Home Health & Hospice

MedPAC Releases Annual Report to the Congress

Homecare Insider, March 19, 2012

On March 15, the Medicare Payment Advisory Commission (MedPAC) released its annual Report to the Congress.

In the report, MedPAC addresses the home health PPS in Chapter 8. MedPAC states that most indicators of payment adequacy for home health are positive.

According to MedPAC, because these indicators are so similar to last year’s research, the Commission is repeating its recommendations from the March 2011 Report to the Congress.

The official recommendations to Congress in regards to home health are as follows:

  • The Secretary, with the Office of Inspector General, should conduct medical review activities in counties that have aberrant home health utilization. The Secretary should implement the new authorities to suspend payment and the enrollment of new providers if they indicate significant fraud.
  • The Congress should direct the Secretary to begin a two-year rebasing of home health rates in 2013 and eliminate the market basket update for 2013. This changed slightly and changed the year of market basket elimination to 2013 as opposed to 2012. 
  • The Secretary 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.
  • The Congress should direct the Secretary to establish a per episode copay for home health episodes that are not preceded by hospitalization or post-acute care use.

Read the complete report today!