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Home Health Compliance

Home care accounts for billions of dollars in Medicare and Medicaid expenditures. Like hospitals and nursing homes, home care providers must meet strict standards for documentation, the quality of services provided and the delivery of care. Meeting these standards results in a provider being accredited, a sign of quality that persons seeking home care should look for. Medicare and Medicaid have rules and regulations for billing these services. The consequences for failing to comply with regulations can be costly, potentially resulting in the loss of revenue and enforcement actions.

The first step in maintaining compliance with regulations and reducing risk is to provide annual updated, expert compliance education to all staff members. This engaging, multimedia online course from HCCS will educate staff on the regulations and compliance issues specific to home health agencies (HHAs).

1 to 100 Learners?

Number of Learners:

More than 100 learners?

Course Outline

  • Fraud, Waste and Abuse
    • Potential consequences of falsifying information for billing
    • OIG's compliance program guidance for home health agencies
  • Conditions of Participation
    • Conditions of participation in the Medicare program
    • Key problem areas
  • Coding and Billing Issues
    • Documentation requirements
    • Proper skill level for needed services
    • Patient must meet eligibility requirements
    • Episode of care billing and payment
    • Continuous 60-day episode of care recertification
    • Requests for anticipated payment (RAP)
    • Outlier payments

Target Audience

Home Health Agency:

  • Administrators/Corporate Officers
  • Medical Directors
  • Physicians referring patients for home health care and overseeing their progress
  • Physical therapists and physical therapy assistants
  • Occupational therapists and occupational therapy assistants
  • Speech-language pathologists
  • Registered nurses
  • Practical nurses (e.g., LPNs and LVNs)
  • Home health aides
  • Public health nurses
  • Social workers and social work assistants