• 2012 Home Health PPS Final Rule Released by CMS


    CMS has made available the 2012 Final Rule for Home Health Agencies, which takes effect January 1, 2012.  The Final Rule was displayed at the Federal Register (and revised 11/9/2011) to update Medicare’s Home Health Prospective Payment (HH PPS) rates for Calendar Year (CY) 2012.

    A summary of the changes introduced include:

    • Payments to home health agencies (HHAs) are estimated to decrease by approximately 2.31 percent, or $430 million in CY 2012, the net effect of a 1.4 percent payment update ($280 million increase), the wage index update ($10 million increase), and a 3.79 percent case-mix coding adjustment ($720 million decrease).
    • The final rule imposes a negative 1.32 percent case-mix coding adjustment to the national standardized 60-day episode payment rates for CY 2013.
    • The final rule finalizes structural changes to the HH PPS by removing two hypertension codes from the case-mix system, lowering payments for high therapy episodes and recalibrating the HH PPS case-mix weights to ensure that these changes result in the same aggregate payments.
    • Finally this rule adds flexibility to allow physicians who attend to a home health patient in an acute or post-acute facility to inform the certifying physician of their encounters with the patient in order to satisfy the face-to-face encounter requirement.

    Related:  The online version of the 2012 Home Health PPS Final Rule is available on the Federal Register website.  See this link for the online version.