CMS1240989

The Centers for Medicare & Medicaid Services (CMS) issued a final rule to update the Medicare Home Health Prospective Payment (HH PPS) rates for calendar year (CY) 2011. Specifically, this rule updates the rates by the home health market basket update minus 1 percentage point, per the Affordable Care Act (ACA) of 2010 (for a 1.1% increase), and updates 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 implements ACA provisions which affect home health outlier payments and certification requirements for the Medicare home health and hospice benefits. This rule also finalizes a policy requiring HHAs that change ownership within three years of initial enrollment to obtain a new State survey or accreditation, exceptions to the 36-month ownership provision, and further clarification on capitalization provisions. Finally, this rule adds clarifying language to home health therapy coverage regulations, and provides clarification regarding the quality reporting requirements for the CY 2012 HH PPS rate update as it relates to HHCAHPS.