CMS Proposes Elimination of RAPs, $250 Million Medicare Payment Increase

Home Health Care News confirms that the Centers for Medicare & Medicaid Services (CMS) is proceeding with many of the provisions originally included in the Patient-Driven Groupings Model. At the same time, it is proposing to eliminate home health pre-payments, implement a new home infusion benefit, and make Value-Based Purchasing Model performance data public. Perhaps most noteworthy in Thursday's proposed rule is CMS's plans to phase out pre-payments for home health services. Home health providers can presently obtain 50 percent to 60 percent of the anticipated payment at the start of a patient's care episode via a Request for Anticipated Payment (RAP). However, government watchdogs have uncovered "a marked increase in RAP fraud schemes perpetrated by existing home health agencies that receive significant upfront payments, never submit final claims, and then close for business," reports CMS. As a result, CMS is proposing to phase out RAP payments for existing providers over the next 12 months and eliminate them altogether by 2021.