Home Health Agencies’ Medicare Reimbursements Will Remain Flat in 2013

Medicare reimbursements to home health agencies will essentially remain flat in calendar year 2013, according to the Centers for Medicare & Medicaid Services (CMS). 

Payments to home health agencies are estimated to decrease by approximately 0.01%, or $10 million, in the upcoming year, says the final rule updating Medicare’s Home Health Prospective Payment System (HH PPS) payment rates. 

The payment update reflects the combined effects of the home health payment update (a $260 million increase), wage index updates ($70 million decrease), a new FDL ratio ($50 million increase), and reductions to the HH PPS to account for a 1.32% case-mix coding adjustment ($250 million decease). 

The rule also rebases and revises the home health market basket; allows additional regulatory flexibility regarding therapy documentation and reassessments as well as face-to-face encounter requirements; and provides information on the home health study regarding home health care access, says CMS, along with implementing new requirements concerning the hospice quality reporting program.

CMS is also establishing requirements for unannounced, standard, and extended surveys of home health agencies, and the rule provides a number of alternative or intermediate sanctions that could be imposed on HHAs that are out of compliance with federal requirements. 

View the rule.

Written by Alyssa Gerace