Home Health & Hospice Week

New Cuts Will Put Half Of HHAs In The Red

If the HHA Medicare reimbursement cuts for 2011 and 2012 take place as proposed, half of HHAs will have profit margins of zero or less, calculates the National Association for Home Care & Hospice.

"Many providers are likely to go out of business with these negative margins, creating a serious threat to access to care," NAHC notes. The cuts are due to CMS's supposed coding creep reductions and cuts included in the health care reform law.

Coding change: NAHC also has received "numerous reports" that agency payments would be reduced by large amounts if CMS eliminates two case mix codes for hypertension -- 401.1 and 401.9.

Benchmark vendor OCS HomeCare analyzed 2009 data and found that the code elimination would result in a 1.87 percent reduction to PPS episode payments, NAHC reports.

"Eliminating the two hypertension diagnosis codes from home health case-mix is not appropriate at this time," NAHC maintains. "Doing so would constitute double dipping by CMS when carried out simultaneously with the case-mix creep adjustment, which includes creep due to the increase in hypertension coding."

Take action: NAHC is urging HHAs to encourage their elected representatives to support legislation curbing the cuts. Reps are home for summer recess for the next few weeks.

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