News
A shift in federal DME fraud oversight demands a shift in compliance thinking
4+ hour, 30+ min ago (705+ words) In my work supporting durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) partners and home care organizations across the country, regulatory change rarely arrives without consequence. The Centers for Medicare & Medicaid Services' (CMS) recent announcement of a six-month nationwide moratorium…...
The revenue gap hiding in home health billing
6+ day, 4+ hour ago (567+ words) Mc Knights Home Care Home health agencies are losing revenue they've already earned. Not from denied claims or underpayment disputes. From billing gaps that never show up on a P&L. The problem is structural. Most home health agencies operate on…...
CMS to raise MA payments by 2. 48 percent in 2027, delay risk adjustment model updates
2+ week, 3+ hour ago (211+ words) The Centers for Medicare & Medicaid Services on Monday issued a calendar year 2027 Medicare Advantage rate announcement that is expected to raise payments by 2. 48%, or over $13 billion. That represents a greater increase than the update proposed in January. "Medicare Advantage and…...
Home care groups CRUSH plans for more anti-fraud requirements
2+ week, 4+ day ago (255+ words) A pair of major home care organizations say that federal regulators simply have to enforce rules already in place rather than impose burdensome new administrative requirements in order to beef up fraud prevention and monitoring practices. The National Alliance for…...
Long-term care balances federal regulatory pullback with states' increased scrutiny
1+ mon, 4+ day ago (1087+ words) With the recent repeal of the federal staffing mandate for nursing homes and the relaxation of other regulations, long-term providers are breathing a little easier about the regulatory outlook this year." But legal experts representing the industry warn providers against…...
Traditions Health agrees to pay $34 M to resolve False Claims Act liability
2+ mon, 3+ week ago (362+ words) Traditions Health LLC has agreed to pay $34 million to resolve its civil liability for billing medically unnecessary home health claims to Medicare as well as providing financial benefits to physicians in exchange for referrals, the US Department revealed last week....
Oz accuses California governor of 'tolerating' home care fraud, requests action plan
2+ mon, 3+ week ago (459+ words) Mehmet Oz, MD, administrator of the Centers for Medicare & Medicaid Services, this week harshly criticized California's Gov. Gavin Newsom (D) for being lax on fraud in the state's Medicaid program, known as Medi-Cal, and Medicare. He specifically called out excessive spending…...
Private equity firm Main Post Partners acquires Home Well Care Services
2+ mon, 4+ week ago (336+ words) Home Well Care Services, which has over 100 franchise owners and 170 units in 35 states, has just inked a deal with San Francisco-based Main Post Partners, a private equity firm with expertise in franchising and consumer service brands. Home Well provides personal…...
2025 home care dealmaking ends on high, beating 2024 by 21 transactions, firm reports
3+ mon, 3+ hour ago (247+ words) In terms of transaction volume, 2025 ended strong for home care. A total of 105 total deals closed during the year, 21 more than last year, healthcare mergers and acquisitions firm Mertz Taggart reported Tuesday. The hospice segment helped lift home care transaction…...
Enhabit sees positive in home health rule, plays hardball with MA payers
4+ mon, 1+ week ago (385+ words) Enhabit continues to take a hard line with Medicare Advantage payers " leveraging quality metrics and patient access data to secure rate increases and showing a willingness to walk away from deals, company executives said during a fireside chat Tuesday at…...