The calendar year (CY) 2010 Home Health PPS final rule recently issued by the Centers for Medicare and Medicaid Services (CMS) contains a 2.0% market basket update to Medicare’s home health prospective payment system (HH PPS) rates and modifications to the home health outlier policy, according to the American Physical Therapy Association (APTA), Alexandria, Va. Specifically, CMS will cap home health outlier payments at 10% per HHA and target total aggregate outlier payments at 2.5% of all HH PPS payments. The current (2009) target for aggregate outlier payments is 5% of total HH PPS expenditures. By lowering the total outlier payment target to 2.5%, this final rule increases home health base rates by 2.5% for CY 2010.

In addition, CMS will continue its current policy of a 2.75% reduction to national standardized 60-day episode payment rates and non-medical supply factors in CY 2010. The CY 2010 reduction is the third year of a 4-year phase-in of HH PPS rate adjustments, which were made final in the HH PPS Refinement and Rate Update for the CY 2008 final rule, says APTA.

The final rule also contains implementation of new payment and enrollment safeguards, including an improved version of OASIS, called OASIS-C, to collect data on all episodes of care beginning January 1, 2010. This data will document important aspects of the patient’s health status including clinical condition, functional abilities, and service needs.

In CY 2010, CMS will publicly report 12 nationally accepted and approved quality measures plus 13 new process measures on its CMS [removed]Home Health Compare Web site[/removed]. HHAs that submit required quality data will receive payments based on the full home health market basket update of 2.0% for CY 2010. The home health market basket index percentage will be reduced by 2 percentage points to 0.0 percent for CY 2010 for those HHAs that do not submit the required quality data.

For CY 2012, CMS will require HHAs to report, as part of the required home health quality measures, the Consumer Assessment of Healthcare Providers and Systems Home Health Care Survey for Medicare and/or Medicaid beneficiaries.

A detailed highlights document can be found on APTA’s Web site.

[Source: APTA]