Home Health & Hospice Week
LUPAs Go Up While Supplies Go Down
Rebasing passes LUPAs by.
Home health agencies may feel under-reimbursed for their services to Medicare patients, but at least payment for one type of service continues to rise.
As in previous years, the Low Utilization Payment Adjustment payment rates will rise by the full home health update percentage of 2.3 percent, the Centers for Medicare & Medicaid Services notes in the 2017 HH PPS proposed rule. Plus, “rebasing adjustments … will … increase the national per-visit payment amounts by 3.5 percent of the national per-visit payment amounts in CY 2010,” CMS adds (see per-visit rates, p. 195).
LUPA add-on rates also will increase, since they are calculated by multiplying the LUPA add-on factor (1.8451 for skilled nursing; 1.6700 for physical therapy; and 1.6266 for speech therapy) by the pervisit LUPA rates (which are increasing).
For example: “For LUPA episodes that occur as the only episode or an initial episode in a sequence of adjacent episodes, if the first skilled visit is SN, the payment for that visit would be $261.16 (1.8451 multiplied by $141.54), subject to area wage adjustment,” CMS explains in the rule.
On the other hand, reimbursement rates for non-routine supplies are subject to a 2.82 percent rebasing adjustment (see NRS rates, p. 195).
Home Health & Hospice Week
- Prospective Payment System:
CMS Proposes $180 Million Cut To Home Health Pay In 2017
Repeated cuts will lead to access problems. The number of home health agencies, users, and [...] - Know Your Facts:
CMS Bases Reimbursement Decisions On These Stats
Home health agencies continue to get squeezed by lower payment rates, despite declining statistics cited [...] - Payment:
LUPAs Go Up While Supplies Go Down
Rebasing passes LUPAs by. Home health agencies may feel under-reimbursed for their services to Medicare [...] - Prospective Payment System:
Prepare For Major Changes To Outlier Reimbursement
New winners, losers under methodology revamp. Time will be of the essence when it comes [...] - Outliers:
CMS Proposes Outlier Safeguards Under New Calculation Method
FDL will increase under time-based system. Medicare officials have already anticipated ways to game the [...] - Value-Based Purchasing:
Significant Tweaks To VBP On Deck
Just who your agency is compared to can make or break your VBP payments. The [...] - Value-Based Purchasing:
VBP Appeals Function Clarified, Expanded
Plus 4 measures dropped. The Centers for Medicare & Medicaid Services also proposes these changes [...] - Supplies:
More Reimbursement For Wound Care Patients Using NPWT Proposed
Consolidated billing exception in the works. A rare carve-out for non-routine medical supplies could put [...] - Pre-Claim Review:
HHAs Receive Pre-Claim Review Instructions
Physician signature requirement will be a major obstacle to payment under demo. Home health agencies [...] - Pre-Claim Review:
Pre-Claim Review Documentation Requirements
In its new operational guide for pre-claim review, the Centers for Medicare & Medicaid Services [...] - Make The Most Of Your Eli's Home Care Week Subscription
You have more than a decade’s worth of information on a multitude of home health [...] - HIPAA:
Other Shoe Drops With HIPAA Audits
Hundreds of providers will receive HIPAA scrutiny this year. You’ve been hearing for years that [...] - HIPAA:
Follow This Advice To Prepare Now For HIPAA Audits
Check and double-check your HIPAA policies and procedures. The HHS Office for Civil Rights’ new [...] - Industry Note:
HHAs Stuck With Loss Of Companionship Exemption -- At Least For Now
Remedy still sought. The U.S. Supreme Court has declined to hear the industry’s challenge to [...] - Industry Note:
OASIS-C2 Manual Out
Get ready for OASIS-C2’s January implementation by reading the tool’s new guidance manual, which the [...] - Industry Note:
HHA PEPPERs Hit In July
Mark your calendar to download the next installment of free billing benchmarks from Medicare. Around [...] - Industry Note:
Chain To Go To Charity
Bayada Home Health Care CEO J. Mark Baiada plans to donate the home care chain [...]
