In The News

The Top Legal, Regulatory Issues Home-Based Care Providers Are Facing In 2023

Home Health Care News / By Joyce Famakinwa
There are a number of key issues that home-based care providers looking to navigate legal and regulatory hurdles need to keep their eye on – some old, and some new. 
In some areas, it will be important for providers to increase their advocacy efforts, like when it comes to a potential ban on non-competes, Angelo Spinola, the chair of home care, home health and hospice at the law firm Polsinelli, told Home Health Care News.
“When the industry has pulled together, worked together, and spoken in a singular voice, that has been a very effective strategy,” he said.
A potential ban on non-competes is just one of the many issues providers need to prepare for. HHCN recently caught up with Spinola and Katy Barnett – director of home care and hospice operations and policy at LeadingAge – to get a complete overview nearly halfway into the year.
Increased government investigations into the home-based care industry
During the height of the COVID-19 pandemic, many home-based care providers relied on the financial lifeline of government relief programs.
Moving forward, home-based care providers should expect to receive more attention from government watchdogs, as those relief programs — such as the Paycheck Protection Program (PPP), the Economic Injury Disaster Loan (EIDL) and employee retention tax credit programs — receive more scrutiny, according to Spinola.
“There’s been a lot of investigation around qualifications to participate in those programs, the use of funds from those programs, and I think we can expect to see that trend continue,” he said.
An increase in investigations means that providers will need to be more proactive.
“Understand what the requirements are, and take proactive steps to be in compliance with those requirements before the government investigation,” Spinola said.
Specifically, it will be imperative for providers to perform self-audits and be able to trace how they’ve spent these funds.
Aside from providers’ use of the aforementioned program funds, there is also more investigation activity around anti-kickback issues and referral relationships.

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Here's How Lawmakers Can Slash Medicare Spending Without Cutting Benefits

Forbes / By Sally Pipes
Politicians don't agree on much these days, but one thing seems to bring even Democrats and Republicans together. And that's refusing to cut Medicare.
That position may be politically popular. But it's at odds with the long-term sustainability of the program. Medicare's hospital insurance trust fund is set to go bankrupt by 2028. The program costs taxpayers $747 billion each year—12% of total government spending.
Fortunately, there's a way for lawmakers to rein in Medicare spending without cutting benefits. By giving seniors vouchers to spend on privately managed Medicare plans, lawmakers can cut costs while increasing quality of care.
Such a model, which already works in one part of Medicare, will help keep seniors healthy while protecting Medicare for future generations.
About 35 million Americans were enrolled in "Traditional Medicare," a fee-for-service system that covers hospital insurance, Part A, and medical insurance, Part B. The federal government administers Traditional Medicare directly, paying out nearly every claim submitted—including about 8% of improper claims, which cost the government around $32 billion each year.
Shifting to a premium support model would rein in Medicare payments. The federal government would give each senior a voucher for a fixed amount of money that they could spend on privately administered insurance or Traditional Medicare.
In other words, insurers would have to compete for seniors' business. They'd have to assemble benefits packages that appeal to potential customers. Competition would drive down costs and improve quality. And that's good news for John Q. Taxpayer, who would ultimately be footing the bill.
According to the nonpartisan Congressional Budget Office, if lawmakers had shifted to a premium support model in 2022, Medicare spending could have fallen between $21 billion and $419 billion by 2026, depending on whether existing beneficiaries participated in the model.
Making the shift today would save beneficiaries $333 billion over a decade, and taxpayers $1.8 trillion over 10 years, according to former CBO director and current American Action Forum president Douglas Holtz-Eakin.

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Updated Resource Available: Introduction to the Hospice Quality Reporting Program (HQRP) Web-Based Training

The Introduction to the HQRP Web-Based Training is a two-part training series for Hospice providers.

Course 1: Getting Started with the HQRP and Public Reporting Provides a general overview of the HQRP and reviews the program’s use of three data sources: The Hospice Item Set (HIS), the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Hospice Survey, and the Medicare claims. Course 1 contains the following six lessons: 

  • · What is the HQRP?
  • · HIS and the HIS Manual
  • · Timing and Maintenance of the HIS
  • · HQRP Claims-Based Quality Measures
  • · The CAHPS® Hospice Survey
  • · Care Compare and Public Reporting

Course 2: HQRP Data Submissions and Reports Provides an introduction to the HQRP data submission requirements and reports available to providers. Course 2 contains the following six lessons:

  • · Getting Ready to Submit the HIS
  • · HIS Item Completion
  • · Successful Submission and Acceptance of the HIS
  • · Identifying and Addressing Errors on the FVR
  • · Overview of the HQRP Provider Reports
  • · HQRP Useful Websites and Resources

Although the course lessons were designed to be completed in sequential order, you may jump to any topic of interest. Each lesson can be completed at your own pace.

Links to web-based trainings:

If you have questions regarding resources and training, please email the PAC Training Mailbox. Content-related questions should be submitted to [email protected].


Expanded Home Health Value-Based Purchasing (HHVBP) Model HHVBP Newsletter – May 2023

The HHVBP Newsletter provides home health agencies (HHAs) with the latest information about the expanded HHVBP Model as well as important tools, news, and timely insights from the Centers for Medicare & Medicaid Services (CMS) and the HHVBP Model Technical Assistance (TA) Team. Please consider sharing this newsletter within your organization.

Information in this edition of the newsletter includes the following:


Rocky Mountain Refuge Fundraising Golf Tournament

Wednesday, June 21, 2023 (8:00 a.m. Shotgun Start; 7:00 a.m. Check-In)

Heather Ridge Golf Course (13521 East Iliff Avenue, Aurora, CO 80014)

Rocky Mountain Refuge is the only shelter in Colorado that offers round the clock custodial family style care, where people experiencing homelessness are kept safe and comfortable and can receive hospice care from our partner agencies.

Every year hundreds of people die on the streets of Denver, alone, often afraid and in uncontrolled pain. According to various govt and service organizations homelessness has increased between 83-94% over the last 5 years. People experiencing homelessness have an average life expectancy of 30 years less than the housed population.

Shelters are not designed to offer 24/7 family style care and Hospice organizations are not shelters. Medicare only offers 5 days of inpatient care for symptom management when on hospice.  We can provide weeks of custodial family style care that is simply unavailable for most of our unhoused neighbors.

Without our services many people experiencing homelessness will die on the streets, often in terrible pain, afraid, and alone. Please help us raise funds by joining our golf tournament (forms on our website or attached) and bring comfort to folks who have nowhere else to turn. 

Visit or download the attached forms below to register: 

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