RHHI

The HCFA Dallas regional office conducted a pilot study(1) during the period from March 1995 through September 1995, which capitalized on the ability of the State surveyors to act as the eyes and ears of the RHHI. The SA was asked to identify and gather information on behalf of the RHHI concerning the homebound status of beneficiaries, home health services billed but not rendered, and inappropriate billing of supplies.

As part of this pilot project, the RHHI provided a list of 75 "at risk" agencies to the SAs, in addition to a list of 20 beneficiaries per HHA.

Under a PPS, cost reporting would (in theory) no longer be required because reimbursement would be based on prospectively set rates, not on costs as determined by the RHHI. In addition, the amount of payment would be known at the time the service is being provided, not several years after the service was provided and the costs incurred.

Costs are calculated by each provider using the Home Health Agency Cost Report (HCFA Form-1728), which the provider submits to one of HCFA's nine contracted Regional Home Health Intermediaries (RHHIs) after the end of its fiscal year.