POSTED ON MONDAY, July 20, 2020
The Office of the Inspector General (OIG) added a new item to its Work Plan titled Analysis of New Rural Add-On Payment Methodology. It entails various projects, including OIG audits and evaluations that are underway or planned to be addressed during the fiscal year and beyond, by OIG’s Office of Audit Services and Office of Evaluation and Inspections.
“Section 50208 of the Bipartisan Budget Act of 2018 (the BBA) extended rural add-on payments for home health episodes and visits ending during calendar years (CYs) 2019 through 2022, and mandated implementation of a new methodology for applying those payments. Beginning in CY 2019, rural add-on payments were provided in varying amounts according to classification in one of three rural categories:
- high utilization,
- low population density, and
- all other.
The BBA requires home health claims to indicate the code for the county in which the home health service is provided. The Centers for Medicare & Medicaid Services (CMS) has instructed providers to use value code 85 to report the county code and will return claims for correction when the code is missing or invalid. The BBA also mandated that the Department of Health & Human Services (HHS)-OIG submit to Congress an analysis of Medicare home health claims and utilization of home health services by county (or equivalent area) and recommendations, as appropriate, based on such analysis. “
Source: NAHC Report
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