Since 2017, CDC has been committed to protecting patients and addressing sepsis, a life-threatening medical emergency that affects at least 1.7 million adults each year. This Sepsis Awareness Month, CDC ushers in a new chapter in advancing sepsis programs and patient care: New Innovative Tools and Scientific Work CDC has led the way providing new, […]
The healthcare technology landscape is constantly evolving, and a crucial question emerges: are established EHR systems, like EPIC, at risk of becoming outdated if they don’t adapt to changing needs and technological advancements? Disruptions have occurred in the past. Blockbuster, once a leader, didn’t adapt to streaming and declined. Netflix embraced innovation and succeeded. This […]
Palmetto GBA has also released the latest data for Q4 2024 on the most common hospice claim denial codes. These findings are essential for hospice providers working to maintain compliance and ensure proper reimbursement under Medicare. Top Denial Codes for Hospice Claims: Agency Recommendations: Staying compliant not only speeds up reimbursement but also prevents potential […]
Palmetto GBA has published its quarterly summary of the top denial reason codes for home health agencies (HHAs) for Q4 2024. These denial reasons offer insight into common compliance pitfalls and documentation errors that directly affect claim approvals and agency cash flow. Top Reasons for Denials in Home Health Include: Each of these denial codes […]
As 2025 unfolds, significant updates to HIPAA regulations are on the horizon, with sweeping changes aimed at increasing patient access to health data while tightening data privacy and security protocols. Healthcare providers should prepare for these changes now to avoid compliance pitfalls and potential financial penalties. The U.S. Department of Health and Human Services (HHS) […]
On February 14, 2025, the Centers for Medicare and Medicaid Services (CMS) stopped introducing the Hospice Special Focus Program (SFP) to conduct a more thorough assessment. This break is a necessary step to recognize that the program is not achieving its intended goals in its current format. The hospice community has long supported strong patient […]
A new regulation has been released regarding Medicare Advantage plans. If you are providing home health services to a patient enrolled in a Medicare Advantage plan, you are now required to issue the Notice of Medicare Non-Coverage. This notice must include information about the BFCC-QIO, allowing patients the opportunity to appeal decisions related to their discharge. […]
Healthcare providers have been facing significant challenges with PCR (Pre-Claim Review) requests in recent months, following a new directive from CMS (Centers for Medicare & Medicaid Services) to Palmetto GBA. The change in interpretation, which began impacting providers in late November, requires a face-to-face encounter performed by the certifying physician or nurse practitioner (NP) for […]
The Centers for Medicare & Medicaid Services (CMS) has announced that the Hospice Benefit Component of the Value-Based Insurance Design (VBID) Model will officially end on December 31, 2024, at 11:59 PM. This decision impacts Medicare Advantage Organizations (MAOs) participating in the Hospice Benefit Component and requires them to make adjustments to ensure continued compliance […]
CMS has announced the updated Medicare Part B premiums and deductibles for 2025. These changes, which reflect adjustments for rising healthcare costs and program expenses, are critical for providers to understand as they plan their billing and patient communications for the year ahead. 2025 Updates to Part B Premiums and Deductibles Premium Increases Deductible Changes […]