tci Medicare Compliance & Reimbursement - 2004 Issue 24

HOME HEALTH: PPS Reshuffling Will Affect HHA Rates In 2005

Outlier, wage index changes most significant in new PPS rule. Outlier patients may be less of a drain on HHAs' bottom line starting Jan. 1. The Centers for Medicare & Medicaid Services has proposed lowering the threshold patients must exceed before qualifying for extra outlier payments under the prospective payment system. That will mean more episodes would qualify for the outlier payments, and those episodes that already qualify would see higher payments, explains Vern Peterschmidt with Albuquerque, NM-based Peterschmidt & Associates. CMS wants to change the "fixed dollar loss" amount home health agencies must hit from 1.13 percent...

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