Are Medicare certified home health providers taking too big a risk by answering rate cuts with more and longer episodes? A leading research firm reports CMS, MedPAC and Congress are watching closely as total Medicare reimbursements for home health services continue to grow despite annually lower payment rates.
Speculation has run wild for two years about how CMS might change the home care payment system this time. Talk of payment bundling, where hospitals get all the money and dole it out as they see fit, is already appearing as a workshop topic. Rumors about payments going directly to patients have come and gone. […]
“More frequently than chance would dictate, denial letters dispose of just enough visits to kick a full-pay episode down to a LUPA. When there were seven visits, they deny three; when there were five visits, they deny one. Rarely if ever do agencies see a seven- or ten-visit episode reduced to five.”
Have you spoken with your software vendor yet about their plans for the HIPAA 5010 claims transaction sets? Testing begins in January, with implementation one year later. After that, CMS claims, ICD-10 will arrive on time in 2013, and it will be obligatory for all HIPAA covered entities, not just those that submit claims to Medicare and Medicaid.
An urgent message has been released by The National Association for Home Care and Hospice (NAHC) and the Home Care and Hospice Financial Managers Association (HHFMA). The mistaken notion since PPS began that home care agency cost reports are less important than they once were may be creating a serious problem.
The Centers for Medicare and Medicaid Services’ (CMS) proposal to place a 2.5% cap on Home Health PPS outlier payments in CY2010 will produce meaningful healthcare savings without negatively impacting patient access to care. Such is the determination announced this week by Healthcare Market Resources (HMR), a research company that provides customized local market analysis […]
