CMS1237510

The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule to update the Medicare Home Health Prospective Payment (HH PPS) rates for calendar year (CY) 2011. Specifically, this rule proposes to update the rates by the home health market basket update minus 1 percentage point, per the Affordable Care Act (ACA) of 2010 (for a 1.4% increase), and update the case-mix reduction percentage for CY 2011 to 3.79% to account for the additional increases in case-mix not due to the underlying condition of the home health patient. The rule also proposes implementation approaches for ACA provisions which affect home health outlier payments and certification requirements for the Medicare home health and hospice benefits. In addition, this rule proposes changes to the HH capitalization requirements, proposes to add clarifying language to home health the therapy coverage regulations, and provides clarification regarding the quality reporting requirements for the CY 2012 HH PPS rate update as it relates to HHCAHPS.