Home Health & Hospice Week
Recoupments To Hit Hospitals For DRG Payments That Were Supposed To Be Prorated For Home Health DCs
You may notice a chilling effect on hospital discharges to home health, following a new OIG report focusing on Medicare’s Post-Acute Care Transfer Policy. Reminder: Last summer, the HHS Office of Inspector General noted that it would be investigating this issue yet again (see HHHW by AAPC, Vol. XXXI, No. 25). The watchdog agency wants to make sure no full DRG payments for hospital patients discharged “early” to home health are sneaking through to hospitals. From January 2019 through December 2022, the OIG found Medicare improperly paid $41.4 million to acute-care hospitals for inpatient claims subject to the transfer policy, according to the report. But after CMS fixed malfunctioning edits in April 2022, “improper payments significantly decreased,” the OIG notes. Thus, the OIG wants CMS to have its contractors recoup those overpayments from the hospitals and have those hospitals look for further overpayments. This activity may lead to some hospitals clamping down on home health referrals, experts warn. The 23-page report is at https://oig.hhs.gov/oas/reports/ region9/92303016.pdf.
Home Health & Hospice Week
- Oasis:
HHAs Called On The Carpet For Seriously Underreporting Falls
Watch out: Extremely low falls QM figures may become a red flag. Providers self-reporting quality [...] - Quality:
These OASIS-Based Quality Measures May Be Next To Draw Feds’ Ire
Will your data for the OASIS items feeding into these measures hold up? The 11 [...] - Assessment:
Brace For Stepped-Up Scrutiny Of OASIS Reporting
Surveys may become much more focused on OASIS compliance. The HHS Office of Inspector General [...] - Studies & Surveys:
Hospice Reduces Medicare Costs, Even For Dementia Patients, Study Says
Plus: Two more recent studies address health equity issues. Law- and policymakers need to take [...] - Overpayments:
Take Some Steps Now, Some Later For Overpayment Compliance In Light Of 60-Day Rule
Be ready to run with the new regs. What can home health and hospice agencies [...] - Mergers & Acquisitions:
2 Nonprofit Florida Hospices Plan To Join Forces
Plus: Amedisys-UnitedHealth deal clears next hurdle. Empath Health and Trustbridge are beginning the process of [...] - Industry Notes:
Step Up For TEP Activity In HH, Hospice
Quality measures, Value-Based Purchasing opportunities available. If home health and hospice providers want the feds [...] - Industry Notes:
Get Comfortable In Your Assigned VBP Cohort, At Least For The Next Year
If you have questions about the Value-Based Purchasing program, a new question-and-answer document may have [...] - Industry Notes:
Submit Your Provider Relief Fund Report By Sept. 30 Or Pay Back Affected Funds
The COVID-19 public health emergency is getting farther and farther back in the rearview mirror, [...] - Industry Notes:
Recoupments To Hit Hospitals For DRG Payments That Were Supposed To Be Prorated For Home Health DCs
You may notice a chilling effect on hospital discharges to home health, following a new [...] - Industry Notes:
New HHS Antidiscrimination Rule May Encourage Home Health Use
The Department of Health and Human Services is taking aim at discrimination in health care [...]
