Home Health & Hospice

MedPAC Issues Annual Report to Congress

Homecare Insider, March 25, 2013

On March 15, the Medicare Payment Advisory Commission (MedPAC) issued its annual report to Congress. This year’s report is very similar to reports in years past. In fact, there are no new recommendations and all recommendations are the same as the 2011 recommendations. The major recommendation that MedPAC continues to call for is the rebasing of home health payments starting this year.

In 2011, the Commission made a multiyear recommendation for home health payments, and this report reiterates that recommendation, including rebasing the home health PPS, changing the case-mix system, implementing a copay for certain home health episodes, and investigating and stopping fraud and abuse in areas with aberrant patterns of use of home health services.

The 2011 report recommendations to Congress were 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 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.

In the report, MedPAC addresses the home health PPS in Chapter 9. MedPAC states that most indicators of payment adequacy for home health are positive.

Read the entire report here.
 

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