Veteran’s Affairs Community Care Network home health updates

Jan. 1, 2022, certified home health updates

The Centers for Medicare & Medicaid Services (CMS) recently announced changes to claim processing requirements that affect using Requests for Anticipated Payments (RAPs) for home health care claims, including changes to submission timelines and late penalties.

For dates of service beginning Jan. 1, 2022, Veteran’s Affairs Community Care Network (VA CCN):

• Will not require a RAP or Notice of Admission (NOA) to be included with home healthcare claims submitted to VA
• Will not implement any of the late penalties since neither a RAP nor NOA is required
• Will pay claims based on the Health Insurance Prospective Payment System (HIPPS) code submitted on the claim and will look to providers to bill appropriately

For dates of service prior to Jan. 1, 2022, which crossover the calendar year, the Patient Driven Grouping Model (PDGM) 2021 rules should continue to be followed.  

Additional information

• 2022 CMS claims processing changes and more, VA Provider Advisor, (Sept. 2021, Issue 35) govdelivery.com
• CMS Medicare requirements at cms.gov
• CMS Manual System, Pub 100-20 one-time notification, R109770TN at cms.gov

Questions?
Contact CCN Provider Services:

• Region 1:  888-901-7407
• Region 2:  844-839-6108
• Region 3:  888-901-6613

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