CMS Wants to Cut Home Health Agency Payments by $20 Million in 2013

 The Centers for Medicare and Medicaid Services (CMS) announced Friday a proposal to cut payment rates to home health agencies by $20 million or 0.1% during calendar year 2013.

The proposed decrease reflects the combined effects of the home health market basket and wage index updates and previously finalized reductions to the home health prospective payment system (HH PPS) rates to account for changes in coding practices.

CMS proposes to rebase and revise the home health market basket to ensure it continues to adequately reflect the price changes of providing efficient home health services.

“The CY 2013 home health market basket would result in a labor-related share of 78.535 percent and a non labor-related share of 21.465 percent,” said the agency.

Provisions of the Affordable Care Act apply a 1 percent reduction to the CY 2013 home health market basket update of 2.5 percent, resulting in a 1.5 percent increase for home health agencies next year. As part of the 2012 HH PPS final rule, CMS finalized a reduction in rates of 1.32 percent in CY 2013 to account for growth in aggregate case-mix that is unrelated to changes in patients’ health status.

“The proposed rule helps to encourage efficiency and payment accuracy, ensuring continued access to care for Medicare beneficiaries and prudent use of taxpayer dollars,” said Jonathan Blum, deputy CMS administrator and director of the Center for Medicare.

In acute or post-acute care settings, the rule seeks to provide additional flexibility in certifying patients as eligible for the home health benefit. The HH PPS rule proposes other changes to help ensure patients maintain access to therapy services, while reducing burden on home health agencies.

The proposed rule would also promote quality of care for patients by ensuring that home health agencies that are out of compliance with federal health and safety standards, known as the Conditions of Participation, could correct their performance and achieve prompt compliance.

CMS will accept comments on the proposed rule until Sep. 04, 2012.

View a copy of the proposed rule here

Written by John Yedinak

John Yedinak



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