Industry Notes:
KEEP AN EYE ON WASHINGTON THIS MONTH
Published on Mon Nov 26, 2007
Your 2008 payment rates are on the budget chopping block.
The clock is ticking on this year's congressional session, but there's plenty of time left for lawmakers to slash your Medicare payment rates for next year.
The Senate Finance Committee plans to consider Medicare legislation Dec. 5, upon returning from Thanksgiving recess.
Lawmakers aim to eliminate physicians' 10.1 percent cut in Medicare reimbursement, which means they'll be looking to make cuts to other providers' payments--and home care is a likely target.
"A physician 'fix' may cost from $18 billion to $24 billion dollars," warns the National Association for Home Care & Hospice. "This puts all other Medi-care providers at risk of payment cuts."
Timeline: Legislators would like to wrap up budget work before Christmas, NAHC notes.
Providers such as nursing homes and managed care plans are firing up their lobbying machines to fend off cuts in their arenas, and home care is no exception. Former Sen. Bob Dole (R-KS) has sent a letter urging key Senate Finance members to avoid home care cuts, NAHC reports.
"I hope you will continue to preserve the full market basket update for home health providers and offer some help to address the extensive regulatory cuts," Dole said in the letter. Dole is special outside counsel for NAHC.
At a Nov. 15 House Small Business Commit-tee hearing, the trade group also denounced the payment cuts for case mix creep that CMS will implement Jan. 1. The manner in which the Centers for Medicare & Medicaid Services is implementing the cuts has gone against the Regulatory Flexibility Act, NAHC charged.
Take action: The association urges home health agencies to contact their representatives to enlist their support for home care. • Round two of competitive bidding is coming--but suppliers will have to wait for bidding details. "DMEPOS competitive bid instructions ... will be released closer to the 2008 bid window," CMS noted Nov. 20. More information will be forthcoming on the CMS Web site soon, an agency official promised in the Nov. 28 home health Open Door Forum. • CMS will use a Common Working File edit to fix its LUPA payment problem under the prospective payment system revisions, according to NAHC. Under the low utilization payment adjustment (LUPA) error, the claims system will sometimes give the $87.93 LUPA add-on to second episodes when it should only apply to first or sole episodes (see Eli's HCW, Vol. XVI, No. 40).
As a CMS official has told Eli, the edit won't begin until July. "In the meantime, there's no way to avoid erroneously paying the add-on to [the] second LUPA episode," the trade group warns. "Therefore, home health agencies should plan to hold any overpayments in reserve until advised by CMS of repayment procedures." • The feds [...]
