Articles by Tom Threlkeld
Selected HHAs Complied With Fed Rules for Provider Relief Fund Payments

The selected home health agencies complied with the terms and conditions and federal requirements for expending Provider Relief Funds (PRF) funds, according to a new Office of Inspector General (OIG) of the Department of Health & Human Services (HHS). The $178 billion PRF program provided funds to eligible providers for health care-related expenses or lost […]
Read MoreHospice Special Focus Program Playbook for Members Will Help Guide Media, Patient Relations

The Hospice Special Focus Program (SFP) was developed by the Centers for Medicare & Medicaid Services (CMS) to identify and improve the performance of hospice providers struggling to meet quality standards. As part of the 2020 HOSPICE Act, the SFP was intended to strengthen oversight, promote quality improvements, and ensure compliance among underperforming hospices. However, […]
Read MoreEnsuring Accurate Medicare Cost Reports: A Key to Effective Advocacy for the Industry

Are inaccurate Medicare cost reports hurting you in the long run? Based on data from self-reported Medicare home health cost reports of providers enjoying an aggregate 20% profit margin, CMS has proposed year-after-year cuts to home health payments, seen most recently in the 2025 final rule. Join the National Alliance for Care at Home and […]
Read MoreWe Need You: Act to Fix the Hospice SFP

The Hospice Special Focus Program (SFP) will fail patients and providers by using bad data to rank hospice provider performance. Currently, the SFP will only benefit poor performers who will go undetected. But there is a path forward. The bipartisan Enhancing Hospice Oversight and Transparency Act (H.R. 10097) will delay the SFP and allow CMS time to fix the […]
Read MoreOIG Audit Reveals Gaps in OCR’s HIPAA Audit Program

On November 25, 2024, the U.S. Department of Health and Human Services’ (HHS) Office of Inspector General (OIG) published findings from an audit of the Office for Civil Rights’ (OCR) HIPAA Audit Program. The report highlights significant shortcomings in OCR’s implementation and oversight of the program, raising concerns about the protection of electronic protected health […]
Read MoreThe Hospice SFP Can Be Fixed. Will You Help?

The Hospice Special Focus Program (SFP) will publicly rank hospice providers’ performance using flawed methods. This threatens to misinform patients and families when they are making critical end-of-life care decisions. This will only benefit bad actors who will go undetected. But there is a solution. The bipartisan Enhancing Hospice Oversight and Transparency Act (H.R. 10097) will delay […]
Read MoreRevised Medicare Non-Coverage Notices Issued

The Office of Management and Budget (OMB) has renewed the Notice of Medicare Non-Coverage (NOMNC, CMS-10123), and the Detailed Explanation of Non-Coverage (DENC, CMS-10124). The NOMNC and DENC renewed notices contain updates which are applicable only to Medicare Advantage (MA) enrollees. Providers must use the current notices until December 31, 2024, and are required to […]
Read MoreDr. Landers Leads Alliance Advocacy on Home Health Cuts, Hospice SFP

The National Alliance for Care at Home is focused like a laser on the two big advocacy priorities — the looming payment cuts to home health care and the Medicare hospice Special Focus Program (SFP) — Alliance CEO Dr. Steven Landers told a gathering of journalists in a media briefing on November 21, 2024. “The […]
Read MoreCMS Releases Annual Updates to Medicaid Eligibility Standards

On Friday, November 15th, the Centers for Medicare & Medicaid Services (CMS) released an information bulletin that provided information about annual updates to the income standards for certain eligibility groups. Many eligibility criteria for older adults and people with disabilities are based on the Supplemental Security Income (SSI) program’s Federal Benefit Rate (FBR), and certain […]
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