New at Noyce Consulting — home care
"Oops, Congress changed that. Hospice isn't covered at 100% any more. Your husband's nurse will collect your 20% hospice co-payment, each visit, Mrs. Jones. And the Social Worker will bring your final bill on the first bereavement visit."
A little harsh, I know. And a bit unthinkable. But in essence, that's the plan promoted at a House Ways and Means Health Subcommittee hearing Oct 16, 2016.
Medicare's "Independence At Home" demonstration is studying whether providing chronically ill patients with in-home visits by primary-care providers results in both enhanced care delivery and cost savings. I applaud this Obamacare gem.
I also believe the program should stretch further and partner with home health agencies to provide a full health-care package to the beneficiaries served, regardless of homebound status.
Home Health Compare 5-Star Ratings grade patient satisfaction survey data in addition to the quality of care that agencies provide to patients.
Agencies who aren't registered in the program by April 1 will miss the deadline and lose money.
During a spot-check quality audit, you discover that the documentation in the patient record doesn't support the amount Medicare paid for the claim. Alarmed, you search the record for any misfiled documents and ask those involved with the patient's care if key information was documented correctly. After your frantic search it is clear that Medicare overpaid your agency for the services in a payment episode several months ago.
Yikes! You know the agency must repay Medicare. But isn't it too late? Was accepting the overpayment in the first place fraudulent?