Welcome to the HealthPRO Heritage Blog

As most home health providers are aware, beginning on 1/1/21 financial penalties will start to incur for any RAP (Request for Anticipated Payment) submission that occurs after 5 days from when a patient is admitted to home health services. Here is a breakdown of what this updated RAP submission will look like and exactly what financial penalties will occur:

Reimbursement, revenue, payment, or better yet, the term “cash flow” seems to be on the mind of every home health agency in the nation today. Not only were agencies hit with the RAP reduction from 60% to a minimum 20% with the start of PDGM in January 2020; but the COVID-19 pandemic, which began in March, seemed to throw gasoline onto an already large cash flow fire by increasing the occurrence of LUPAs (Low Utilization Payment Adjustment).

CMS released the 2021 home health final rule on Thursday, October 29, 2020. HealthPRO Heritage at Home sorted through the mixed bag and found more treats than tricks!

There were minimal changes compared to the home health proposed rule that was released in July 2020. Probably the best news in the rule was the 1.9% aggregate increase (or $390 million) in reimbursement that agencies will realize in 2021. Although the increase was less than the original 2.6% increase that was in the proposed rule.

Other highlights from the final rule are as follows:

Happy Physical Therapy Month!
The profession of physical therapy is 99 years old this year (2020)! To celebrate, HealthPRO Heritage would like to recognize and applaud all of our dedicated, hard-working Physical Therapy Practitioners. We are grateful for each and every one of you, and we are thankful to have you as vital parts of our team. Thank you for your continued dedication to the residents/patients/clients you serve!

From CMS' press release  on October 8, 2020 there are amended terms for repayment on Accelerated and Advance Payment (AAP) Program. This allows CMS to make advance payments to providers and are typically used in emergencies. 

The National Academies of Sciences, Engineering, and Medicine have made recommendations to the U.S. Department of Health and Human Services about who should get priority for SARS-CoV-2 vaccines when they become available. (NASEM’s recommendations are usually followed.) You can buy a copy of this detailed document for $70 at the link below. These are the proposed phases of rollout as recommended by NASEM:

On CMS' Technical Page, the agency announced via this post that an error was made in the PDPM Grouper! Six ICD-10 codes (T8484XA, T8389XA, T8321XA, T82399A, T82392A, and T83021A) were excluded. These codes are significant, because they contribute points toward the NTA case mix group when coded on the PPS MDS assessment.