CMS Issues Manual Updates Related to PDGM

The Centers for Medicare and Medicaid Services (CMS) has issued Change Request (CR) 11527, which includes further updates to the Claims Processing Manual, chapter 10, related to the Patient Driven Grouper Model (PDGM). The CR clarifies that a beneficiary is not required to be discharged form home health services if an inpatient stay spans across…

Medicare Home Health Services Proposed Rule: RAP Phase-Out

Analysis and recommendations for home health agencies By NAHC President William A. Dombi The Centers for Medicare and Medicaid Services (CMS) has proposed that the split payments made to home health agencies under the Request for Anticipated Payment (RAP) process will end in 2021. As an interim step, no “new” HHAs will receive RAPs in…

CMS to Supress RAP Payments on New Home Health Agencies

The Centers for Medicare & Medicaid Services (CMS) issued a Med learn (MLN) Matters® article, SE 19005 that will place all new home health agencies (HHAs) into a provisional period of enhanced oversight. The provisional period will include a suppression of all Requests for Anticipated Payment (RAP) payments for 30 days to 1 year, effective…