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2013-11-30
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Medicare and Medicaid Programs; Home Health Prospective Payment System Rate Update for CY 2014, Home Health Quality Reporting Requirements, and Cost Allocation of Home Health Survey Expenses
Part III
Rules and Regulations
D09002ee1bdc8c947
D09002ee1bdc8ca40
United States
Department of Health and Human Services
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org
United States Government Agency or Subagency
United States
Centers for Medicare & Medicaid Services
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org
United States Government Agency or Subagency
This final rule will update the Home Health Prospective Payment System (HH PPS) rates, including the national, standardized 60- day episode payment rates, the national per-visit rates, the low- utilization payment adjustment (LUPA) add-on, and the non-routine medical supply (NRS) conversion factor under the Medicare prospective payment system for home health agencies (HHAs), effective January 1, 2014. As required by the Affordable Care Act, this rule establishes rebasing adjustments, with a 4-year phase-in, to the national, standardized 60-day episode payment rates; the national per-visit rates; and the NRS conversion factor. In addition, this final rule will remove 170 diagnosis codes from assignment to diagnosis groups within the HH PPS Grouper, effective January 1, 2014. Finally, this rule will establish home health quality reporting requirements for CY 2014 payment and subsequent years and will clarify that a state Medicaid program must provide that, in certifying HHAs, the state's designated survey agency carry out certain other responsibilities that already apply to surveys of nursing facilities and Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF-IID), including sharing in the cost of HHA surveys. For that portion of costs attributable to Medicare and Medicaid, we will assign 50 percent to Medicare and 50 percent to Medicaid, the standard method that CMS and states use in the allocation of expenses related to surveys of nursing homes.
78 FR 72256
https://www.govinfo.gov/app/details/FR-2013-12-02/2013-28457
2013-28457
fr02de13-34
RIN 0938-AR52
4120-01-P
CMS-1450-F
https://www.govinfo.gov/app/details/FR-2013-12-02/2013-28457
https://www.govinfo.gov/content/pkg/FR-2013-12-02/html/2013-28457.htm
https://www.govinfo.gov/content/pkg/FR-2013-12-02/pdf/2013-28457.pdf
Grant Programs-Health
Health Facilities
Medicaid
Privacy
Reporting and Recordkeeping Requirements
65 p.
72256
72320
78 FR 72256
Code of Federal Regulations
Title 42 Part 431
42 CFR Part 431
Regulation Identification Number 0938-AR52
RIN 0938-AR52
Medicare and Medicaid Programs; Home Health Prospective Payment System Rate Update for CY 2014, Home Health Quality Reporting Requirements, and Cost Allocation of Home Health Survey Expenses; Federal Register Vol. 78, Issue
RULE
2013-28457
III
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
2014-01-01
CMS-1450-F
4120-01-P
2013-28457
Final rule.
This final rule will update the Home Health Prospective Payment System (HH PPS) rates, including the national, standardized 60- day episode payment rates, the national per-visit rates, the low- utilization payment adjustment (LUPA) add-on, and the non-routine medical supply (NRS) conversion factor under the Medicare prospective payment system for home health agencies (HHAs), effective January 1, 2014. As required by the Affordable Care Act, this rule establishes rebasing adjustments, with a 4-year phase-in, to the national, standardized 60-day episode payment rates; the national per-visit rates; and the NRS conversion factor. In addition, this final rule will remove 170 diagnosis codes from assignment to diagnosis groups within the HH PPS Grouper, effective January 1, 2014. Finally, this rule will establish home health quality reporting requirements for CY 2014 payment and subsequent years and will clarify that a state Medicaid program must provide that, in certifying HHAs, the state's designated survey agency carry out certain other responsibilities that already apply to surveys of nursing facilities and Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF-IID), including sharing in the cost of HHA surveys. For that portion of costs attributable to Medicare and Medicaid, we will assign 50 percent to Medicare and 50 percent to Medicaid, the standard method that CMS and states use in the allocation of expenses related to surveys of nursing homes.
These regulations are effective on January 1, 2014.
Hillary Loeffler, (410)786-0456, for general information about the HH PPS.
Grant Programs-Health
Health Facilities
Medicaid
Privacy
Reporting and Recordkeeping Requirements
Medicare and Medicaid Programs:
Home Health Prospective Payment System Rate Update for CY 2014, Home Health Quality Reporting Requirements, and Cost Allocation of Home Health Survey Expenses
,
hhcahps@rti.org
OIRA_submission@omb.eop.gov
cms.gov
http://www.ahrq.gov/workingforquality/nqs/nqsplans.pdf
http://www.cdc.gov/nchs/data/icd9/icd9cm_guidelines_2011.pdf
http://www.cms.gov/Center/Provider-Type/Home-Health-Agency-HHA-Center.html
http://www.cms.gov/Center/Provider-Type/Home-Health-Agency-HHA-Center.html?redirect=/center/hha.asp
http://www.cms.gov/medicare-coverage-database/staticpages/icd-9-code-lookup.aspx
http://www.cms.gov/Medicare/Coding/ICD9ProviderDiagnosticCodes/index.html?redirect=/ICD9ProviderDiagnosticCodes/
http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/FY2014-IPPS-Final-Rule-Home-Page.html
http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/HomeHealthPPS/CaseMixGrouperSoftware.html
http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/HomeHealthPPS/Home-Health-Prospective-Payment-System-Regulations-and-Notices.html
http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HomeHealthQualityInits/HHQIQualityMeasures.html
http://www.cms.gov/Outreach-and-Education/Outreach/OpenDoorForums/index.html
http://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/index.html
http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/MedicareProgramRatesStats/Downloads/mktbskt-summary.pdf
http://www.guideline.gov/browse/by-topic-detail.aspx?id=11560&ct=1
http://www.hhs.gov/secretary/about/priorities/priorities.html
http://www.medicare.gov/HHCompare/Home.asp
http://www.qualityforum.org/npp/
http://www.qualityforum.org/Publications/2012/07/Patient_Outcomes_All-Cause_Readmissions_Expedited_Review_2011.aspx
http://www.qualityforum.org/Setting_Priorities/Partnership/Measure_Applications_Partnership.aspx
http://www.whitehouse.gov/omb/bulletins/index.html
http://www.whitehouse.gov/omb/circulars_a004_a-4
https://homehealthcahps.org
https://www.cms.gov/Medicare/Demonstration-Projects/DemoProjectsEvalRpts/Downloads/IAH_Solicitation.pdf
www.cms.gov/Regulations-and-Guidance/Legislation/PaperworkReductionActof1995/
www.medicare.gov
www.whitehouse.gov/omb/bulletins/b03-04.html
Federal Register
Vol. 78, no. 231
Office of the Federal Register, National Archives and Records Administration
2013-12-02
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Table of Contents:
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https://www.govinfo.gov/app/details/FR-2013-12-02
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