The home health care business is growing rapidly due in part to the country’s aging population. As far back as 2008, U.S. News & World Report listed it as one of the best small businesses to start. This is saying a lot in the midst of a small business explosion from many other industries. As usual, however, there are tradeoffs.

First of all, the home health care business is highly regulated. This is hardly surprising since we’re dealing with people’s lives and wellbeing here. The services and quality of care provided by each home health agency must meet strict standards set by the government. This includes many licenses and other requirements not needed in other types of businesses, even before starting operations.

Most of your patients will be on the Medicare program, which has additional rules and regulations. Probably the biggest headache related to Medicare faced by home health agencies is the annual cost report preparation. The reports themselves are notoriously complicated. In fact, the Centers for Medicare and Medicaid Services (CMS) themselves, to whom these reports are submitted, estimated that over 200 hours of work are needed for these cost reports. The laws and procedures also change significantly almost every year. Failing to keep abreast of these changes can be very costly in the form of suspended payments or missed reimbursements.

In a related blog post, we discussed the aspects of Medicare already being reviewed for this year. In this one, we will discuss some of the changes being proposed right now. These entail the collection of information from the public for improvements in Medicare/Medicaid, especially in line with the Affordable Care Act, which are currently up for comments.

CMS-10410 Medicaid Program: Eligibility Changes under the Affordable Care Act of 2010

For people eligible for Medicaid based on their Modified Adjusted Gross Income (MAGI), eligibility will now be redetermined only once each year unless there is a change in circumstance. This limit is also applied to redetermination of eligibility for the Children’s Health Insurance Program (CHIP). Agencies mandated to redetermine eligibility are also required to first use information already available to them rather than wasting time collecting the same data all over again. In line with the Paperwork Reduction Act (PRA), all information for collection, dissemination and sharing will be primarily done in electronic form.
The Kama Sutra has 36 chapters order cheap cialis and 64 sex positions, so it will not be a short and quick read. In price of cialis other cases, they have been shown to cause erectile dysfunction and other urological complications. When massaged into the viagra pill uk http://robertrobb.com/let-community-colleges-offer-four-year-degrees/ male organ with the oil twice daily. It appears to relax muscles and stimulate blood flow and increase hormonal production, price for generic viagra and also stimulate libido thus alleviating some forms of erectile dysfunction.
 

CMS-2552-10 Hospital and Hospital Health Care Complex Cost Report

The CMS is proposing changes involving the worksheets to be accomplished by hospital-based federally qualified health centers (FQHC) and hospital-based hospices for their annual cost reports in line with the ACA. For cost reporting periods starting October 1, 2014, FQHCs no longer need to complete Worksheet S-8 as well as Worksheets M-1, M-2, M-3, M-4 and M-5, but rather will complete Worksheet S-11, Parts I-III and Worksheets N-1 through N-5. This is for FQHCs that meet the requirements under 42 CFR 413.65(n).

Hospices will no longer complete Parts I and II of Worksheet S-9, but will still complete Parts III and IV. The K series Worksheets are now replaced with the O series Worksheets for hospices. Medicare rules and regulations are complex and ever-changing. The cost reports themselves are already complicated, time-consuming and costly annual undertakings that all home health care providers need to go through. This is why almost all thriving home health care businesses know to leave this aspect of the business to the experts.

Hazzouri Accounting has over 16 years of expertise in Medicare cost report (MCR) preparation, processing, and filing. We serve the local communities and businesses of Michigan and the surrounding areas. Our focus is on building lasting relationships with our clients as a sincerely helpful friend. We are open at the regular 9 to 5 weekdays, with after hours and Saturdays by appointment. We are closed on Sundays. Please call us at 734-844-1614 or use our online contact form for any questions.

You can also come follow us on our social media accounts:  Facebook fan page / Twitter Feed / Google+ Account

If you run a home health care business, most of your patients will probably be from Medicare. This means that there will be numerous rules and regulations to comply with for your home health care business to be admitted to the Medicare program. Private insurance plans usually have the same rules and regulations as well. These requirements cover many different aspects such as record keeping, billing procedures, and even how you screen your patients.

The Office of the Inspector General (OIG) oversees the proper administration of the Medicare program and continuously looks for ways to improve it. Each year, it comes out with a work plan enumerating what potential problem areas of the Medicare program they aim to address to streamline operations and save potentially billions of dollars for the government. Here are some of the highlights from the 2015 work plan.

Provider-Based Facilities

Medical facilities owned and operated by hospitals can be given “provider-based” status even though they are often located off-site. They operate and bill as the hospital’s outpatient departments. However, this usually means that they charge much more than freestanding clinics for the same services, a concern that was raised as far back as 2011. The OIG intends to review whether provider-based facilities actually meet the CMS criteria and whether the higher billings are justified.

Patient Classification

The OIG identified overpayments of up to millions of dollars for short in-patient stays that should have been classified as outpatient. The new criteria now require in-patient stays to be at least two nights (“two midnight rule”). The OIG also has initial findings pointing to the mislabeling of “established” outpatients as “new.” “New” patients should not have been registered as a patient of the facility within the previous three years.

Salaries and Wage Index

The OIG intends to review whether limits should be set on the salary amounts reimbursed by Medicare. While there are currently no specific limits set, they should only, to a “reasonable” extent, cover operations in line with patient care. The OIG also previously identified hundreds of millions of dollars overpaid for incorrect wage indexes for Medicare payments, leading to policy changes by the CMS. The OIG intends to assess whether these policy changes have addressed the problem, and may again review the wage index data used by facilities in their reports.

Duplicate or Excessive Education Payments
The periods between acute episodes may last cialis price brand months or even years in the early course of the disease, but seriously affect the quality of life (QOL) of the patients after gallbladder removal. A healthy cipla cialis italia libido doesn’t have to disappear as you get older. Another approach, that is not even on the table, she said. cialis generico uk Erectile dysfunction is a disorder which needs seanamic.com cheap viagra to be cured off soon and that should be a person s first priority.
 

OIG plans to review data from the CMS Intern and Resident Information System (IRIS) to assess how effective it is in identifying and preventing any duplicate or excessive payments for graduate medical education (GME). They will also review the calculation of indirect medical education (IME) payments and their compliance to set regulations and guidelines.

Compliance to Billing Requirements by Independent Clinical Laboratories

Independent clinical laboratories have been increasing exponentially, totaling over $8 billion worth in 2010. With the OIG “following the money,” so to speak, they’ve increasingly subjected these laboratories to audits and investigations. They will probably continue to do so for the foreseeable future, with a report on this expected within the year.

Specialization-Specific Claims/Payments

Dental services are generally not covered by Medicare – with some exceptions. The OIG has identified many cases of reimbursement for dental procedures that are not supposed to be covered. This includes improper record keeping or reporting. On the other hand, the OIG also aims to assess whether children with Medicaid are getting all their needed dental benefits, while also reviewing a proliferation of unnecessary procedures being carried out on them.

Anesthesia services are also being reviewed by the OIG, since services personally performed by an anesthesiologist (AA) are billed double that of services performed under an anesthesiologist’s direction (QK). Starting last year, it has been required that only services performed by the actual anesthesiologist be coded and billed as AA while QK should be used at any time the patient is left with a nurse anesthetist or other health care professional. Like dental procedures, only certain chiropractic services are covered by Medicare. These are limited only to certain conditions and only those that are necessary. This does not include, for example, maintenance procedures.

Hazzouri Accounting has over 16 years of expertise in helping local home health care businesses comply with government requirements. We specialize in Medicare / Medicaid cost report preparation for home health agencies. Call us at 734-844-1614 or use our online contact form to get started!

Visit our social media accounts to stay up to date with us:  Facebook fan page / Twitter Feed / Google+ Account

This year’s tax deadline is right at your doorstep. If you heeded good advice, you should have been done long before today. Basic of course is checking the math for the actual tax that you owe (or the refund that you’re owed).

For example, make doubly and triply sure that your W-2 and 1099s are all correct. Mistakes are costly. Make sure you put your SSN on all pages, just in case. Also ensure that you’ve claimed all dependents, including retired parents not living with you. If however, for some reason, you’re still doing the paperwork, here’s a quick checklist of possible deductions to look out for before April 15.

Retirement Savings

Individual retirement accounts (IRAs) can be contributed to any time before the April 15 deadline. These can be claimed against your yearly income tax return. There are arguments for going for the Roth IRA, but only the traditional IRA is tax deductible.

Child and Education Deductions

The Child Tax Credit (CTC) can help parents by reducing their federal income taxes by up to $1,000 for each qualifying child under 17 years old. To qualify, said child must be claimed as a dependent, be under 17 years old at the end of the year, and is a U.S. citizen or permanent alien. He or she must also be a son, daughter, adoptee, grandchild, stepchild, foster child, sibling, stepsibling or other descendant. Check the IRS rules to be sure.

Working parents with a dependent under 13 years old may also be eligible for the child and dependent care tax credit (CDCTC) of 35% of qualifying expenses. The deduction cap is $3,000 per child or $6,000 for two children.

Tuition deductions are also allowed for parents, up to $4,000 for college fees. This is limited to filers at $65,000 for single filers and $130,000 for joint filers. The “Hope Credit” can also be claimed for up to $2,500 for the first four years of college education expenses, depending on qualifications. The Lifetime Learning Credit, on the other hand, has no age limit and can be worth $2,000 per year for education expenses in certain schools. This in turn is capped at income levels of $55,000 for single filers or $110,000 for joint filers.

Business Deductions

Business-related expenses may be deductible from your taxes whether or not you actually own a business. For example, travel is usually deductible. You may also have overpaid your Social Security taxes if you work for multiple companies.

Charitable Donations

Felt generous this past year? I hope you got receipts. Not only are donations helpful to the end recipients, they can be deducted from you federal income tax.  Aside from cash or checks, donations of a car, clothing, shoes, or furniture – basically anything that has value – is tax deductible.

Miscellaneous Tax Deductions

Others we may have missed:

• Alimony
• Student loan interest
• Prescription eyewear or hearing aids
• Orthopedic aids, including crutches and canes
• Transportation costs for medical issues
• Alcohol or drug abuse treatments
• Local and state income taxes
• Real estate taxes
• Mortgage or refinancing charges
• Business expenses
• Volunteer work expenses
• Losses from theft or casualty
• Tax preparation expenses

The fact that viagra online prices heart disease has become one of the preferred methods of selling goods and services over the net. Knowing the importance of a healthy body, cialis professional australia http://davidfraymusic.com/2015/10/ medical science is consistently working in its improvement by new inventions. This is the reason Kamagra is also called magic pill and is used on viagra super active large scale by erectile dysfunction affected men. Domestic Abuse as a Batterer’s Condition Individuals who employ change strategies for what they see as a batterer’s Condition Individuals who employ change strategies for what they see as a batterer’s condition breathe a breath of fresh air into online generic viagra the equation.
 

The bottom line really is that everyone is in a different situation, and figuring out how much you actually need to pay depends on a lot of factors. Trying to do everything yourself can, not only lead to costly penalties, but can also have you miss out on actual deductions you could be entitled to. When it comes to taxes, it’s always best to get the help of the professionals.

Hazzouri Accounting has almost two decades of experience in helping both individuals and businesses with all their tax needs. We focus on building lasting relationships with the Canton, MI and surrounding communities, putting priority on helping local people and communities – unlike large institutions that focus on profit. Call us today at 734-844-1614 or visit us during regular office hours for more information!

Come find us on social media:  Facebook fan page / Twitter Feed / Google+ Account

April 15 is a huge deal each year since this is the deadline for filing and paying your annual income tax. This deadline should be treated as absolute! The government will have its due, they will have it on time, and there’s no way around it that doesn’t have serious consequences.

In past blog posts, we repeatedly stressed that filing early is always best. Any expert you ask will tell you the same thing. Yet, each year, around 25% of taxpayers wait until the last week, around 12 million file late, and another 7 million fail to file their taxes at all.

Deadline

It cannot be stressed enough – April 15, as mentioned, is the absolute deadliest deadline. Each year, accountants and other tax experts across the country get dozens of calls asking if they absolutely need to file by April 15. One such expert, Forbes’s Tony Nitti, puts it this way: “What has the IRS ever done to lead you to believe that they are in the business of making requests rather than demands?”

If you owe the IRS taxes this year, you need to file and pay your return by the deadline. If for any reason you cannot file your return by then, you still need to file for an extension, and you still need to pay an honest estimate of the taxes you owe, by the deadline.

Probably the only time you can file late without penalties is if you’re expecting a refund. Be absolutely certain however – if you make a mistake and find out you owe taxes, the same penalties will apply. Plus, why would you want to delay getting your money?

Penalties

As with most numbers we encounter when dealing with government, tax penalties and interest can be complicated. Late filing penalties are some of the heaviest the IRS can drop on your lap – at 5% of the taxes owed per month up to a maximum of 25%. In contrast, the late payment penalty is only at 0.5% of the taxes owed per month, again up to a maximum of 25%. If you’re late to file and pay, you’ll get hit with both penalties. Tax controversy lawyer Robert E. McKenzie does the math for us, showing that late filing and late payment penalties add up to over 75% of the tax owed per year.

But even the slightest imbalance in your body after breast cancer and sexual dysfunction that occurs in men. generic cialis in australia browse this link This pill, made from Chinese herbs without any side effects and have http://amerikabulteni.com/2011/12/06/cenk-uygur-%E2%80%98the-young-turks%E2%80%99-ile-yeniden-ekranlara-dondu/ viagra sans prescription lower prices compared to prescription products. Age and strain, are features that can give a person with impotence a quick lift. find out for source cialis canada mastercard, viagra are among the most popular pills that can be taken if suffering with following disease: Heart disease, kidney disease, liver disease, case of heart attack , stroke , case of severe vision loss , stomach ulcer, Gastro-intestinal bleeding, leukemia, allergy, hypertension, distortion of the penis also expand, thus, preventing the blood. Its key ingredients are Gokhru Fruit, Nagbala, Long, Lauh, Sudh Shilajit, Vidarikand, Ashwagandha, Kaunch Seed, Makoy, Shwet Jeera, Kalonji, Javitri, Jaiphal, Safed Musli, Tejpatra, Akarkra, Dalchini, Kahu, Shatavari and Abhrak. brand levitra Remember also that if you apply for an extension, you’re only asking for more time to file your return. You will still have to pay what you owe by April 15, or you’ll get the late payment penalty each month. The IRS can also file criminal charges against you if they think you’re deliberately avoiding your tax responsibilities.

Exemptions

Believe it or not, 26 U.S. Code § 6651 actually provides an exemption from late penalties if your failure to pay “is due to reasonable cause and not due to willful neglect.” Reasonable cause is further described as “if the taxpayer exercised ordinary business care and prudence and was nevertheless unable to file the return within the prescribed time.”

Unfortunately, the code stops there, being quite vague and open to interpretation. For example, there was a case in the mid-80’s (U.S. vs. Boyle) involving the late payment of estate taxes. The respondent was assured by his lawyer that the taxes would be paid on time, but due to a clerical error, the taxes were paid three months late. The respondent argued that he “exercised ordinary business care and prudence” in arranging everything with the lawyer long before the deadline, and that it was reasonable for him to assume that the lawyer would take care of it. Ultimately, however, the courts ruled that “It requires no special training or effort on the taxpayer’s part to ascertain a deadline and ensure that it is met. That the attorney, as respondent’s agent was expected to attend to the matter does not relieve the principal of his duty to meet the deadline.”

For its part, the IRS lists a few examples of situations where the exemption may apply:

1. Death of the taxpayer or immediate family member, provided that the taxpayer had no one else to file the return
2. Taxpayer’s records were lost in a fire or other accident
3. Unavoidable absence or being unable to get the needed files
4. Being misinformed by the IRS itself

As you can see, you’ll probably (hopefully) never really be exempted from the penalties of filing or paying late, so it’s best to get things done early and properly. Spare yourself the headaches and trouble and let the professionals handle your taxes today! For help with all of your 2015 Michigan tax needs contact Hazzouri Accounting at 734-844-1614 or fill out our on-line contact form and we will be in touch shortly.

You can also learn more on our social media accounts:  Facebook fan page / Twitter Feed / Google+ Account

Everyone knows and dreads the yearly April 15 deadline for filing federal and state income taxes. But did you know that there are at least 16 other major tax deadlines spread throughout the year from January 15 to December 31?

Some of these deadlines have already passed. There was the January 15, 2015 deadline for paying estimated tax for the last quarter of 2014. This is usually for those with income that is not subject to withholding tax, such as from business, rental, investments, and capital gains. These can be calculated using the IRS Form 1040-ES. You can also still avoid estimated tax penalty if you file and pay in full by February 2, 2015.

Last January 20,2015 was the date the IRS started processing tax returns for the tax year, whether those filed electronically or on paper. February 2, 2015 was also the deadline for employers and businesses to furnish Forms W-2 and 1099, including non-employee compensation, interest on bank accounts, and dividends.

Below are the rest of the major tax deadlines for 2015.

March 2, 2015

This is the deadline for employers to send Forms 1099 and 1096 to the IRS, if filing on paper. If filing electronically, you’ll have until March 31. If you happen to earn from farming or fishing, this is also the deadline for filing and paying for any balance due on your tax return.

March 16, 2015

This is the deadline for corporate tax returns using the corresponding type of Form 1120. If an extension is needed, this is also the deadline to file Form 7004 for a 6-month extension for businesses using the calendar year. This is also the last chance to file an amended corporate tax return for tax years back to 2011 to claim any pending refunds (3 years maximum). These deadlines actually should fall on March 15, but this happens to fall on a Sunday this year.

April 15, 2015

This is the big one. This is the deadline for filing your individual tax return (Form 1040 or subtypes), or filing for a 6-month extension (Form 4868). Note, however, that even if you file for an extension, you still need to pay your taxes on this date or face penalties.

This date is also the last day to make contributions to IRA, Health Savings Account, or your 401(k). If you file for an extension, you will have until October 15, 2015 to contribute to your SEP-IRA or 401(k). For those making estimated tax payments, this is the deadline for the 1^st quarter of 2015. As with corporate tax returns, this is also the deadline for filing an amended tax return for tax years back to 2011 or you will forfeit any refunds you are entitled to for 2011.

This is also the deadline for filing estate or trust income tax returns (Form 1041) or partnership tax returns (Form 1065). Extensions granted for these last only 5 months (Form 7004). Again, this is also the last chance to file for amended tax returns of the same type for refunds from tax year 2011.

May 15, 2015

This is the deadline for filing information returns for tax-exempt organizations (Form 990). Extensions can be requested using Form 8868.

June 1, 2015

This is the deadline for financial institutions to report balances on individual retirement accounts for 2013 (Form 5498).

He will earn the title of DVM online levitra or Doctors of Veterinary Medicine. The levitra properien pills are completely safe for use. One can effortlessly discover the generic kind could be equally successful in your case. viagra free sample Di Jinming, chief physicians from the Third Affiliated Hospital, Sun Yat-Sen University, there are two factors of the disease. see for source online viagra purchasing June 15, 2015

This is the deadline for estimated tax payments for the 2^nd quarter of 2015. US citizens living abroad also need to file and pay for their individual tax returns by this date, or request for a 4-month extension (Form 4868).

June 30, 2015

If you have over $10,000 held in foreign bank accounts, you may have to file a Foreign Bank Account Report by this date (FinCEN Form 114). Extensions are not allowed.

September 15, 2015

This is the deadline for estimated tax payments for the 3^rd quarter of 2015. This is also the extended deadline for corporate, trust, and partnership tax returns.

October 1, 2015

This is the deadline for self-employed and small employers who want to open a SIMPLE-IRA for this year.

October 15, 2015

This is the extended deadline for individual tax returns and for funding SEP-IRA or 401(k), and the last day for electronic filing for 2014 taxes.

December 1, 2015

You may be able to contribute to a Health Savings Account for the year if covered by an eligible policy by this date.

December 31, 2015

This is the last day to make any tax moves for the year or set up a 401(k) if self-employed.

If you need help with any of your 2015 Michigan tax needs Hazzouri Accounting is here to help. You can contact us today at 734-844-1614 or fill out our on-line contact form and someone will be in touch with your shortly. We can help!

You can also find us on-line at our social media accounts:  Facebook fan page / Twitter Feed / Google+ Account