Home Health & Hospice Week

Not surprisingly, hospice-nursing home relationships also are on the watchdog agency's hit list.

You can expect another reduction to the home health prospective payment system base rate when rebasing begins in 2014. That's because the HHS Office of Inspector General wants to remove physician therapy service costs from the PPS pool of money, according to the OIG's recently released semiannual report to Congress.

"Since 2003, Medicare has allowed Part B payments to physicians for therapy services furnished during episodes in which beneficiaries are receiving home health care. Medicare also includes physicians' therapy services in the home health PPS base rate paid to the HHA," the OIG says in the report. "As a result, Medicare pays twice."

The OIG also hits the non-routine medical supply problem in its report. In 2007 and 2008, Medicare overpaid durable medical equipment suppliers an estimated $3.4 million for non-routine supplies that should have been bundled under PPS, the watchdog agency says in the report.

Medicare contractors should "process and recover this type of overpayment in a timely manner," the OIG says. That could result in you getting more hassles from DME suppliers that have their claims rejected or recouped for overlapping supplies.

On the hospice side, the OIG reiterates its concerns from this summer's report about so-called "high percentage" hospices who treat a large ratio of their patients in nursing homes. "We recommended that CMS monitor hospices that depend heavily on nursing facility residents and modify the payment system for hospice care in nursing facilities," the OIG says in the report at http://oig.hhs.gov/reports-and-publications/semiannual/index.asp -- scroll down for the link.