Penalty for Requests for Anticipated Payments Received More Than Five Days Early

There has been an issue identified in which the Home Health Pricer program is incorrectly applying a penalty to RAPs received more than five days earlier than the FROM date of the RAP. The associated claims cannot be readily identified for MAC suspension. A system fix is scheduled for 3/1/2021. Once the fix is implemented, the MACs shall adjust claims with a value code QF amount greater than $0 (penalty amount) and a RAP RECEIPT DT of more than five days earlier than the FROM date. Agencies may still submit RAPs as they choose. We will provide updates when applicable.

Posted 2/1/2021