Providers in home health agencies (HHAs) expected 2020 to be challenging – the shift to the Payment Driven Groupings Model (PDGM), Review Choice Demonstration (RCD) affecting certain states, and numerous other disruptions to their businesses due to continued regulatory changes.
And then, of course, this year’s COVID-19 pandemic exacerbated it all.
This year’s upheavals have many home health providers deeply concerned with how to stay afloat. There are silver linings – for instance, smaller HHAs have been able to take advantage of federal relief, which potentially eased the burdens of PDGM. One major billing change could upend things once again.
Right now, many HHAs finance operations through a Request for Anticipated Payment (RAP), which allows them to obtain up to 20% of the anticipated payment for a patient’s care episode before care is administered. HHAs have come to rely on this process to keep cash flow stable.
However, the Centers for Medicare and Medicaid Services (CMS) views RAPs as a gateway to potential fraud – and has moved to phase them out this year, eliminating RAP payments entirely by 2021.
In addition, home health providers will have a new notice of admission (NOA) requirement, replacing the RAP entirely, starting in 2022 that comes with built-in penalties. And industry insiders predict even more uncertainty and frustration with the onset of this process.
So, how will the RAP phase out affect HHA billing requirements and business models in 2020 and beyond?
In this RAP-focused deep dive, you’ll learn:
- The primary reasons CMS is eliminating RAPs and how this affects cash flow
- How HHAs can address PDGM concerns amid the phase out
- The process for phasing in the NOA and how HHAs will manage revenue cycles in the future