tci Medicare Compliance & Reimbursement - 2003 Issue 18

Reimbursement: PEP ADJUSTMENTS BACK ON - NO, REALLY THIS TIME

It looks like the Centers for Medicare & Medicaid Services plans to gradually nibble away at home health agencies' reimbursement over the next year rather than taking one big bite now for PEP recoupments. The recoupment process for partial episode payment (PEP) adjustments has been repeatedly delayed, CMS admits in a statement announcing the new implementation date. The claims processing system accidentally failed to make the PEP adjustments in the first few years of the prospective payment system in certain cases. HHAs have forgotten about the PEP take-backs with all the false starts, perhaps believing CMS would never make...

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