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Delta Connect Blog

Home Infusion Demo Maps A Way Forward For Future Medicare Changes

Posted by Crystal Parks on Aug 19, 2014 12:02:52 PM

A Medicare demonstration project bundling payment for home infusion of intravenous immune globulin (IVIG) maps a potential way forward for future reimbursement changes involving home infusion more broadly, which would benefit larger providers like BioScrip, Walgreen, CVS, Express Scripts, privately-held Diplomat that recently filed an S-1 and privately-held AxelaCare Health.  While the demonstration will have limited impact in the near term, given that insurers tend to piggy back on Medicare even though it comprises less than 15-20% of the industry payer mix for specialty home infusion providers, the policies CMS wants to test could have reverberating effects among all insurers and bring consistency to the current haphazard state of home infusion reimbursement. 

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Topics: Home Care reimbursement

Proposed Medicare Home Health Services Rates Would Reshape Payments Significantly

Posted by Crystal Parks on Jul 31, 2014 2:06:05 PM

With the Notice of Proposed Rulemaking, the Centers for Medicare and Medicaid Services (CMS) sets out a plan to recalibrate all 153 Home Health Resource Groups in the case mix adjustment model. These proposed changes, if finalized later this year, would result in a dramatic reshaping of the payment distribution model. CMS has evaluated and modified all variables that affect the assignment of an HHRG to a particular patient episode.

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Topics: Home Care reimbursement

Home Health Claims to Identify Certifying Physician who Signs the POC

Posted by Crystal Parks on Sep 26, 2013 1:22:00 PM

The Centers for Medicare & Medicaid Service (CMS) has issued Change Request 8441 which instructs home health agencies to report the NPI and name of the physician who certifies the patient for home health services. The Change Request  also requires home health agencies to report the NPI and name of the physician who signs the POC.

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Topics: Change Request 8441, Home Health Claims, Home Care reimbursement


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