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:: NAHC Report
NAHC Report: Issue# 2345, 01/03/2014
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ARTICLE ARCHIVES MEMBER RESOURCES eNEWSLETTERS CARING STORE
MedPAC Expected to Again Recommend Home Health Payment Rate Freeze, Copays and Accelerated Rebasing: New Recommendation on Rehospitalization Penalties
National Council on Medicaid Home Care Creates Primer to the Ten Dual Eligible Agreements
For Your Information: 2014 Provider Enrollment Application Fee Published or Hospice Providers
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MedPAC Expected to Again Recommend Home Health Payment Rate Freeze, Copays and Accelerated Rebasing: New Recommendation on Rehospitalization Penalties

The Medicare Payment Advisory Commission (MedPAC) met recently as part of its annual ritual of developing recommendations to Congress. This year, MedPAC appears poised to simply restate last year’s recommendations and add a new one focused on penalizing home health agencies with abnormal levels of rehospitalizations.

The recommendations expected to be repeated are a zero inflation update and shifting rebasing from a four year phase-in to a two year phase-in. MedPAC staff expressed that home health agencies maintained a 14.6 percent margin in 2012 and that the current rate rebasing is “too modest” and should be deepened. MedPAC staff forecast that home health agencies will be able to offset most of the rate cuts through cost reductions leading to continued “overpayments” from Medicare.

NAHC does not agree with MedPAC’s assessment of the impact of rebasing nor the ability of home health agencies to sufficiently control cost growth to maintain current Medicare margins. Data demonstrates that margins are declining while care costs are increasing.

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2014 Provider Enrollment Application Fee Published or Hospice Providers

The Centers for Medicare & Medicaid Services (CMS) announced that beginning January 1, 2014 the provider enrollment application fee will be $542.00. Hospice providers will pay this amount if they need to revalidate their enrollment (via a revalidation request from a hospice’s assigned Medicare administrative contractor); complete a new CMS Form 855A, and when becoming a new provider.

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National Council on Medicaid Home Care Creates Primer to the Ten Dual Eligible Agreements

On November 25, the Centers for Medicare and Medicaid Services (CMS) and the state of Washington signed a Memorandum of Understanding (MOU) establishing the Medicare-Medicaid Alignment Initiative (MMAI) in capitated form for two counties in Washington State. This marked the latest of such MOUs signed coordinating care and financials of the dual eligible population.

Ten (10) MOUs have been signed already in the states of Massachusetts, Washington State (twice), Ohio, Illinois, California, Virginia, New York, Minnesota, and South Carolina. Eight of these MOUs - Massachusetts, Washington State, Ohio, Illinois, California, Virginia, New York, and South Carolina - were signed as part of the MMAI. The MMAI is a joint federal and state project that seeks to improve care and reduce costs associated with beneficiaries eligible for both Medicare and Medicaid, or “dual eligibles.”

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