Home Health & Hospice Week

Rural hospices see bigger boost. Hospices won't be getting the 3.3 percent payment increase they had hoped for next year.

The Centers for Medicare & Medicaid Services in August issued hospice payment rates that increased by that amount (see Eli's HCW, Vol. XIII, No. 28, p. 222). But the newly released hospice wage index scales back the increase to just 1 percent for all hospices.

Rural hospices will see a bigger boost, however - 2.9 percent over 2004 levels. "As a result of improvements in how payments are calculated, Medicare payments for hospice services in rural areas will more accurately reflect costs," CMS Administrator Mark McClellan says in a release. "This payment increase helps ensure that beneficiaries in rural areas have access to the quality hospice services that they need."

You won't see the effect of revised definitions for Metropolitan Statistical Areas, new definitions for Micropolitan Statistical Areas or Combined Statistical Areas until 2006, CMS notes in the Aug. 27 Federal Register notice of the new wage index.

The extra boost to rural hospices won't help the industry overall very much, notes the National Association for Home Care & Hospice. "The majority of hospices and their services are provided in urban areas, with 1,469 hospices designated as 'urban' and 916 designated as 'rural,'" NAHC notes.

The biggest wage index swing occurs in the rural East South Central region (Alabama, Kentucky, Mississippi, and Tennessee) with a 6.5 percent increase, NAHC says The biggest index dips are in rural Puerto Rico (-4.1 percent) and rural New England (-0.5 percent). Medicare will conduct more claims data analysis so it can detect and deal with potential fraud and abuse problems quicker. CMS appears to have learned its lesson from power wheelchair fraud that quickly spun out of control, and it promises in a proposed rule in the Aug. 27 Federal Register to increase its efforts to catch improper payments sooner.

CMS will monitor claims data "on a national level so it can identify problems at the health care provider- and service-specific levels," CMS explains in a release. The agency will use the information to "proactively identify potential problematic utilization spikes so that their underlying cause can be determined."

CMS also plans to open a satellite office in California, much like the one that already exists in Miami, to "reduce the unusually high rates of improper payments identified" in that state, the agency says. New home health outcomes data hit Medicare's Home Health Compare Web site Sept. 2, CMS says. Check out your newly updated scores on the 11 measures via the link at www.medicare.gov. Regional home health intermediary Palmetto GBA is giving home health agencies and hospices hit by Hurricane Charley some leeway. Palmetto will grant expedited accelerated payments to [...]