United States Government Publishing Office publisher pbl distributor dst United States National Archives and Records Administration Office of the Federal Register author aut Government Organization text government publication eng FR Regulatory Information 2015_register executive 2015-11-05 article Part II Rules and Regulations D09002ee1c7f6ec3d D09002ee1c7f6ed38 United States Department of Health and Human Services originator org United States Government Agency or Subagency United States Centers for Medicare & Medicaid Services originator org United States Government Agency or Subagency This final rule will update Home Health Prospective Payment System (HH PPS) rates, including the national, standardized 60-day episode payment rates, the national per-visit rates, and the non- routine medical supply (NRS) conversion factor under the Medicare prospective payment system for home health agencies (HHAs), effective for episodes ending on or after January 1, 2016. As required by the Affordable Care Act, this rule implements the 3rd year of the 4-year phase-in of the rebasing adjustments to the HH PPS payment rates. This rule updates the HH PPS case-mix weights using the most current, complete data available at the time of rulemaking and provides a clarification regarding the use of the "initial encounter" seventh character applicable to certain ICD-10-CM code categories. This final rule will also finalize reductions to the national, standardized 60-day episode payment rate in CY 2016, CY 2017, and CY 2018 of 0.97 percent in each year to account for estimated case-mix growth unrelated to increases in patient acuity (nominal case-mix growth) between CY 2012 and CY 2014. In addition, this rule implements a HH value-based purchasing (HHVBP) model, beginning January 1, 2016, in which all Medicare-certified HHAs in selected states will be required to participate. Finally, this rule finalizes minor changes to the home health quality reporting program and minor technical regulations text changes. 80 FR 68624 https://www.govinfo.gov/app/details/FR-2015-11-05/2015-27931 2015-27931 fr05no15-21 RIN 0938-AS46 4120-01-P CMS-1625-F https://www.govinfo.gov/app/details/FR-2015-11-05/2015-27931 https://www.govinfo.gov/content/pkg/FR-2015-11-05/html/2015-27931.htm https://www.govinfo.gov/content/pkg/FR-2015-11-05/pdf/2015-27931.pdf Health Facilities Medicare Emergency Medical Services Health Professions Reporting and Recordkeeping Requirements 96 p. 68624 68719 80 FR 68624 Title 42 Part 409 42 CFR Part 409 Title 42 Part 424 42 CFR Part 424 Title 42 Part 484 42 CFR Part 484 RIN 0938-AS46 Medicare and Medicaid Programs; CY 2016 Home Health Prospective Payment System Rate Update; Home Health Value-Based Purchasing Model; and Home Health Quality Reporting Requirements; Federal Register Vol. 80, Issue RULE 2015-27931 II DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 2016-01-01 CMS-1625-F 4120-01-P 2015-27931 Final rule.

This final rule will update Home Health Prospective Payment System (HH PPS) rates, including the national, standardized 60-day episode payment rates, the national per-visit rates, and the non- routine medical supply (NRS) conversion factor under the Medicare prospective payment system for home health agencies (HHAs), effective for episodes ending on or after January 1, 2016. As required by the Affordable Care Act, this rule implements the 3rd year of the 4-year phase-in of the rebasing adjustments to the HH PPS payment rates. This rule updates the HH PPS case-mix weights using the most current, complete data available at the time of rulemaking and provides a clarification regarding the use of the "initial encounter" seventh character applicable to certain ICD-10-CM code categories. This final rule will also finalize reductions to the national, standardized 60-day episode payment rate in CY 2016, CY 2017, and CY 2018 of 0.97 percent in each year to account for estimated case-mix growth unrelated to increases in patient acuity (nominal case-mix growth) between CY 2012 and CY 2014. In addition, this rule implements a HH value-based purchasing (HHVBP) model, beginning January 1, 2016, in which all Medicare-certified HHAs in selected states will be required to participate. Finally, this rule finalizes minor changes to the home health quality reporting program and minor technical regulations text changes.

Effective Date: These regulations are effective on January 1, 2016. For general information about the HH PPS please send your inquiry via email to: HomehealthPolicy@cms.hhs.gov. Michelle Brazil, (410) 786-1648 or Theresa White, (410) 786-2394 for information about the HH quality reporting program. Lori Teichman, (410) 786-6684, for information about HHCAHPS. Robert Flemming, (844) 280-5628, or send your inquiry via email to HHVBPquestions@cms.hhs.gov for information about the HHVBP Model. 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Table of Contents: AE 2.7: GS 4.107: AE 2.106: KF70.A2 https://www.govinfo.gov/app/details/FR-2015-11-05 P0b002ee18ddffb7b 0097-6326 0042-1219 0364-1406 769-004-00000-9 000582072 f:fr05no15 https://www.govinfo.gov/app/details/FR-2015-11-05 https://www.govinfo.gov/content/pkg/FR-2015-11-05/pdf/FR-2015-11-05.pdf https://www.govinfo.gov/content/pkg/FR-2015-11-05/xml/FR-2015-11-05.xml fdlp 68421 68742 DGPO 2015-11-05 2024-06-02 FR-2015-11-05 machine generated eng FR FR-2015-11-05 80 214