CMS Issues a Workaround for RAPs Without Value Code 61

Home health agencies (HHAs) have had requests for anticipated payments (RAPs) retuned to providers (RTP’d) related to value code 61. With the no pay RAP policy, effective January 1, 2021, the Centers for Medicare & Medicaid Services (CMS) is no longer requiring that HHAs report value code 61 and the core-based statistical area (CBSA) on…

CMS Issues Instructions for the Misuse of RAPs

The Centers for Medicare & Medicaid Services (CMS) has issued Change Request 10789 that adds a new section to the Medicare Program Integrity Manual addressing actions the Medicare Administrative Contractors (MACs) should implement when potential fraud, waste or abuse is identified in relation to home health agency’s misuse of requests for anticipated payments (RAPs). In…