From PalmettoGBA – How are end of episode claims selected for review?

PalmettoGBA, the Medicare Administrative Contractor, has FAQ’s related to Jurisdiction 11 Home Health and Hospice issues. Occasionally they share them by email, which is the genesis of the rest of the post:

This FAQ discusses how end of episode claims are selected for a probe review. Please share this with your staff.

If you are a home health or hospice and don’t get these emails, click on this link.


Palmetto GBA Home Health Notice – Overpayment Demand Letters with reason code 7INAP

This is a notice from Palmetto GBA to Juridiction 11 Home Health Agencies regarding overpayment demand letters with a code 7INAP. If you receive one of these letters, you need to consider your options in an expeditious manner as there are deadlines for filing appeals! The text of the notice: Some home health providers areContinue Reading

ANA Publishes Book on Nurse Staffing

The American Nurses Association has published “Nurse Staffing 101: A Decision-making Guide for the RN,” a guide for nurses responsible for staffing or anyone else interested in nurse staffing issues. The book covers the following questions: Historical and political setting of safe staffing Workplace, safety, and quality considerations Examples of professional nursing practice models StaffingContinue Reading

A Thank You to Houston ENA

I had a chance to speak to the Houston chapter of the Emergency Nurses Association last night. I want to thank the chapter for their hospitality. It was good see a few old friends (though, unfortunately not all of my friends with Houston ENA – I’m looking at you, Debbie McCrea!) and to talk withContinue Reading

Do Administrative Hearings Require a Lawyer?

I pose this as a question, but the answer is a resounding YES! I post this because my friend, Chuck Newton, recently posted on a niche practice area for security clearances. And at the bottom of the first paragraph – there was the gem of wisdom that I just had to link too: If youContinue Reading