Palmetto GBA announced that it is in process of restoring RAP payments to agencies which have submitted Corrective Action Plans or Rebuttals that meet their requirements. If the provider is making strides in reducing the number of auto-cancels, is filing a majority of their finals timely when compared with auto-cancels, and are in good standing, Palmetto is restoring their RAP payments at 60% as new RAPs are received.
PGBA is also working on refinements to the RAP suppression standards that will be applied prospectively in evaluating the status of HHAs with auto-cancelled RAPs. The home care industry has recommended that the standards and process be revised to better target providers that present program integrity risks to Medicare. PGBA has already included one such refinement in its standards by considering the percentage of RAPs to final claims in evaluating rebuttals submitted by HHAs.
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