NAHC Addresses RAP Suppression with Palmetto GBA
Palmetto GBA, the largest home health and hospice Medicare Administrative Contractor (MAC) took steps last week to suppress payments to home health agencies identified as having a “high number” of auto-cancelled Requests for Anticipated Payment (RAP). At this time, Palmetto plans to suppress RAP payments for any home health agency that had 100 or more RAPs auto-cancelled between January 1 and April 15, 2013 (See NAHC Report, April 23, 2013).
In response to calls for assistance from its members, the National Association for Home Care and Hospice (NAHC) contacted Palmetto to discuss this action and identify steps home health agencies should take to be removed from RAP suppression. NAHC pointed out that Medicare’s authority to suppress RAP payments is based on program integrity, and therefore RAP payment suppression should be limited to cases where fraud or abuse is suspected. NAHC suggested that Palmetto carry out a second level of information analysis before suppressing RAP payments based simply a number of cancelled RAPs in order to ensure that only agencies that are suspected of fraudulent or abusive practices are having their payments suppressed.