Archive for January 18th, 2011

January 18, 2011

MedPAC recommends copays for Medicare home health

Last week the Medicare Payment Advisory Commission (MedPAC) recommended that Congress impose copayments obligation on Medicare home health patients, and that provider payment rates be cut in several ways starting in 2012 and continuing thereafter.

The National Association for Home Care & Hospice (NAHC) strongly disagrees with these ideas and believes that there would be detrimental effects on beneficiaries and that the moves would drive up health care costs.

The MedPAC copayment proposal would require seniors and disabled Medicare beneficiaries to pay a $150 copayment for each 60-day episode of home care where they do not go to a hospital or skilled nursing facility first.

Home health had copayments in the past, but the fees were removed because, among other reasons, there was no evidence copayments saved the government money; some poor seniors could not enter home healthcare, and the costs were transferred to the Medicaid program.

MedPAC also voted to recommend to Congress that home health payment rates be cut beginning in 2012. MedPAC data shows that 35 percent of home health agencies are now paid less than the cost of care and that scheduled cuts will bring that number to nearly 50 percent by 2012.

In its annual March report, MedPAC will deliver its recommendations to Congress.

Interested in having your voice heard on potential copayments? Click here to use the NAHC Legislative Action Network NOW to send this message to your legislators.

Thank you to TAHC for providing some information for this post!

January 18, 2011

You cannot keep a patient for PT/INR only

Question: Is it possible to keep a patient for home health only to perform PT/INR labs. Initially we received this patient for CVA. She currently is stable but still requires therapeutic drug monitoring. Every other disease process is stable and been taught on. Is therapeutic drug monitoring a valid reason, and can it be the only reason why we continue to have the patient on board?

Lisa says: Venipuncture is a skill but not a qualifying skill for Medicare home health. A patient such as you described is usually receiving observation and assessment as the skill. Observation and assessment is considered a skill only if there is a potentially fluctuating condition. If there have been no changes, then O and A probably is no longer skilled.

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