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Ms. Mary Carr, MPH, BSN, RN

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CY 2026 Home Health Final Payment Rule

Posted By Mary Carr 11-28-2025 05:23 PM
Found In Egroup: Home Heath \ view thread
CMS has released the Calendar Year (CY) 2026 Home Health Prospective Payment System Final Rule. The Alliance will share its analysis of the rule soon. 2025-21767.pdf ------------------------------ Mary Carr Vice President, Regulatory Affairs National Alliance for Care at Home ...

OASIS and Part B therapy

Posted By Mary Carr 11-20-2025 10:54 AM
Found In Egroup: Home Heath \ view thread
CMS has released the October quarterly OASIS FAQs. Notably, CMS issued a correction to last quarter's guidance regarding OASIS collection and reporting for Part B outpatient therapy patients treated by a home health agency. In the July FAQs, CMS had indicated that OASIS requirements applied to these ...

RE: HH Referral Order Requirements

Posted By Mary Carr 11-19-2025 10:42 AM
Found In Egroup: Home Heath \ view thread
Hi Holly, There is no requirement for the POC to be fully developed and signed by the ordering practitioner before initiating care. You must have an order for any skilled service provided during the admission visit, but this may be obtained verbally. A common practice is for the admitting ...

RE: HH Referral Order Requirements

Posted By Mary Carr 11-19-2025 09:59 AM
Found In Egroup: Home Heath \ view thread
Hi Toi, There is no requirement to include all ordered disciplines on the F2F encounter. Nor is there a requirement for the encounter to include a narrative that supports homebound and the need for skilled services . The narrative was eliminated in 2015. Currently, the F2F encounter must include ...

RE: Can the Medicaid Episode be put on hold, when a patient needs to be flipped to Medicare for a bit.

Posted By Mary Carr 11-19-2025 09:27 AM
Found In Egroup: Home Heath \ view thread
Hi Jennifer, You'll have check with your state Medicaid office regarding operations and processes related to switching to Medicare. The main issue is assuring that Medicaid is the payer of last resort for dual eligibles.

HHVBP APRs posted

Posted By Mary Carr 11-13-2025 12:14 PM
Found In Egroup: Home Heath \ view thread
Expanded HHVBP Model: Final CY 2025 Annual Performance Reports (APRs) are Available in iQIES Final CY 2025 Annual Performance Reports (APRs) are Available in iQIES The Final CY 2025 Annual Performance Reports (APRs) for the expanded HHVBP Model have been published in the Internet Quality Improvement ...

Federal Government Reopens

Posted By Mary Carr 11-13-2025 11:59 AM
Found In Egroup: Home Heath \ view thread
As you are well aware, last night, the House passed the Senate Amendment to H.R. 5371, the Continuing Appropriations and Extensions Act, 2026, sending the measure to the President. President Trump subsequently signed this bill into law, formally ending the 43-day government shutdown. The bill provides ...

Federal Government Reopens

Posted By Mary Carr 11-13-2025 11:59 AM
Found In Egroup: Hospice \ view thread
As you are well aware, last night, the House passed the Senate Amendment to H.R. 5371, the Continuing Appropriations and Extensions Act, 2026, sending the measure to the President. President Trump subsequently signed this bill into law, formally ending the 43-day government shutdown. The bill provides ...

TRICARE

Posted By Mary Carr 10-08-2025 05:40 PM
Found In Egroup: Home Heath \ view thread
FYI: The Department of Defense has released information on the status of health care operations and TRICARE coverage for active-duty military personnel during the government shutdown. Notably, TRICARE may be unable to process or pay medical claims for services provided on or after October 1, 2025, until ...

TRICARE

Posted By Mary Carr 10-08-2025 05:40 PM
Found In Egroup: Hospice \ view thread
FYI: The Department of Defense has released information on the status of health care operations and TRICARE coverage for active-duty military personnel during the government shutdown. Notably, TRICARE may be unable to process or pay medical claims for services provided on or after October 1, 2025, until ...

Home health F2F and telehealth

Posted By Mary Carr 10-01-2025 05:36 PM
Found In Egroup: Home Heath \ view thread
We understand that during the RCD webcast this morning, Palmetto stated that for all SOCs dated on or after October 1, 2025, the face-to-face encounter must be conducted in person. The Alliance contacted Palmetto for clarification and reminded them that the F2F encounter may occur up to 90 days prior ...

Shutdown and telehealth

Posted By Mary Carr 10-01-2025 12:01 PM
Found In Egroup: Hospice \ view thread
The Centers for Medicare & Medicaid Services (CMS) sent an MLN Connects Special Edition newsletter this morning addressing Medicare claims processing and telehealth, among other Medicare operational issues. CMS acknowledges that the telehealth restrictions that are now in place due to the expiration ...

Shutdown and telehealth

Posted By Mary Carr 10-01-2025 11:59 AM
Found In Egroup: Home Heath \ view thread
The Centers for Medicare & Medicaid Services (CMS) sent an MLN Connects Special Edition newsletter this morning addressing Medicare claims processing and telehealth, among other Medicare operational issues. CMS acknowledges that the telehealth restrictions that are now in place due to the expiration ...

HHQRP Reports

Posted By Mary Carr 07-11-2025 05:49 PM
Found In Egroup: Home Heath \ view thread
CMS released the Preview Reports and Star Rating Preview Reports for the October 2025 refresh of Home Health Quality Reporting Program (HH QRP) data on July 9. One agency has reported highly unusual results in their data. We are interested in learning whether other home health agencies are experiencing ...

comment due date

Posted By Mary Carr 07-08-2025 01:27 PM
Found In Egroup: Home Heath \ view thread
FYI: CMS has issued a correction notice to the comment due date for the 2026 Home Health Payment Update Proposed Rule. Public comments on the rule are due August 29, 2025. C1-2025-12347.pdf. ------------------------------ Mary Carr Vice President, Regulatory Affairs National Alliance for ...

RE: Oasis for All Impact on Quality Reporting Requirements: QAO Calculation

Posted By Mary Carr 03-25-2025 12:30 PM
Found In Egroup: Home Heath \ view thread
We need to seek clarification from CMS regarding whether their system has the capability to exclude Non-Medicare/Medicaid patients admitted before July 1, 2025, but have a subsequent OASIS assessment completed and submitted on or after July 1, 2025. ------------------------------ Mary Carr Vice ...

RE: NOMNC Timing questions

Posted By Mary Carr 02-27-2025 10:54 AM
Found In Egroup: Home Heath \ view thread
The NOMNC is issued prior to (2 days/second to the last visit) when the agency anticipates the patient will be discharge . It should not be provided to the patient at the of an episode if the coverage is continuing. There is an exception to the timing of the notice when care ends because the ...

RE: Dating provider signatures when VA is payer source

Posted By Mary Carr 01-09-2025 05:03 PM
Found In Egroup: Home Heath \ view thread
There are a couple of places in HHCoPs where signature and date are referenced, standards for verbal orders and clinical records. A signature and date on orders and the certification are Conditions for Medicare payment. 42 CFR 484.60(b)(4)When services are provided on the basis of a physician or allowed ...

All Item OASIS

Posted By Mary Carr 12-23-2024 04:13 PM
Found In Egroup: Home Heath \ view thread
CMS has released the final All-Items OASIS. This is in addition to last week's release of the final individual OASIS time points. OASIS-E1 All Items ------------------------------ [Meloni] [Jensen] [RN, BSN, MSM] [Director, Quality Improvement] [Providence St Joseph Home Care] [Anaheim] [CA] ...

HH 2025 payment rule corrections

Posted By Mary Carr 12-20-2024 04:45 PM
Found In Egroup: Home Heath \ view thread
CMS has issued a correction notice to Calander Year 2025 Home Health Payment Rate Update Rule. 2024-30169.pdf II. Summary of Errors On page 88375, in the table titled ''Table 7: Final OASIS Points Table for CY 2025'', we made a typographical error in a column heading. On page 88376, ...