these states will collectively forgo $423.6 million in federal funding, and leave 6.7 million uninsured.

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Still No Word on IN Republicans' Alternative Medicaid Plan

April 15, 2014 - Indiana Republican Gov. Mike Pence and Republican state legislators are hopeful that their alternative plan to traditional Medicaid expansion is still being considered by the Administration despite Secretary Sebelius' recent resignation. The Governor has not heard from the Administration on this matter since he met with the former secretary in February 21. Gov. Pence had sent Secretary Sebelius a follow up letter on March 4.


Corbett plan will test federal agency on Medicaid

April 14, 2014 - Accompanying Corbett's proposal is a request to pare the existing Medicaid program for adults, including limiting hospital admissions, medical supplies and radiology procedures such as MRIs, CT scans and X-rays. That, Alker said, has nothing to do with the purpose of a waiver, and it is possible CMS tells Corbett to request those changes separately.


Kansas Senate Approves Prompt Pay Bill

March 26, 2014 - H.B. 2552 would provide a cause of action for providers who are not promptly paid by KanCare's MCOs. Providers will be able to assess a 12% fee each month that payment is not fully paid. The bill follows another such bill, S.B. 317, that stalled in the Senate in February.


Massachusetts Receives $110.6 Million Grant to Expand HCBS

March 25, 2014 - The $110.6 million grant from the Centers for Medicare and Medicaid Services (CMS) stipulates that Massachusetts must spend at least 50 percent of their federal funds on home and community-based services (HCBS). Specific use of the funds will be determined in the coming months. This follows the Governor's FY 2015 budget which expands the Commonwealth Home Care Program by $16.9 million, as well as the Governor's proposal to expand Massachusetts' Supportive Housing Program from 31 to 41 sites.


Advocates Push for Amendment Banning HCBS Cuts in Louisiana

March 18, 2014 - Home and community-based services (HCBS) advocates are pushing for a constitutional amendment in Louisiana that would prevent rate reductions for HCBS and hospice. Similar constitutional amendments for hospital and nursing homes/intermediate care facilities will be presented to voters in the fall.


Kansas Officials Cleaning Up HCBS Waitlists

March 14, 2014 - Last week, Kansas sent letters to around 2,600 physically disabled, stating that if they did not reply by June 30 indicating an interest in receiving services, they would be taken off the wait list. The physical disability waiver currently has 5,515 beneficiaries, and Kansas is attempting to raise that capacity to 5,900.


New York Times Profiles MLTSS Shortcomings

March 6, 2014 - The New York Times discusses the negative impacts of cost containment in managed long term services and supports (MLTSS) programs in Tennessee, New York, Wisconsin, and Minnesota.


California PACE Program Faces Significant Reimbursement Cuts

March 3, 2014 - California's Program of All-Inclusive Care for the Elderly (PACE), a program used to keep seniors and the disabled living at home at 11% of the cost of skilled nursing facility care, has faced cuts over the last six years. A bill in California's Assembly hopes to reverse the 10% MediCal cuts effective late last year.


Elder Abuse Bills Gain Traction in Georgia and Iowa

February 17, 2014 - In Georgia, a House panel approved a bill that would increase the first offense of operating an unlicensed personal care home from a misdemeanor to a felony. In Iowa, a bill would provide emergency orders and resources and referrals for elderly abuse victims.


California Replaces Sanctioned Plans for Duals Demo

February 14, 2014 - Two of California's duals plans had been sanctioned this year by CMS, one because of marketing and enrollment issues, and the other because of quality issues. California has managed to substitute the two contractors with three. The revised start date for the Duals Demo, though previously delayed numerous times, remains at April of this year.


North Carolina Paying Millions in Consulting Fees to Revamp Medicaid

February 14, 2014 - One consultant contract, for $3.25 million, provides for a reorganization of NC's Medicaid department, while the second, at almost $500,000, seeks to assess the state's fraud and audit capabilities and provide recommendations in that space.


Florida MCOs Transitioning Enrollees from Nursing Homes to Home Care

February 10, 2014 - Sunshine Health, one of seven of Florida's Medicaid MCOs, has transitioned 163 Medicaid enrollees from the nursing home. Seventy of those have been transitioned to home care. Florida is in the process of transitioning 45,000 nursing home residents and 40,000 home care and assisted living facilities residents to managed care.


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