CMS-1450-P

The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule (CMS-1450-P) to update Medicare's Home Health Prospective Payment System (HH PPS) payment rates and wage index for calendar year (CY) 2014. As required by Section 3131(a) of the Affordable Care Act, this rule proposes rebasing adjustments, with a 4-year phase-in, to the national, standardized 60-day episode payment rates; the national per-visit rates; and the NRS conversion factor. Payments to home health agencies (HHAs) are estimated to decrease by approximately 1.5 percent, or -$290 million in CY 2014, reflecting the combined effects of the 2.4 percent HH payment update percentage ($460 million increase), the rebasing adjustments to the national, standardized 60-day episode payment rate, the national per-visit payment rates, and the NRS conversion factor ($650 million decrease), and the effects of ICD-9 coding adjustments ($100 million decrease). This proposed rule would also establish home health quality reporting requirements for CY 2014 payment and subsequent years and proposes to specify that Medicaid responsibilities for home health surveys be explicitly recognized in the State Medicaid Plan, which is similar to current regulations for surveys of Nursing Facilities (NF) and Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF-IID). In addition, this proposed rule also seeks comment on a methodology for calculating state Medicaid programs’ fair share of Home Health Agency (HHA) survey costs. Finally, this rule proposes to describe our transition to ICD-10-CM coding and announces the release of draft lists of ICD-10-CM codes to be included in the HH PPS Grouper. (Posted June 27, 2013)