Home Health & Hospice Week

Medicare may have made clear in the home health final rule for 2022 that Value-Based Payment adjustments were off the table for 2022, but apparently the Medicare payment system didn’t get the memo for a few of the VBP states.

The problem: “HHAs in … Florida, Tennessee and North Carolina did not receive a provider file update to set [VBP] model adjustment rates to zero, due to the model ending one year early for the HHAs in the nine original Model States,” HHH Medicare Administrative Contractor Palmetto GBA says on its website. The same happened for “several HHAs in Arizona, Maryland, Massachusetts and Washington state,” the MAC adds. “For the affected HHAs, this caused adjusted payments for claims with 2022 dates of service.”

The solution: Palmetto has now updated the files, so “no HHVBP payment adjustments will occur on claims received after February 22,” it says. “Palmetto GBA will adjust claims affected by this issue that were received prior to February 22, 2022, in the near future.”

How you’ll know: “When the claims complete adjustment, they will show as type of bill 32I on your remittance advice and have ‘2022 HHVBP adjustment’ in the claim remarks field (page 4 in Direct Data Entry),” Palmetto instructs.