Home Health & Hospice Week

Prospective payment system proposed rule holds bad news for home health agencies. Get ready to shoulder your expanded regulatory burden with less money next year, if the prospective payment system proposed rule gets finalized as is. The Centers for Medicare & Medicaid Services proposes to cut home health agency prospective payment system rates by 3.35 percent starting in January 2012, according to the PPS proposed rule put on display at the Federal Register July 5. The cut would translate to an estimated decrease of $640 million compared to HHA payments in 2011, CMS says in a release. The culprit: CMS proposes a 5.06 percent reduction for so-called "case-mix creep" -- upcoding by HHAs. That combines with a 1.5 percent inflation update, which is reduced by 1 percent. Plus: CMS wants to remove two hypertension codes from the case-mix system -- 401.1 (Benign Essential Hypertension) and 401.9 (Unspecified Essential Hypertension), it says in [...]