News

Forty-three states and DC must impose an 80-hour monthly work requirement by January 1, 2027. The medical frailty exemption is where home care lives, and your claims may be the proof.

Medicare effectively paid low-visit hospices $573 per routine home care visit versus $232 at high-visit hospices. What GAO-26-107585 found and how to measure your own visit intensity.

Home health agencies were named in nearly 32% of the health care fraud reports banks filed with FinCEN, more than any other provider type. What banks flag, and how clean books avoid it.

CMS posted Annual QAO performance reports on September 18, 2026. Below 90% means a 2-point cut to your Medicare update, and older OASIS assessments are rejected after December 31.

California, Colorado and Michigan have published January 1, 2027 minimum wages. New York, the state with the highest home care aide floor, has not. What that means for margins.

CMS recalibrated all 432 PDGM case-mix weights and LUPA thresholds for CY 2026, and OASIS-E2 took effect April 1. Where the dollars leak, and what CY 2027 adds.

CMS reports 20.37% of hospices failed quality reporting for FY 2026, each losing four points off the annual payment update. Where HOPE stands and what the FY 2027 final rule settled.

The CERT improper payment rate for home health is 7.7%. When OIG audited one agency this summer, 37 of 100 sampled claims were in error. How extrapolation turns $8,332 into $43,074.

Every Medicare-certified home health agency carries a -5% to +5% adjustment on every claim, decided by performance delivered two years earlier. The measure weights and the report calendar.

Midyear projections put 2026 hospice transaction volume at 44 deals — a post-COVID high. What buyers are underwriting now, and how the enrollment moratorium limits deal structure.

The nationwide freeze on new Medicare home health and hospice enrollment hits six months on November 13, 2026. The dates, the CHOW trap, and what to do before then.

CMS sent its proposed CRUSH rule to OMB on August 7, 2026. What the AI models flag in hospice claims, and how to prepare for a pre-payment review you won't be warned about.

CMS delayed two Access Rule provisions in 2026 but not the 80% pass-through. The real timeline to 2030, and what a shrinking Medicaid census does to your 20%.

CMS's FY 2024 RCD data: 97% of pre-claim requests affirmed, a 3.5% denial rate, and 51.6% of appeals overturned — but only 7% of denials were ever appealed.

Aveanna Healthcare’s second-quarter revenue beat puts demand, labor costs, reimbursement, margins, and outlook under investor scrutiny, with practical accounting lessons for home-based care providers.

Alignment Healthcare shares dropped 16.7% after whistleblower accounting allegations triggered a securities investigation, raising questions about expense classification and Adjusted EBITDA.

Nova Leap Health reported record second-quarter 2026 revenue, operating income and Adjusted EBITDA, supported by acquisitions and expansion across North America.

Pennant’s quarterly growth, led by home health and hospice operations, highlights financial and operational lessons for Chicagoland care providers.

A new home care survey identifies compliance, scheduling and billing as leading technology priorities while highlighting growing AI use and the need for stronger financial data practices.

A New York investigation examines $733 million in Medicaid billing by Flushing social adult day-care centers, alleged kickbacks, oversight failures, and compliance lessons for healthcare providers.