CMS has posted the CY2014 Proposed Rule for Medicare and Medicaid Home Health Programs to the Federal Register.
Major Provisions in the Proposed Rule:
1. ICD-9-CM to ICD-10-CM
CMS is proposing removal of 170 ICD-9-CM codes in two code categories as factors in calculating Home Health Prospective Payments in the HH PPS Grouper. The Proposed Rule would also replace ICD-9-CM codes with ICD-10-CM codes to report medical diagnoses and inpatient procedures in the HH PPS Grouper beginning October 1, 2014.
2. 30 Day Hospitalization Rates
CMS is proposing to introduce two new home health quality measures for a.) Rehospitalizations, and b.) Emergency Department Use Without a Hospital Stay. Both measures would come from claims data and include events within the first 30 days of a patient’s home health services.
3. 1.5% Average Payment Reduction to Providers
The proposed payment cut incorporates rate rebasing along with changes in case mix weight calculations resulting in a reduction in payments to home health providers of approximately $290 million in 2014.
CMS will be considering comments for 60 days, or through August 26, 2013, and the Final Rule is expected November 1, 2013.
Read the complete CY2014 Proposed Rule here on the Federal Register.