tci Medicare Compliance & Reimbursement - 2003 Issue 19

Reimbursement: HHAs WIN BREATHING ROOM ON PEPS

Home health agencies have received another reprieve from the recoupments of tens of thousands of dollars, this time while industry representatives plead their case to Medicare. The Centers for Medicare & Medicaid Services had informed HHAs that recoupment for partial episode payment (PEP) adjustments would begin May 5. The claims processing system had failed to make PEP adjustments since the beginning of the prospective payment system in October 2000, and CMS planned to take back the money incorrectly paid for episodes that should have been PEP'd. But CMS sent out a May 2 message informing providers that "this project...

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