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Home Health & Hospice Week

Therapy:

20-Visit Threshold Sees Biggest Payment Decrease Under Case Mix Changes

Published on Wed Jun 15, 2011

The feds are aiming changes at scammers who pad their therapy visits. The only question some home care industry members have about the therapy case mix changes is "what took so long?" That's what financial consultant Pat Laff of Laff Associates in Hilton Head Island, S.C. wonders. The Centers for Medicare & Medicaid Services should have shifted the emphasis on therapy in the home health prospective payment system case mix model "as soon as they saw the thresholds becoming points of concentration," Laff tells Eli. "We know it takes a while for CMS to get the info they need," says therapist and consultant Cindy Krafft with Fazzi Associates. That's even when the conclusion seems obvious to providers. The number of no- or low-therapy episodes fell or remained flat from the inception of PPS to 2009, while 10-to-13-visit therapy episodes peaked when 10 therapy visits was the payment threshold and 14+-visit [...]
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