{"id":659,"date":"2019-04-29T17:27:58","date_gmt":"2019-04-29T17:27:58","guid":{"rendered":"https:\/\/advantagehcconsulting.com\/blog\/?p=659"},"modified":"2019-04-29T17:32:10","modified_gmt":"2019-04-29T17:32:10","slug":"new-hha-cost-report-may-give-rise-to-rebasing","status":"publish","type":"post","link":"https:\/\/advantagehcconsulting.com\/blog\/2019\/04\/29\/new-hha-cost-report-may-give-rise-to-rebasing\/","title":{"rendered":"New HHA Cost Report May Give Rise To Rebasing"},"content":{"rendered":"\n
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New hourly wage calculation will prove crucial to future rate reductions, expert predicts.<\/em><\/strong><\/p>\n\n\n\n

A new cost report form and instructions don\u2019t just bring extra work for home health agencies \u2014 they also may usher in lower payment rates.<\/p>\n\n\n\n

In the April 16 Federal Register<\/em>, the Centers for Medicare & Medicaid Services <\/strong>published a Paperwork Reduction Act notice for cost report revisions. \u201cThe Form CMS\u20131728\u201319 cost report is needed to determine a provider\u2019s reasonable cost incurred in furnishing medical services to Medicare beneficiaries and reimbursement due to or from a provider,\u201d CMS says in the notice. The \u201ccost report is also used for annual rate setting and payment refinement activities, including developing a home health market basket.\u201d<\/p>\n\n\n\n

Plus:<\/strong> The Medicare Payment Advisory Commission <\/strong>\u201cuses the home health cost report data to calculate Medicare margins, to formulate recommendations to Congress … and to conduct additional analysis of the HHA PPS.\u201d<\/p>\n\n\n\n

The update is far from routine, says cost report expert Dave Macke <\/strong>with VonLehman & Co. <\/strong>in Ft. Wright, Kentucky. \u201cThis is going to catch a lot of people off guard,\u201d Macke predicts.<\/p>\n\n\n\n

In the new report, Worksheet S-3 Part V collects new data, Macke explains. \u201cThis worksheet is an attempt to get specific wage and benefit data for each of the direct care cost centers. Wages and benefits will be separately reported for RNs, LPNs, Nursing Assistants\/Aides. In addition, Physical Therapists, Physical Therapy Assistants, Physical Therapy Aides, Occupational Therapists, Occupa\u00adtional Therapy Assistants, Occupational Therapy Aides, Speech-Language Pathologists, and Other Medical Staff,\u201d he says.<\/p>\n\n\n\n

\u201cThe same categories apply to any contract labor costs,\u201d Macke adds. \u201cIt is very important to separate out direct cost for W-2 wages from contract labor on your financial statements.\u201d<\/p>\n\n\n\n

Thanks to these changes, \u201cthe agency will need to accumulate additional statistics consistent with the reported costs, i.e. LPN visits and patients served, physical therapy assistant visits and patients served, and certified occupational therapy assistant visits and patients served,\u201d advises The Health Group <\/strong>in Morgantown, West Virginia.<\/p>\n\n\n\n

Along \u201cwith the detailed reporting of wages and contract labor, CMS is also requesting total paid hours for each of these categories,\u201d Macke says. \u201cThe purpose of this Worksheet is to compute an average hourly wage for each occupational category.\u201d<\/p>\n\n\n\n

Reporting total paid hours is going to be tricky for some agencies that haven\u2019t been tracking the data carefully up until now, Macke tells Eli<\/strong>. And it may prove a significant problem to agencies that pay per visit.<\/p>\n\n\n\n

Why it matters: <\/strong>Once CMS starts gathering the data to calculate hourly wages, you can expect the agency to start comparing HHA costs versus Medicare payment rates, Macke predicts. \u201cAnd then CMS will start recalculating rates,\u201d Macke believes.<\/p>\n\n\n\n

If you think that\u2019s a remote threat, just look at what CMS is doing in the hospice arena, Macke points out. In its newly proposed rule, CMS is rebalancing payment levels based on hospice cost report data (see story, p. 115<\/em>).<\/p>\n\n\n\n

Other changes included in the revision are separate reporting of Medicaid versus other patients and separate reporting for aides on Worksheet S-3, Part I, the National Association for Home Care & Hospice <\/strong>says in its member newsletter.<\/p>\n\n\n\n

And \u201ctelehealth has been added as a reimbursable cost center and remote patient monitoring has been added as a general service cost center on Worksheet A,\u201d points out The Health Group in its electronic newsletter.<\/p>\n\n\n\n

One problem: <\/strong>CMS indicates the cost report changes are supposed to take effect in 2019, \u201cbut we are already four months into the year,\u201d Macke notes. CMS will need to change the date to 2020, Macke says.<\/p>\n\n\n\n

If CMS doesn\u2019t, HHAs must \u201csegregate the additional financial information and statistics retroactive to January 1, 2019,\u201d The Health Group counsels.<\/p>\n\n\n\n

HHAs have until June 17 to comment on the changes, CMS says in the Federal Register <\/em>notice.<\/p>\n\n\n\n

Note: The notice is at www.govinfo.gov\/content\/pkg\/FR-2019-04-16\/pdf\/2019-07500.pdf<\/a>.<\/em><\/p>\n\n\n\n

Source- SuperCoder<\/a><\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

New hourly wage calculation will prove crucial to future rate reductions, expert predicts. A new cost report form and instructions don\u2019t just bring extra work for home health agencies \u2014 … Continue Reading →<\/a><\/p>\n","protected":false},"author":1,"featured_media":37,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5],"tags":[26,34],"class_list":["post-659","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-reimbursement","tag-costreport","tag-hha"],"_links":{"self":[{"href":"https:\/\/advantagehcconsulting.com\/blog\/wp-json\/wp\/v2\/posts\/659","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/advantagehcconsulting.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/advantagehcconsulting.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/advantagehcconsulting.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/advantagehcconsulting.com\/blog\/wp-json\/wp\/v2\/comments?post=659"}],"version-history":[{"count":4,"href":"https:\/\/advantagehcconsulting.com\/blog\/wp-json\/wp\/v2\/posts\/659\/revisions"}],"predecessor-version":[{"id":666,"href":"https:\/\/advantagehcconsulting.com\/blog\/wp-json\/wp\/v2\/posts\/659\/revisions\/666"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/advantagehcconsulting.com\/blog\/wp-json\/wp\/v2\/media\/37"}],"wp:attachment":[{"href":"https:\/\/advantagehcconsulting.com\/blog\/wp-json\/wp\/v2\/media?parent=659"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/advantagehcconsulting.com\/blog\/wp-json\/wp\/v2\/categories?post=659"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/advantagehcconsulting.com\/blog\/wp-json\/wp\/v2\/tags?post=659"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}