Home Health & Hospice Week

Say goodbye to therapy money under latest recommendations.

If Congress listens to the Medicare Payment Advisory Commission, it will pass these changes to home health agency reimbursement this year:

• a rate freeze (0 percent payment update) for 2017;
• two years of rebasing cuts starting in 2018;
• eliminating therapy as a PPS factor in 2018, concurrent with rebasing.

“Home health payments need to be significantly reduced,” MedPAC insists in its annual report to Congress released in March. Current reductions are “modest, and substantial margins for many agencies are likely to remain, particularly for those that are efficient or focus on higher paying services.” MedPAC also reiterates its unimplemented recommendations from previous reports:

• a home health copay (perhaps $150 per episode); and
• increased medical review in counties with “aberrant” utilization, resulting in payment suspensions and enrollment prevention when fraud is identified.

And the commission more informally discusses using surety bonds, increased fraud-fighting activities in fraud-prone areas, and quality measure requirements that, when not met, would result in termination or probation.