Home Health & Hospice Week

Make sure your costs are fully represented.

The Centers for Medicare & Medicaid Services is living up to its word on supplies costs, and that could mean more accurate cost data for home health agencies. Industry experts have worried HHAs' costs would be understated due to a billing glitch that required agencies to strip supplies costs from their Medicare claims. But CMS pledged last month to allow agencies to report the missing supplies costs on their cost reports, rather than making them individually adjust all affected claims (see Eli's HCW, Vol. XII, No. 45, p. 357). In a Jan. 2 One-Time Notice (Trans. No. 37), CMS instructs regional home health intermediaries to allow agencies to report the costs accordingly, and not to adjust the supplies cost data down to the figure on the agency's PS&R reports. "Supply charges do not directly affect HH PPS claim payment, but are valuable for use in future research to support HH PPS payment refinements," CMS says in the instruction. Agencies served by RHHI Associated Hospital Service of Maine are exempt, since the RHHI was using a different payment system than the one that contained the glitch, CMS says at http://cms.hhs.gov/manuals/pm_trans/R37OTN.pdf. Medicare spending for freestanding HHAs grew 7.2 percent from 2001 to 2002, CMS says. The second year of the "rebound in Medicare spending" was due in part to a change in the definition of "homebound" for eligibility purposes, making more beneficiaries qualify for Medicare home care coverage, CMS maintains in a release. You can throw that approval for your cost report methodology out the window - apparently it's worth less than the paper it's printed on. So concluded CMS in reversing a Provider Reimbursement Review Board decision that said once an intermediary has approved a cost report methodology, it can not be reversed until the intermediary informs the provider of the change. "The Administrator does not agree that the methodology ... can be allowed only on the basis that it was approved by the prior intermediary," CMS says in a recently released Administrator's Decision regarding Mercy Home Health in Springfield, PA (see Eli's HCW, Vol. XII, No. 32, p. 254). "This basis for such an allowance ignores the dictates of the Medicare program," CMS insists. A Medicare recipient who retains mobility through the use of a power wheelchair or scooter saves taxpayers more than $5,300 over a three-year period. That's the finding of a new study conducted by RRC Inc. and initiated by The SCOOTER Store. "We found that statistically significant savings persisted for at least 12 quarters after obtaining the powered vehicle," said RRC President Dr. Donald House. "The powered vehicle appears to enable qualified individuals to remain mobile longer, which reduces total [...]