Proposed Revisions to Medicare This 2015

The home health care business is growing rapidly due in part to the country’s aging population. As far back as 2008, U.S. News & World Report listed it as one of the best small businesses to start. This is saying a lot in the midst of a small business explosion from many other industries. As usual, however, there are tradeoffs.

First of all, the home health care business is highly regulated. This is hardly surprising since we’re dealing with people’s lives and wellbeing here. The services and quality of care provided by each home health agency must meet strict standards set by the government. This includes many licenses and other requirements not needed in other types of businesses, even before starting operations.

Most of your patients will be on the Medicare program, which has additional rules and regulations. Probably the biggest headache related to Medicare faced by home health agencies is the annual cost report preparation. The reports themselves are notoriously complicated. In fact, the Centers for Medicare and Medicaid Services (CMS) themselves, to whom these reports are submitted, estimated that over 200 hours of work are needed for these cost reports. The laws and procedures also change significantly almost every year. Failing to keep abreast of these changes can be very costly in the form of suspended payments or missed reimbursements.

In a related blog post, we discussed the aspects of Medicare already being reviewed for this year. In this one, we will discuss some of the changes being proposed right now. These entail the collection of information from the public for improvements in Medicare/Medicaid, especially in line with the Affordable Care Act, which are currently up for comments.

CMS-10410 Medicaid Program: Eligibility Changes under the Affordable Care Act of 2010

For people eligible for Medicaid based on their Modified Adjusted Gross Income (MAGI), eligibility will now be redetermined only once each year unless there is a change in circumstance. This limit is also applied to redetermination of eligibility for the Children’s Health Insurance Program (CHIP). Agencies mandated to redetermine eligibility are also required to first use information already available to them rather than wasting time collecting the same data all over again. In line with the Paperwork Reduction Act (PRA), all information for collection, dissemination and sharing will be primarily done in electronic form.
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CMS-2552-10 Hospital and Hospital Health Care Complex Cost Report

The CMS is proposing changes involving the worksheets to be accomplished by hospital-based federally qualified health centers (FQHC) and hospital-based hospices for their annual cost reports in line with the ACA. For cost reporting periods starting October 1, 2014, FQHCs no longer need to complete Worksheet S-8 as well as Worksheets M-1, M-2, M-3, M-4 and M-5, but rather will complete Worksheet S-11, Parts I-III and Worksheets N-1 through N-5. This is for FQHCs that meet the requirements under 42 CFR 413.65(n).

Hospices will no longer complete Parts I and II of Worksheet S-9, but will still complete Parts III and IV. The K series Worksheets are now replaced with the O series Worksheets for hospices. Medicare rules and regulations are complex and ever-changing. The cost reports themselves are already complicated, time-consuming and costly annual undertakings that all home health care providers need to go through. This is why almost all thriving home health care businesses know to leave this aspect of the business to the experts.

Hazzouri Accounting has over 16 years of expertise in Medicare cost report (MCR) preparation, processing, and filing. We serve the local communities and businesses of Michigan and the surrounding areas. Our focus is on building lasting relationships with our clients as a sincerely helpful friend. We are open at the regular 9 to 5 weekdays, with after hours and Saturdays by appointment. We are closed on Sundays. Please call us at 734-844-1614 or use our online contact form for any questions.

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