MHA's Executive Briefing

CMS releases home health proposed rule

The Centers for Medicare & Medicaid Services on July 1 released the proposed rule for the home health prospective payment system for calendar year 2015, which updates Medicare payment rates to home health agencies and implements the second year of the four-year phase in of the rebasing of this payment system. Overall, the rule would reduce home health payments by 0.3% from 2014 payment levels.

The regulation also reports on CMS’s ongoing monitoring of the impact of the face-to-face encounter, which was mandated by the Affordable Care Act, and proposes to simplify the requirements for this policy. The rule also notes CMS’s finding that home health service use dropped from CY 2011 to CY 2012, and states the agency’s belief that this change may, in part, be due to the face-to-face encounter policy.

The policy requires a physician to meet face-to-face with patients transitioning from general acute-care hospitals, and other settings, to home care to certify that the service is medically necessary. The rule will be published in the July 7 Federal Register with comments accepted for 60 days.

[ via AHA News Now ]

Home Health PPS: Proposed Rule for CY 2014

The Centers for Medicare & Medicaid Services (CMS) in the July 3 Federal Register published its calendar year (CY) 2014 proposed rule for the home health (HH) prospective payment system (PPS). Under the proposed rule, home health agencies would receive a net payment reduction of 1.5 percent (-$290 million), which is the result of a 2.4 percent market-basket update, minus the 3.5 percent offset for the first stage of HH PPS rebasing required by the Patient Protection and Affordable Care Act (ACA), and other reductions.

In addition, the regulation would update the HH quality reporting program, change cost allocation protocols for Medicare and Medicaid costs, and remove selected HH codes that CMS believes are not applicable to this setting. Highlights of the rule are covered in an AHA Regulatory Advisory. If you are an MHA member and would like a copy, email Shawn Rossi at srossi@mhanet.org. 

Home Health: Reasons why 2014 will be a tough year

Home health agencies will be faced with what could be the toughest year since the interim payment system (IPS) was in effect in 1997 to 2000–during which period over 3,000 agencies left the field. Reimbursement is being affected now by a 2 percent sequestration cut coupled with an additional 1.5 percent Medicare payment cut.

The 2014 national standardized home health episode payment rate will be $2,860.20 in 2014, down from $2,963.65 in 2013. This newsletter issue includes an analysis of the impact of the 2014 reimbursement policies on different types of home health agencies.

Hardest hit will be freestanding proprietary agencies (-1.7 percent), then freestanding government-owned agencies (-1.6 percent).

[ via AHA Resource Center blog ]