Home Health & Hospice Week

Unfortunately for home health agencies, partial episode payment (PEP) adjustments look like they'll be back on track in mere weeks.

Beginning the week of July 28, regional home health intermediaries will start recouping PEPs that the claims system failed to make in the first two-and-a-half years of the prospective payment system, the Centers for Medicare & Medicaid Services says in a July 16 announcement.

The RHHIs will process small, random batches every week for two years to reclaim the funds, with the maximum batch reaching 725 adjustments. "This is a fraction of 1 percent of the average number of home health claims paid at these sites per week," CMS insists.

And HHAs shouldn't whine about their cash flow problems, even when some providers expect to see PEP recoupments of nearly half a million dollars over the two years. "It is unlikely that any HHA will miss an entire payment due to the adjustments," CMS says in the notice. "Since all RHHIs issue payments more frequently than weekly, it is also unlikely that any HHA would experience a full week without Medicare payments as a result of this process."

If HHAs do see cash flow hardships, they can appeal to their RHHIs for help, CMS offers.

Intermediaries will issue instructions to HHAs on how to check their PEPs before the recovery process starts (see Eli's HCW, Vol. XII, No. 24, "Billing:  Check PEPs Before RHHIs Start Recouping").