AAHomecare Digs Deeper Into CMS’s Rural Rate Plan

Association research further shows how CMS’s newly implemented rates will hurt providers in rural and non-bid areas.

• By David Kopf
• May 04, 2017

After releasing some sample numbers demonstrating the negative impact that CMS’s newly implemented rate plan will have on rural and non-bid area providers and patients, the American Association for Homecare has done additional number crunching to further illustrate the plan’s damage.

As reported yesterday, instead of calculating the 50/50, blended fee schedule for rural and non-bid area providers' claims based on the Jan. 1, 2016 fee schedule, CMS has used the lower July 1, 2016 fee schedule, which has resulted in considerably lower reimbursement for those claims. AAHomecare and other industry advocates have said that, at the least, CMS's move violates the spirit of the CURES Act. 

In its research, AAHomecare compared the blended reimbursement for the top 25 HCPCS codes based on the July 1, 2016 fee schedule and the Jan. 1, 2016, and showed the difference between the two. The association then broke those calculations out for each geographic region.

The analysis is available for download as region-specific Excel spreadsheets here: https://www.aahomecare.org/pages/reimbursement-adjustments-for-rural-non-bid-providers-july-dec-2016.