Regulation No.

CMS-1353-P

Title

HH PPS Refinements and Rate Update for CY 2012

Publication Date

07/12/2011

Year

CY 2012

Display Date

07/05/2011

Description

Home Health Prospective Payment System Refinements and Rate Update for CY 2012

CMS-1353-P - (Display Date: July 5, 2011): A proposed rule was displayed at the Federal register, proposing to update the Medicare Home Health Prospective Payment (HH PPS) rates for CY 2012 by a negative 3.35 percent. This includes an estimated net decrease of $640 million compared to HHA payments in CY 2011. This update includes the combined effects of the 1.5 percent market basket and wage index updates (a $310 million increase), as well as reductions to the HH PPS rates to account for increases in aggregate case-mix that are not related to changes in the health status of patients (a $950 million decrease). This rule also proposes structural changes to the HH PPS by removing two hypertension codes from the case-mix system, lowering payments for high therapy episodes and recalibrating the HH PPS case-mix weights to ensure that these changes result in the same aggregate payments. Finally this rule proposes added flexibility to allow physicians who attend to a home health patient in an acute or post-acute setting to inform the certifying physician of their encounters with the patient in order to satisfy the face-to-face encounter requirement.