Home Health & Hospice Week

HHAs have a new reimbursement limit proposal to contend with in Congress. In H.R. 3245, Reps. Jim Matheson (D-Utah) and Brett Guthrie (R-Ky.) propose limiting the number of episodes for which an agency can bill to 3.3 episodes per patient in a rural area or 2.7 in a non-rural area. The limit would apply on average, not to individual patients.

"An episode cap runs a risk of imposing a barrier to care for chronically ill Medicare beneficiaries," protests the National Association for Home Care & Hospice. It also will punish agencies’ who serve a higher proportion of longer-stay patients.

The measure could "push the benefit to short term care without actually revising the benefit itself," NAHC warns.

"NAHC does not believe that HHAs should be presumed guilty of Medicare fraud, waste or abuse as occurs with an inflexible episode cap," the trade group tells its members. "Instead, if Medicare has suspicions about the propriety of care utilization, it should target utilization review directly."

You can see the brief bill text at http://thomas.loc.gov/cgi-bin/query/z?c113:H.R.3245.