Home Health & Hospice Week

Problem: Benchmarking reports target high wage index providers, trade group protests.

If you’re one of the 5,000 home health agencies that has received a comparative billing report from SafeGuard Services, you’d better take a close look at it. You can bet reviewers and surveyors will be looking at the same type of data.

Back in December, the Centers for Medi-care & Medicaid Services announced that CBR contractor SGS would issue home health reports Jan. 23. But those reports contained inaccurate data, notes the Visiting Nurse Associations of America. Now SGS has reissued reports with the correct data, reports the National Association for Home Care & Hospice.

Only about half the nation’s agencies re-ceived reports, VNAA points out. “So if your agency did not receive one, you should not be concerned,” the trade group says in a message to members.

HHAs that received the report were those with the highest per beneficiary payment in 2011 — the year from which SGS drew the reports’ data, NAHC says.

The reports cover “(1) the average number of home health visits per beneficiary rendered by you, (2) the average number of home health therapy visits (revenue codes 042X, 043X, and 044X) per beneficiary rendered by you, and (3) the average Medicare payment per beneficiary,” SGS says in a sample report on its website. “All three measures are statistically compared to the average of your state and the nation.”

What to do: The reports are “a collaborative effort between the Medicare provider community and [CMS] to support best billing practices and effective management of Medicare program resources,” they tell recipients. “The billing data and references in this report can assist you in performing a self-audit in assessing your compliance with Medicare guidelines for billing Home Health Services. The report also provides an opportunity for comparing your billing practices to other Home Health Agencies billing for these services. We hope you find this information helpful and that it will provide insights into your current and future billing practices.”

In other words: “The agencies receiving CBRs are advised to analyze the data and consider whether they billed Medicare correctly for services provided,” NAHC explains.

A number of problems exist in these reports, NAHC protests. The report data isn’t wage index-adjusted, so agencies in high wage index areas will be inappropriately targeted, the trade group maintains. And the reports should be risk adjusted for variables such as age, presence of multiple comorbidities, agency size, and referral sources., the trade group says.

Note: The sample report is online at www.safeguard-servicesllc.com/cbr/sample.asp.