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CMS Plans For RAP Adjustments In "Awkward Transition" Year

November 22, 2020

CMS has issued a new MLN Matters Article MM11855: Penalty for Delayed Request for Anticipated Payment (RAP) Submission – Implementation (PDF).   This MLN Matters Article is for Home Health Agencies (HHAs) who wish to bill Medicare Administrative Contractors (MACs) for services provided to Medicare beneficiaries.  The article informs you about the implementation of the Calendar Year (CY) 2021 Home Health (HH) Request for Anticipated Payment (RAP) payment policies.  These changes are effective January 1, 2021.

Starting in CY 2021, the split-percentage payment would be lowered to 0 percent for all HHAs (newly enrolled and existing). However, all HHAs would still be required to submit a RAP at the beginning of each 30-day period of care (84 FR 60548). 

Since no payment will be associated with the submission of the RAP in CY 2021, HHAs are to submit the RAP when:

1. The appropriate physician’s written or verbal order that sets out the services required for the initial visit has been received and documented as required at 42 Code of Federal Regulations (CFR) Sections 484.60(b) and 409.43(d); and

2. The initial visit within the 60-day certification period has been made and the individual is admitted to HH care (84 FR 60548)

The information needed for submission of the RAP in CY 2021 will mirror the one-time Notice of Admission (NOA) process, also finalized in the CY 2020 HH PPS final rule with comment period, starting in CY 2022 (84 FR 60549).  Read more about it here.

Bayview Partners with GCHC

BAYTOWN, TX, Sept. 19, 2020 -- Bayview Home Health Services is pleased to announce it is partnering with Gulf Coast Health Center in Jefferson County!

Bayview Home Health Services Expands!

BAYTOWN, TX, Aug. 22, 2019 -- Bayview Home Health Services is currently in the process of expanding into Jefferson County and expects to complete the process before the end of Q3 2019.  Jefferson County has a population of over a quarter-million people and we are excited to be here! 

Bayview Home Health Welcomes Nitacha Broussard as New Administrator

BAYTOWN, TX, Aug. 14, 2019 -- Bayview Home Health Services announced today that Nitacha Broussard, LVN has joined the company as its new Administrator.  

Nitacha is a seasoned 18-year healthcare professional that grew up working in the home health sector alongside her mother.  She has managed home health agencies with censuses of 50 to 230 patients.  Clinically trained as an LVN, she has a deep appreciation for both the complexities of home health service delivery, operations, business development, industry compliance, and regulation.

Beyond the Basics: 3 Things Home Health Providers Should Know About PDGM

"There are a variety of technical changes and nuances home health providers need to be aware of before the new Patient-Driven Groupings Model (PDGM) goes into effect in 2020.  The Centers for Medicare & Medicaid Services (CMS) released details of its home health payment reform plan in its July 2 proposed rule. In its initial announcement, CMS broadly highlighted how PDGM is meant to better align reimbursement with patient needs and address payment incentives found within the current system. Since then, industry experts have been able to break down some of the most notable proposed changes—which together will be far-reaching." Read More...