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Biomedical subjects

W A Dombi

Publications and source records attributed to W A Dombi.

At least 19 recordsLinked to original sources
PubMed2001

Quality of care compliance plans under PPS.

With the onset of Medicare home health Prospective Payment System (PPS), home care agencies must retool their internal compliance efforts to address the new risk areas. PPS presents a reversal of the incentives that existed under previous Medicare reimbursement principles, significantly reducing the risk of non-compliance and fraud in the financing of services while dramatically increasing non-compliance risks in areas related to quality of care and access to services.

Aged↗
PubMed2001

The new age of opportunity & risk. Medicare PPS.

The home care community must take appropriate measures to ensure that PPS does not undermine the values and principles of home care. The temptation of PPS to achieve profit at the expense of quality of care and access to services must be confronted by the home care community through reinforced values systems and concrete risk management measures.

Aged↗
PubMed2001

Case-mix--adjustment--the next generation.

This article explores the ongoing efforts of Centers for Medicare and Medicaid (CMS) to improve on the case-mix adjustment system. Currently, CMS, through outside contractors, is engaged in a variety of research projects, studying aspects of the home health case-mix adjustment system. With these efforts, the home health community can expect to operate with an ever-changing case-mix adjuster.

Aged↗
PubMed2000

Agencies at risk: increased liability under PPS.

With the long anticipated shift from cost reimbursement to a prospective payment system (PPS) for Medicare home health services, the home care industry can look forward to improved opportunities for service flexibility, the end to retroactive cost disallowances, and opportunities for financial rewards through efficiencies in operation. However, bringing home care into a more modern world of reimbursement also means that new forms of risk emerge, creating the potential for a liability that must be recognized and properly managed.

Home Care Services↗
PubMed2000

Home health PPS: new payment system, new hope.

In light of the financial turmoil most home health providers experienced over the past two years, a new payment system brings a sense of hope. The prospective payment methodology will provide different incentives than a cost-based reimbursement system. These new incentives will open the way for new approaches to deliver home health care. However, this new hope is accompanied by a sense of anxiety because the system is new and untested.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1999

Overpayment guidance for home health agencies.

IPS brought many changes for home health providers, including intensified claims review and audits, resulting in overpayments. Agencies have several options despite the limited protection they have under Medicare, including challenging determinations, rebutting the decision, requesting a waiver, and appealing decisions.

Aged↗
PubMed1999

Interim payment system and risk management.

Agencies need to be aware of the legal implications of the Medicare reimbursement system changes in the high-risk areas of patient care. Agencies must take deliberate steps to manage the risks that are sure to ensue under the new system of restricted payments and to minimize liability concerns.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1998

Interim Payment System and risk management.

To stay afloat under the new Interim Payment System, agencies will need to be aware of the legal implications of the new changes. Agencies need to take deliberate steps to manage the risks that are sure to ensue under the new system of restricted payments.

Budgets↗
PubMed1998

The OIG's model compliance program.

Home care agencies face never-ending and hard-to-track list of rules. The Office of the Inspector General has provided guidelines for agencies on implementing a voluntary compliance program to prevent fraud, abuse, and waste. Through the development of internal controls, which promote adherence to federal and state laws, agencies safeguard themselves from problems.

Adult↗
PubMed1995

Medicare: current audit & reimbursement issues.

Home care agencies have been under the Medicare microscope lately for issues of fraud; the Health Care Financing Administration (HCFA) is retooling its audit process in light of this focus. HCFA is also reconsidering its policies on deductible costs of lobbying. What do agencies need to know about this and other issues to stay financially healthy?

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1994

Legal issues in home care--1994.

Expanding home care services opens the industry to legal considerations from every angle. This article serves as an overview to this issue of CARING, touching on salient points of the legal issues important to home care providers.

Antitrust Laws↗
PubMed1991

The patient's right of self-determination.

Recent legislation requires Medicare and Medicaid providers to assure the patient's right of self-determined care. This legislation necessitates that health care providers understand their state laws and standards affecting the patient's right to issue advance directives on health care, to refuse or accept treatment, and to make decisions concerning the receipt of health care services.

Advance Directives↗
PubMed1991

Medicaid reimbursement rates.

Inadequate rates of payment have resulted in a decline of Medicaid-covered home care services. Although solutions to the payment rate problems exist, patients and providers may have to resort to litigation to enforce their rights under federal law.

Health Services Accessibility↗