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NAHC Report: Issue# 2478, 7/30/2014
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ARTICLE ARCHIVES MEMBER RESOURCES eNEWSLETTERS CARING STORE
Proposed Medicare Home Health Services Rates Would Reshape Payments Significantly
Reps. Reed and Tonko Invite Colleagues to Sign Onto a Letter Urging CMS to Suspend Home Health Claim Denials Arising from F2F Physician Narrative Requirement
For Your Information: Congresswoman Gabby Giffords and Capt. Mark Kelly, Financial Expert Ric Edelman, Senate Finance Committee Chairman Ron Wyden, and Doug Rauch, Former Chairman of Trader Joe’s, All Scheduled to Address NAHC’s Annual Meeting
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Proposed Medicare Home Health Services Rates Would Reshape Payments Significantly

With the Notice of Proposed Rulemaking, the Centers for Medicare and Medicaid Services (CMS) sets out a plan to recalibrate all 153 Home Health Resource Groups in the case mix adjustment model. These proposed changes, if finalized later this year, would result in a dramatic reshaping of the payment distribution model. CMS has evaluated and modified all variables that affect the assignment of an HHRG to a particular patient episode.

The recalibration is based on the methodology that was used to modify the 2008 and 2012 case mix adjustment weights. CMS used preliminary 2013 home health claims data for generating the proposed 2015 case mix weights. The dependent variable that was used in the recalibration is the same that was applied in 2012: wage weighted minutes of care using Bureau of Labor Statistics data on national hourly wage plus fringe rates for the six disciplines of care. All 164 variables in the four-equation model were examined. The four-equation model consists of four “legs:” early episode 0-13 therapy visits; early episode 14+ therapy visits; later episode 0-13 therapy visits; and later episode 14+therapy visits. The evaluation affects both the Clinical and Functional domains in the model.

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Reps. Reed and Tonko Invite Colleagues to Sign Onto a Letter Urging CMS to Suspend Home Health Claim Denials Arising from F2F Physician Narrative Requirement
Deadline for signatures is August 7, 2014; NAHC urges its members to contact their Representatives and ask for their support

Rep. Tom Reed (R-NY) and Rep. Tom Tonko (D-NY) are urging their colleagues to join them in sending a letter to CMS Administrator Marilyn Tavenner urging her to suspend claim denials, including reversing previous denials, arising from the Face-to-Face (F2F) physician narrative requirement pending adoption of the final F2F rule eliminating the narrative requirement.

Recently, CMS released its 2015 proposed Home Health Prospective Payment System (HHPPS) rule, which will go into effect on January 1, 2015. Reps. Reed and Tonko – urged on by the successful advocacy of New York and New Jersey NAHC members - were instrumental in getting 77 other Representatives to join in a previous F2F letter last September.

For more on CMS’ HHPPS rule, please see NAHC Report, July 8, 2014.

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Congresswoman Gabby Giffords and Capt. Mark Kelly, Financial Expert Ric Edelman, Senate Finance Committee Chairman Ron Wyden, and Doug Rauch, Former Chairman of Trader Joe’s, All Scheduled to Address NAHC’s Annual Meeting
Annual Meeting being Held October 19 – 22 in Phoenix, AZ

Registration is now open for NAHC’s Annual Meeting & Exposition, held this year in Phoenix, AX October 19 – 22. This year’s Annual Meeting & Exposition includes nationally and internationally renowned keynote speakers such as former Congresswoman Gabby Giffords and Capt. Mark Kelly, financial expert Ric Edelman, and Senate Finance Committee Chairman Ron Wyden.

This year’s Annual Meeting will also offer track-specific educational sessions, informative round table discussions and much, much more.

For more on this year’s General Session speakers, please click here.

To register to attend this year’s Annual Meeting & Exposition, please click here.

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