New Rule, New Fines for Home Health Providers?

While the Centers for Medicare and Medicaid Services’ (CMS) $20 million cut in home health agencies’ payment rates does not come as a surprise to the agencies they ultimately impact, implications of the newly proposed method of dealing with non-compliant providers proves new ground for concern.

The cut in fact, could have run even deeper, according to the National Association for Home Care & Hospice (NAHC).

The proposed cut is equivalent to a 0.1% reduction in payment rates and will go into effect at the beginning of calendar year 2013.

“The numbers that they put out there are in line with our expectations,” Bill Dombi, vice president for law for the NAHC, told HHCN. “CMS does have the power and authority to bring cuts even higher, but we appreciate that they kept it lower.”

Although the numbers do not come as a surprise to NAHC, the portion of the proposal that seeks to change the process for dealing with a provider who has been observed as non-compliant with one or more rules sparks a bit of concern.

In accordance with the new proposal, surveyors would be allowed to impose a financial requirement on non-compliant providers and require that they work toward correcting areas in which they are deficient.

“One of the concerns we will look into is will this increase provider costs and will this increase penalties assessed,” said Dombi.

The current procedure in dealing with a non-compliant provider only allows for surveyors to terminate the provider’s position. This presents a worry that surveyors are often not as tough as they should be when evaluating providers because most do not want to terminate a position, according to Dombi.

Dombi also emphasizes that home care providers should be attentive to any change in their wage index.

Written by Erin Hegarty