Home Health Agency (HHA) Center
- Influenza Season is Around the Corner
- Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2013, Hospice Quality Reporting Requirements, and Survey and Enforcement Requirements for Home Health Agencies (CMS-1358-P) was put on display at the Office of the Federal Register on July 6, 2012. This proposed rule updates Medicare's Home Health Prospective Payment System (HH PPS) payment rates for Calendar Year (CY) 2013. Payments to home health agencies (HHAs) are estimated to decrease by approximately 0.10 percent, or -$20 million. The rule also proposes to rebase and revise the home health market basket, allow additional regulatory flexibility regarding therapy and face-to-face encounter requirements, and extend certain hospice quality reporting requirements to subsequent years. Lastly, this rule would establish requirements for unannounced, standard, and extended surveys of HHAs and provide a number of alternative (or intermediate) sanctions if HHAs were out of compliance with Federal requirements.
- On May 7, 2012, CMS released an MLN article (SE1219) designed to provide education on the contents of the home health certification, including homebound criteria and requirements for the face-to-face encounter and documentation. It includes guidance that physicians, non-physician practitioners, physician support personnel, and home health agencies can use to ensure that all certification requirements are understood and met. In addition, on May 4, 2012 updated face-to-face encounter Qs & As (revised on June 21, 2012) were posted and are also available by clicking on the first link under Home Health Face-to-Face below.
- HHA VBP Report to Congress - The Affordable Care Act requires the Secretary of Health and Human Services to develop a plan to implement a value-based purchasing (VBP) program for payments under the Medicare program for home health agencies (HHAs). The Secretary shall submit the report containing this plan to Congress.
The Report to Congress describes the current efforts to improve quality and payment efficiency in HHAs. In addition, it considers the steps required in designing and implementing an HHA VBP program for payments under the Medicare program. CMS views VBP as an important step forward in revamping how Medicare pays for health care services; moving the program towards rewarding better value, outcomes, and innovations, instead of merely volume.
The HHA VBP Report to Congress was authorized under Section 3006(b) of the Patient Protection and Affordable Care Act (Pub. L. 111-148), enacted on March 23, 2010, as amended by the Health Care and Education Reconciliation Act of 2010 (Pub. L. 111-152), enacted on March 30, 2010 (collectively known as the Affordable Care Act) (as added by section 10301(a) of the Affordable Care Act).
Open Door Forum
- CMS Open Door Forum: Home Health Study and Report [PDF, 167KB]
- Home Health Study Report Literature Review [PDF, 430KB]
Home Health Face-to-Face
- Home Health Face-to-Face Encounter Question & Answers (6/21/12)
- Chapter 4 Physician Certification and Recertification of Services Manual Changes (4/22/11)
- Update on Physician Signature Requirement and Face-to-Face Encounter Requirements (3/31/11)
- Chapter 7 Home Health Manual Updates with Face-to-Face Revisions - February 16, 2011
- Additional Time to Establish Protocols for newly Required Face-to-Face Encounters for Home Health and Hospice Recertification - December 23, 2010
- Home Health face-to-face Guidance PowerPoint (2/16/11)
- Special Edition MLN Matters article detailing home health face-to-face provision and requirements (12/22/10)
- Listserv home health face-to-face announcement (12/20/10)
Therapy and Skilled Nursing
- Therapy Questions and Answers (3/28/12)
- Chapter 7 Home Health Manual Update with Therapy Revisions (5/6/11)
- Therapy Requirements Fact Sheet (3/23/11)
- CR 7182 submitting implementing new therapy and nursing reporting requirements, as well as 2 new G codes (12/22/10)
- MLN Matters article issued detailing new and revised therapy and nursing requirements (12/22/10)
- 2011 Alpha-numeric HCPCS complete list of the new and revised G Codes and descriptions (12/22/10)
Medicare Learning Network (MLN) Spotlights
Go to the Spotlight page for the latest MLN products and announcements! Check it often!
Billing / Payment
- Home Health PPS
- Coding and Billing Information
- Home Health Prospective Payment System (HH PPS) PC Pricer
- CY 2011 Home Health PPS Wage Index File [ZIP, 32KB]
- Home Health Case Mix Grouper Software Package
Outcome and Assessment Information Set (OASIS)
- Outcome and Assessment Information Set (OASIS)
- OASIS User Manuals
- OASIS - (Attachment D: Selection & Assignment of OASIS Diagnosis) Guidance
- Statement of Patient Privacy Rights in English and Spanish (Zip, 1.5 MB) [ZIP, 1MB]