tci Medicare Compliance & Reimbursement - 2003 Issue 35

Home Care: PRRB Decision Provides Ammo for some HHAs

Medicare beneficiaries are entitled to covered home health services no matter where they live, and the government should pay for them. That's the argument one home health agency in a remote part of California's Sierra Nevada mountains has made, and the Provider Reimbursement Review Board seems to agree. Back in 1998 Medicare was paying HHAs under cost-based reimbursement, and under the interim payment system the then-Health Care Financing Administration slashed per-visit limits for many agencies. For Bishop, CA-based Pioneer Home Health, the only HHA serving two isolated mountain counties, the cuts were life threatening. "They chopped us off at...

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