PHILADELPHIA, Pa. (WTAJ) — A Pennsylvania-based home care agency has been ordered by a federal judge to pay $129,697 in back wages to 66 caregivers.Blue Ridge HomeCare, based in Philadelphia and Dover, Delaware, was ordered to pay back wages and damages after an investigation found that the company knowingly denied overtime pay to 66 home care workers.Additionally, the U.S. District Court for the Eastern District of Pennsylvania ordered the company to pay $49,434 in civil penalties to the U.S. Department of Labor. Prior to the judgment, the Department of Labor said Blue Ridge had already paid $100,000 in unpaid wages…
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A state comptroller’s audit found that New Jersey home care provider Heart to Heart improperly billed and was overpaid by Medicaid by nearly $2.4 million. The provider billed New Jersey Medicaid for unsubstantiated services, failed to verify the professional qualifications of attendants, and failed to meet Medicaid quality of care requirements. TRENTON – The State Comptroller’s Office (OSC) today announced it has issued an audit report that found Heart to Heart, a home care services provider with locations in Paterson, Hackensack, East Orange, Lakewood and Vineland, improperly billed Medicaid and received overpayments totaling $2,386,287, and must repay the overpayments to…
Key Insights CMS is proposing a permanent prospective adjustment of negative 4.067% in 2025 to account for the transition to a patient-driven grouping model. CMS estimates an increase of 2.5%, but when combined with the behavioral offset and other payment changes in the rule, the updates are estimated to result in a 1.7% decrease (approximately $280 million) compared to calendar year 2024. CMS is proposing to replace current COVID-19 reporting standards with new standards that cover a broader range of acute respiratory illnesses. CMS is proposing updates to the enrollment process for providers who resume Medicare billing privileges to reduce…
As a candidate in 2020, President Biden campaigned on building upon the Affordable Care Act (ACA) by increasing the amount of financial assistance available to people buying their own health insurance coverage through the ACA Marketplaces. Temporary subsidies were originally passed as part of the American Rescue Plan Act (ARPA) in 2021, which included two years of enhanced subsidies (2021 and 2022). The Inflation Reduction Act (IRA), which passed in 2022, extended these enhanced subsidies for an additional three years, ending after 2025. The IRA and ARPA’s enhanced health insurance subsidies both increase the amount of financial help available to…
This article is part of the HHCN+ Membership There is a villainous icon in the home health care industry. But according to William A. Dombe, president of the National Association of Home Care & Hospice (NAHC), there is a difference between a provider who makes an error in billing or delivering quality of care and one who knowingly engages in fraud. “Blatant and deliberate fraud is the issue of greatest concern,” he told Home Health Care News. “Bad actors are those who get into home health care with the intent of stealing money from Medicare, Medicaid, etc. Their goal is…
A Kaiser Permanente home health agency opened in Kona last week, allowing Kaiser Permanente members who need in-home care on Hawaii Island to have that care delivered to their homes. Photo courtesy of Kaiser Permanente The agency aims to provide nursing and physical therapy in the home for members who use assistive devices such as walkers, canes or wheelchairs, or whose health conditions make it difficult for them to leave their homes and whose care can only be safely carried out under the supervision of a skilled nurse or therapist. “Having skilled medical professionals caring for our residents in their…
This article is part of the HHCN+ Membership Leaders of major home care companies don’t operate in a vacuum. Rather, many use competitive analysis to stay one step ahead. In general, a competitive analysis is a benchmarking tool. “Many healthcare organizations use competitive analysis as a benchmark to see where they stand or how they are performing relative to similar organizations in their area,” Creamon Moore Jr., president and CEO of American Advantage Home Care, told Home Healthcare News. “This is used as a way to determine whether you are similar or different to your competitors and whether those differences…
Rapidly emerging applications of large language models–such as chat bots, apps that aid clinical care, or generate encounter notes, for example–can improve health care decision making and outcomes for providers and for patients. But without the right governance and regulatory guardrails, these models may cause more harm than good. Join Penn LDI and the Wharton Healthcare Analytics Lab as we gather national experts for an in-person conference that explores how large language models can improve clinical decision making and patient communication, and to discuss health system and policy strategies to reduce risks and maximize opportunities for advancing health care. Conference…
Long-term services and supports (LTSS) encompass the broad range of paid and unpaid medical and personal care services that assist with activities of daily living (such as eating, bathing, and dressing) and instrumental activities of daily living (such as preparing meals, managing medication, and housekeeping). They are provided to people who need such services because of aging, chronic illness, or disability, and include services such as nursing facility care, adult daycare programs, home health aide services, personal care services, transportation, and supported employment. These services may be provided over a period of several weeks, months, or years, depending on an…
The acquisition will allow HHAeXchange to expand into new states and gain access to a talent pool with extensive home care technology experience.NEW YORK, July 08, 2024 (GLOBE NEWSWIRE) — HHAeXchange, a leader in home care management solutions for providers, managed care organizations (MCOs), state Medicaid agencies, and financial intermediaries, today announced the acquisition of Generations Homecare System. Generations offers an all-in-one home care agency management software solution that provides providers with the capabilities to connect care teams, simplify day-to-day operations, and stay compliant. The acquisition brings together two companies that share a common vision and values aimed at driving…