Home Health & Hospice Week

In addition to imposing a copayment for home health agency episodes and keeping HHA payment rates flat in 2012, the Medicare Payment Advisory Commission makes four other recommendations for HHAs in its March report to Congress:

1. The Department of Health and Human Services and the HHS Office of Inspector General should conduct medical review in counties that have aberrant home health utilization and HHS should implement the new authorities to suspend payment and the enrollment of new providers if they indicate significant fraud.

2. Congress should direct HHS to begin a two-year "rebasing" of home health rates in 2013. (Expect big payment rate reductions from any rebasing project, home care experts warn.)

3. HHS should revise the home health case-mix system to rely on patient characteristics to set payment for therapy and nontherapy services and should no longer use the number of therapy visits as a payment factor.

4. Congress should direct HHS to modify home health PPS to protect patients from stinting or low quality care due to rebasing. The modifications should include risk corridors and payment blending PPS and cost-based reimbursement.