September 9, 2019

Home health agencies demand CMS halt 8% cut based on perceived misbehavior

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Fierce Healthcare

Home health agencies are imploring the Trump administration to hold off on a potential 8% cut to Medicare reimbursement rates, saying the cuts punish an entire industry for a few bad apples.

Companies submitted comments due Monday for a proposed rule released by the Centers for Medicare & Medicaid Services in July that outlines 2020 payment rates for home health agencies. The rule implements major changes in how payments to home health companies are calculated.

Home health agencies are livid with a proposed 8.01% reduction to reimbursements to compensate for how the agencies may behave throughout the year. For instance, CMS assumes that home health agencies won’t use the appropriate billing code for a diagnosis and instead use another billing code that pays more, a practice called “up-coding.” So CMS is planning for an 8.01% reduction to compensate for this assumed behavior.

But home health agencies are balking at the cut.

“An 8.01% reduction is one of the most significant reductions taken in any new or existing Medicare payment system to date and will certainly have far-reaching negative consequences,” according to comments from the Partnership for Quality Home Healthcare, an association that represents home health agencies.

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