2nd Wave Incoming

As we speak, Europe is experiencing the dreaded 2nd COVID-19 wave. In the UK, stricter lockdown and closing measures are in place for at least the next 6 months. Other European countries are taking or discussing similar precautions. What we most dreaded even as we began to loosen restrictions and have a semi normal type of existence over the past 2 months is now coming true. So, based on the virus spread from January through April, we can logically expect that we'll see an increase in cases in the next 4-6 weeks on our shores. If the suddenness and scale of Europe's outbreak is any indication, we should expect lockdowns, and especially lockouts from our referral sources once again. This time

Is Patient Freedom of Choice a Thing of the Past?

There are several developments regarding patients’ right to freedom of choice that providers, including hospital discharge planners/case managers, need to know about because they underscore the continuing importance of this right. First, the South Shore Physician Hospital Organization (SSPHO) in South Weymouth, Massachusetts, has agreed to pay $1,775 million to settle allegations that it operated a recruitment grant program through which it paid kickbacks to its physician members in exchange for referrals. Kickbacks were paid in the form of cash grants to doctors who agreed to make referrals to SSPHO providers. Between 2001 and 2010, SSPHO allegedly approved 103 recruitment grants to 33 di

More Referral Success

I received more great news on new referrals from an attendee from our current Home Care Marketing Accelerator (COVID Edition) Program. I love getting messages like this... "Michael, I’d like to share a success story... I’ve been re-teaching what we are doing on our Wednesday call and look what I just got from one of my reps .... 'Good Afternoon. TGIF!! So I finally had my F2F lunch with Jane from (account name...new Target account) I picked up 5 potential referrals for insulin mgmt. I pray you all have a safe and relaxing weekend!!'" For agencies and reps that put in the work, these types of results are not unusual. You have an opportunity to join the next Home Care Marketing Accelerator sta

Safely Contract With Physicians

On June 9, 2015, the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services, the primary enforcer of fraud and abuse prohibitions, issued a Special Fraud Alert entitled “Fraud Alert: Physician Compensation Arrangements May Result in Significant Liability.” In this Special Fraud Alert, the OIG encourages physicians to carefully consider the terms and conditions of medical directorships and other compensation arrangements with providers to which they make referrals before entering into them. Specifically, the OIG stated that the following are violations of the anti-kickback statute: Payments to physicians that take into account the volume or value of referrals fr

2 New Admits Per Month?

I received an email over the weekend from a participant in the current Home Care Marketing Accelerator webinar program. Here is an excerpt: "Hi Michael, I received 2 new HH referrals last week by asking for the referral. These were new offices with no history of stopping by for months. I felt after the training my confidence had improved and I need to be asking for a rx every sales call. I started in HH last November with no training. I have over 150 offices that I visit where I'm the "cookie man". Per your last session I realized that I have allowed it to be OK with most of my prospects not sending referrals, they all love me but no referrals." Now this is only one example, but our training

Preventing Fraud & Abuse is Everyone's Responsibility

Providers are generally familiar with prohibitions against fraud and abuse in the Medicare and Medicaid Programs, including Medicaid waiver programs, and other state and federal health care programs such as the VA and TriCare. Private insurers now often enforce the same prohibitions applicable to federal and state programs. But there are at least two (2) common misconceptions about fraud and abuse as follows: (1)Enforcers must prove intent in order to show that providers engaged in fraud, but providers may not understand what the government can use to show "intent." Many providers seem to think that the only way to show intent is to prove that they sat down at their desks on a Monday mornin

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