The 2013 Home Health Prospective Payment System Final Rule for CY2013 has been published to the Federal Register as of this morning, November 8, 2012, after being filed for public inspection on November 2, 2012.
In the Final Rule, PPS payments to home health agencies (HHAs) are estimated to remain virtually unchanged (decreasing by approximately 0.01 percent or $10 million across all home health providers). This reflects the net effect of a 1.3 percent home health payment update, an updated wage index, an update to the fixed-dollar loss (FDL) ratio, and a case-mix coding adjustment intended to offset coding changes unrelated to changes in patient health needs.
The rule rebases and revises the home health market basket and allows additional regulatory flexibility and clarification regarding therapy reassessments and face-to-face encounter requirements. The rule also establishes new survey and certification requirements for HHAs and provides a number of alternative (or intermediate) sanctions if HHAs are out of compliance with Federal requirements.
Lastly, the Final Rule addresses the public reporting of an agency’s Acute Care Hospitalization (ACH) and Emergency Department Use Without Hospitalization performance rates on Home Health Compare being calculated using claims data from the CASPER system instead of OASIS data.