US Judge Elects Not To Block Non-Compete Ban, Spelling Trouble For Home Care Providers

Home Health Care News / By Andrew Donlan
 
A U.S. judge decided not to block the Federal Trade Commission’s (FTC) ban on non-compete agreements this week, continuing an ongoing saga that home care providers are paying close attention to. 
 
Broadly, the ban on non-competes is seen as generally positive for home care leaders, who can now freely move on to better career opportunities. It likely won’t affect caregivers much, as many already work for more than one agency. 
 
Where it will likely have an effect, however, is in non-solicitation agreements. Those keep clients from using home care agency caregivers, and then ultimately hiring those caregivers directly and cutting out the agency. A non-solicitation is different from a non-compete, of course, but some states are already viewing them in the same light, which could be a major threat to home care operators. 
 
The FTC in April banned non-competes in a 3-2 vote. It was a major change in direction, specifically because non-compete laws were historically handled on a state level. Some states – like California and Connecticut – already had very strict laws against non-compete agreements. Other states were less strict. 
But this ban comes from the federal level. 
 
“The rulings and the positions are going beyond just the traditional non-compete agreement into client service agreements that have direct-hire provisions or penalty provisions not allowing the client to hire the caregiver away,” Angelo Spinola, the home health, home care and hospice chair at the law firm Polsinelli, recently told Home Health Care News. “That’s a big concern with what the FTC is doing – that they’re going to take that position and apply the term non-compete very broadly. If you look at the language of the final rule, it absolutely suggests that’s going to be their enforcement position.”…

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CMS Issues Home Health Claims Processing Fix

NAHC Report

The Centers for Medicare & Medicaid Services has issue Change Request 13684 that provides instructions to the Medicare Administrative Contractors (MACs) to ensure home health claims submitted more than 24 months from the date of admission are not returned in error due to Notice of Admission records being purged from the Fiscal Intermediary Shared System (FSS).

During the processing of a Home Health (HH) prospective payment system claim, the claim is matched to the corresponding Notice of Admission (NOA) to determine the NOA receipt date. The NOA receipt date is then used to apply any applicable late NOA penalty to the claim payment. The NOA receipt date is stored in FISS in the HRAP (Request for Anticipated Payment) file). If an NOA receipt date is not found in the HRAP file, the claim is returned to the provider with reason code 19963.

Previous instructions stated where a corresponding NOA cannot be found and the claim From date is 24 months or more after the claim Admission date, the contractor shall send the claim Admission date to the HH Pricer in the RECEIPT DATE field.” In these cases, the NOA is assumed to have been received in the past and subsequently purged. However, a claim may have a From date within 24 months of the Admission date but a Through date that falls after 24 months. In these cases, the claim cannot be processed because the NOA will be purged.

This CR revises the criteria for reason code 19963 to send the claim Admission date to the HH Pricer in the RECEIPT DATE field in these cases also. Several home health agencies have reported a significant number of claims impacted by this issue claims and have had to rely on intervention by the MACs.

Neuroscientists Discover Brain Circuitry of Placebo Effect for Pain Relief

Neuroscience / By University of North Carolina Health Care

The placebo effect is very real. This we've known for decades, as seen in real-life observations and the best double-blinded randomized clinical trials researchers have devised for many diseases and conditions, especially pain. And yet, how and why the placebo effect occurs has remained a mystery. Now, neuroscientists have discovered a key piece of the placebo effect puzzle.

Publishing in Nature, researchers at the University of North Carolina School of Medicine—with colleagues from Stanford, the Howard Hughes Medical Institute, and the Allen Institute for Brain Science—discovered a pain control pathway that links the cingulate cortex in the front of the brain, through the pons region of the brainstem, to cerebellum in the back of the brain.

The researchers, led by Greg Scherrer, PharmD, Ph.D., associate professor in the UNC Department of Cell Biology and Physiology, the UNC Neuroscience Center, and the UNC Department of Pharmacology, then showed that certain neurons and synapses along this pathway are highly activated when mice expect pain relief and experience pain relief, even when there is no medication involved.

"That neurons in our cerebral cortex communicate with the pons and cerebellum to adjust pain thresholds based on our expectations is both completely unexpected, given our previous understanding of the pain circuitry, and incredibly exciting," said Scherrer. "Our results do open the possibility of activating this pathway through other therapeutic means, such as drugs or neurostimulation methods to treat pain."

Scherrer and colleagues said research provides a new framework for investigating the brain pathways underlying other mind-body interactions and placebo effects beyond the ones involved in pain…

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Trella Health Unveils its 2024 Post-Acute Care Industry Trend Report

PR Newswire / Trella Health
 
"As part of our mission to promote industry-wide performance visibility, our team is excited to share the findings of this year's Post-Acute Care Industry Trend Report," said Scott Tapp, CEO of Trella Health. "At Trella Health, we believe in the power of data to foster meaningful change in healthcare. Continuous innovation in an industry requires strong collaboration, and with data-backed insights, we are shaping the future of healthcare together."
 
Below are a few key takeaways from this year's report:

• Medicare Advantage enrollment continues to increase, and MA penetration eclipsed the much-anticipated 50% mark in 2023, hitting 54.7% as of February 2024.
• FFS inpatient discharge instruction rates for home health and skilled nursing continue to inch closer to pre-pandemic levels, though these rates remained more stable than previous year-over-year changes.
• Annualized changes in home health (-3.0% between 2022 Q3 and 2023 Q3 reporting periods) and skilled nursing (-13.8% between 2022 Q4 and 2023 Q4 reporting periods) FFS admissions continue to decrease due to increased MA enrollment.
• Hospice admissions increased by 2.1% between the 2022 Q4 and 2023 Q4 reporting periods. Further, hospice utilization increased to 49.8% in the 2023 Q4 reporting period, four percentage points higher than the 2020 Q4 reporting period. This was due to lower utilization rates during the pandemic when COVID-related deaths were usually not admitted into hospice.

Trella Health invites you to leverage the insights in this report to drive innovation, elevate your business, and build a stronger future for the entire industry.
 
Read the full press-release here or access the Post-Acute Care Industry Trends Report here.