Menu
Simpson Estate and Elder Law
  • Home
  • Our Services
  • Videos
  • Articles
  • Directions
  • Contact

417-256-1968

naela

Close Menu
March 20 2020

New Medicare Payment Method Causing Cuts to Home Health Care Services

Marty Simpson Articles

A new payment method for Medicare providers is making it harder for some home health care patients to receive physical, occupational, or speech therapy. Under the new system, providers are refusing to cover some therapy services. 

On January 1, 2020, the federal Centers for Medicare and Medicaid Services (CMS) instituted a new way of paying home health care providers, called the Patient-Driven Groupings Model (PDGM). Previously, provider payments were based on the amount of therapy delivered. The PDGM requires payments to be based on a complicated formula that takes into account a patient’s medical condition, the extent to which the patient is impaired, and whether the patient was hospitalized. In addition, CMS now pays providers in 30-day periods of care, rather than the earlier 60-day periods. 

In response to this new system, providers are slashing therapy services, according to Kaiser Health News, which found that therapists are being laid off, being asked to decrease services, or are incorrectly telling patients that services aren’t covered. There are also fewer incentives for home health providers to treat patients who need long-term therapy. 

While providers have reacted to the new payment system by cutting services, CMS sent a letter to providers reiterating that actual coverage for services has not changed. As long as a patient meets the conditions for receiving home health care under Medicare regulations, the patient should get home health care services, including therapy. Home health care agencies shouldn’t ignore physician orders, CMS maintained. 

If you encounter coverage problems, contact the Center for Medicare Advocacy or an elder law attorney. To find an attorney near you, go here: https://www.elderlawanswers.com/elder-law-attorneys. 

How Secure Is Social Security? Medicare and Medicaid Will Cover Coronavirus Testing

Related Posts

Articles

5 Reasons for Seniors to Celebrate in 2023

Articles

Protecting Spouses of Medicaid Applicants: 2023 Guidelines

Articles

Does Medicare Cover the Cost of Getting a Second Opinion?

Recent Posts

  • 5 Reasons for Seniors to Celebrate in 2023
  • Protecting Spouses of Medicaid Applicants: 2023 Guidelines
  • Does Medicare Cover the Cost of Getting a Second Opinion?
  • What Is the Difference Between Medicaid and Medicare?
  • Does Medicare Pay for Assisted Living?

Archives

  • December 2022
  • October 2022
  • August 2022
  • May 2022
  • March 2022
  • February 2022
  • January 2022
  • November 2021
  • October 2021
  • July 2021
  • May 2021
  • February 2021
  • January 2021
  • December 2020
  • November 2020
  • October 2020
  • September 2020
  • August 2020
  • July 2020
  • June 2020
  • April 2020
  • March 2020
  • February 2020
  • January 2020
  • December 2019
  • November 2019
  • October 2019
  • January 2019
Back To Top

facebook

Contact

417-256-1968

844-273-2923 fax

Address

303 Aid Avenue
West Plains, MO 65775, USA

© Simpson Estate and Elder Law - A web solution by CHVentures     Login