CMS Proposed Rule to HH PPS for Calendar Year 2014 Full Document Now Available

To access the document, click here.
Expected changes/updates include:
  • CMS proposes cuts to medicare payments to home health agencies (HHA) of net 1.5% in a savings of $290 million.
  • The proposed rule includes an across-the-board reduction to case-mix weights in an effort to reset weights to an average of 1.00.
  • CMS proposes updates that would remove two categories of ICD-9-CM codes from the HH PPS Grouper: diagnosis codes that are “too acute,” meaning the condition could not be appropriately cared for in a home health setting; and diagnosis codes for conditions that would not impact the home health plan of care, or would not result in additional resources when providing home health services to the beneficiary.
  • In addition, the proposed rule would include ICD-10-CM codes in the HH PPS Grouper to be used starting on October 1, 2014. The new ICD-10-CM codes will replace the existing ICD-9-CM codes used to report medical diagnoses and inpatient procedures.
  • Finally, the proposed rule would add two claims-based home health quality measures: (1) Rehospitalization During the First 30 Days of a Home Health Stay, and (2) Emergency Department Use Without Hospital Readmission during the first 30 days of Home Health. 

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