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Home Health & Hospice Week

Industry Notes:

PPS REFINEMENTS ADJUSTMENTS STILL UNDERWAY AT ONE RHHI

Published on Wed Apr 22, 2009

HHAs will see long-awaited underpayments finally fixed. Don't be surprised if you continue to see lots of home health agency claims adjustments from regional home health intermediary Palmetto GBA. The intermediary is currently working its way through adjustments for five of the nine prospective payment system errors the Centers for Medicare & Medicaid Services identified in Oct. 31, 2008 Transmittal No. 397 (CR 6250). Currently Palmetto is working on the 2008 PPS errors regarding: the nonroutine supply add-on that incorrectly paid for claims spanning Jan. 1, 2008; incorrectly paying the full NRS amount for an episode that should have been prorated due to a partial episode payment (PEP) adjustment; recoding certain clinical domain values; and incorrectly paying the 2007 wage index instead of the 2008 one. And Palmetto is working on the big adjustment many agencies have been waiting for -- the correction of PPS episode sequencing. Initially, the system under [...]
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