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Home Health & Hospice Week

Regulations:

Don't Count On Your Wage Index Just Yet

Published on Thu Nov 11, 2004

The Centers for Medicare & Medicaid Services will be issuing corrections to the wage index it put out in the final rule for the home health prospective payment system (see Eli's HCW, Vol. XIII, No. 38, p. 298).

The hospital wage index used to calculate the home care index had flaws, a CMS official explained in the Nov. 9 Open Door Forum for home care providers. Accordingly, CMS expects to correct the home care index "real soon," the staffer promised.

Home health agencies can probably expect a longer wait for answers on wage index issues such as reclassifications and transitional rates. CMS staff declined to address those issues in the forum.

Other HHA-related topics raised in the forum include:

  • Patient choice. Critical access hospitals are exempt from the new hospital condition of participation on discharge planning, the Texas Association for Home Care's Heather Vasek noted in the call. The COP requires hospitals to give patients discharged to home care a list of local HHAs (see Eli's HCW, Vol. XIII, No. 29, p. 226). Agencies need to know what to do when CAHs direct all their referrals to their own agency, Vasek said.

  • M0175. The National Association for Home Care & Hospice railed against including long-term care hospitals in the acute hospital category on OASIS item M0175. Because patients receive rehab in LTCHs, requiring agencies to categorize the stay as acute care in M0175 deprives agencies of money that should be theirs under the question, NAHC contends.

    A CMS official said in the forum that no changes on M0175 can take place until other PPS refinements occur - which is likely several years down the line. But NAHC is hoping CMS could make a change sooner, similar to the OASIS wound care coding changes for pressure ulcers (see Eli's HCW, Vol. XIII, No. 30, p. 234).

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