Driving Recovery in the Opioid Crisis – The Technology to Get Us There

The opioid crisis has been long in the making and has yet to cease force as it continues to permeate the healthcare community. Drug use admission rates have increased 500 percent since the early 2000s. According to the CDC, there were more than 63,000 overdose deaths in 2016, which surpasses the number of car accidents and gun deaths in that same year. When studying the opioid epidemic, it’s important to consider the causes of addiction, which can range from genetics,…

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Patient-Driven Groupings Model (PDGM): What Home Health Agencies Should Know

Home health agencies have a lot to look forward to when it comes to upcoming regulatory requirements for reimbursements as proposed by the Centers for Medicare and Medicaid Services (CMS). Let’s dive in to learn more about what they can do now to prepare for new payment changes in 2020. What is Patient-Driven Groupings Model, or PDGM? PDGM has roots from the previously proposed Home Health Groupings Model, or HHGM, which CMS has described as focusing on the value versus…

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How the Recent Opioid Legislation Impacts Community-Based Providers

Today President Trump signed into law legislation intended to help stem the opioid crisis. The SUPPORT for Patients and Communities Act provides additional funding to combat addiction, improve access to treatment and authorizes a pilot financing program to incentivize providers to invest in technology to better coordinate care. We’ve all seen the stats when it comes to the opioid crisis: More than 72,000 people died in the U.S. in 2017 from an opioid overdose. The Centers for Disease Control and…

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PDGM Proposal Merits Close Scrutiny

The Patient Driven Groupings Model (PDGM) recently released by CMS is a good news/bad news scenario for home health organizations. We’ve examined the proposal closely and submitted comments to the Centers for Medicare & Medicaid Services on behalf of our home health and hospice clients. The good news is that the proposal is budget-neutral. Under the previous Home Health Groupings Model (HHGM), which was withdrawn last year following the public comment period, organizations faced an estimated 15 percent cut in…

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Congress Passes Major Opioid Bill: Includes Health IT Financial Incentives for Behavioral Health and Substance Use Treatment Providers

Behavioral health organizations, including community mental health centers, psychiatric hospitals, addiction treatment and other key providers consistently lag behind acute care in the adoption of technology. Despite an increased demand for services and the fact they serve some of the nation’s most at-risk populations, these providers weren’t fully eligible for federal financial incentives on a par with acute care providers for purchase of electronic health record (EHR) platforms, key to enhancing care quality and efficiency in all healthcare settings. Significantly,…

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Electronic Visit Verification (EVV) Requirements on the Horizon

A lesser-known component of the 21st Century Cures Act is the electronic visit verification (EVV) requirement that goes into effect January 1, 2020, for personal care services (PCS), and January 1, 2023, for home health care services (HHCS). So, what is EVV and how can your organization prepare to comply with this requirement? One of the greatest impacts will be to PCS providers who offer opportunities to Medicaid beneficiaries to receive services such as activities of daily living (ADL) in…

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Revisiting a 2018 Highlight: Annual Cap Lifted for Therapy Services

The Bipartisan Budget Act of 2018, passed by Congress earlier this year, included a provision lifting the annual cap for physical, occupational and speech therapy services. The provision ends a 20-year back-and-forth between attempts to set a financial cap and efforts to prevent that from happening. It also cements an earlier settlement between patients (Jimmo) and the Centers for Medicare & Medicaid Services (CMS) that allows for continued therapy services for maintenance of mobility or activities of daily living, instead…

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5 Things to Know about the Recent Opioid Regulations for Medicare Part D

In June, the House of Representatives passed legislation that will impact the already complex Medicare Part D requirements. Spurred in part by a Department of Health and Human Services report that showed one-third of Medicare Part D beneficiaries received an opioid prescription in 2016. For the approximately 13 million people enrolled in Part D, nearly 80 million opioid prescriptions were written. More than 501,000 people received “high” amounts of opioids and 69,563 received “extreme” amounts, some as a result of…

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Shaping Home Health and Hospice Through Advocacy

One thing that’s constant in healthcare is change. Both home health and hospice industries are certainly no stranger when it comes to making adaptions and adjustments on a regular basis. With ever-changing policies and regulations such as pre-claim review, electronic visit verification, home health groupings model, continuous reimbursement cuts and more, it’s important for providers to have a voice in the direction of the industry. After all, you have boots on the ground, seeing day in and day out the…

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Fully-Informed Care: Legislation Updates Law and Protects Privacy

Netsmart has been a strong advocate for passage of the Overdose Prevention and Patient Safety Act (H.R. 3545) in the U.S. House and a companion bill, the Protecting Jessica Grubb’s Legacy Act (S. 1850), in the Senate. The legislation would closely align decades-old 42 CFR Part 2 regulations with HIPAA, helping assure fully-informed diagnosis and treatment for persons with a substance use disorder or history of SUD treatment. Gerald “Jud” DeLoss, Netsmart’s healthcare privacy counsel, testified on Netsmart’s behalf at…

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