tci Medicare Compliance & Reimbursement - 2004 Issue 38

Hospitals: HHAs Lose Out On PRRB Ruling

Provider to file appeal in federal court over physical therapist compensationHome health agencies continue to fall prey to stingy Medicare payment limits - and hundreds of thousands of dollars in home health agency reimbursement hangs in the balance.The Centers for Medicare & Medicaid Services has applied contractor payment limits to directly employed physical therapists in a string of Provider Reimbursement Review Board decision reversals. And this time it could cost VNA-TIP HomeCare more than $310,000.Then-regional home health intermediary Wellmark imposed contractor salary equivalency guidelines to the agency's directly employed PTs in 1993 and 1994 cost reporting...

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