Sequestration impacts Home Health and Hospice reimbursement

On March 8, 2013, CMS announced that all Medicare FFS claims with dates of service or dates of discharge on or after April 1, 2013, will incur a 2 percent reduction in Medicare payment due the sequestration order issued by President Obama on March 1, 2013 as required by law.

William Dombi, Vice President for Law at the National Association for Home Care and Hospice (NAHC), announced that NAHC was seeking clarification regarding the dates that would be used to determine the episodes which will be subject to the reduction.

Earlier today Mr. Dombi announced on the NAHC listserv the following clarification:

CMS informed us today that the sequestration that takes effect on April 1, 2013 will be implemented as follows:

1. Home Health Services: the 2% payment reduction will be applied to episodes with end dates of April 1 and later
2. Hospice: the claim “through date” which is generally meaning that with calendar month billing, services beginning April 1, 2013.

The specific response from CMS is:

“the answer to your question on home health payments is that, working just like the annual update to HH PPS payments, CMS will use the “Claim Through” date, on the claim, to apply the reductions. For home health, that is also considered the “end of episode” date. If the “Claim Through” date (i.e. end of episode date) is on or after the effective date of the reduction (April 1, 2013), the reduction will apply. Similarly, for hospices, CMS will use the claim “Through” date to apply the reductions.”

For more information regarding this statement, go to the NACH website.

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Until next time,

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