The Centers for Medicare & Medicaid Services (CMS) announced a proposed 2.2 percent home health market basket update to the home health prospective payment system (HH PPS) rates for calendar year (CY) 2010.
CMS is also proposing to cap outlier payments at 10 percent per agency and target total aggregate outlier payments at 2.5 percent of total HH PPS payments. Currently, the target for outlier payment targets is 5 percent of total HH PPS payments.
In the rule, CMS proposes a 2.75 percent reduction to the national standardized 60-day episode payment rates and non-routine medical supply factor in CY10 to offset for an increase in home health case-mix that is not associated with any underlying change in the clinical condition of patients. This reflects the third year of a four-year phase-in of adjustments to HH PPS rates, which were finalized in the HH PPS Refinement and Rate Update for CY 2008 final rule.
HHAs that submit required quality data will receive payments based on the full proposed home health market basket update of 2.2 percent for CY 2010. The proposed home health market basket percentage would be reduced by 2 percentage points to 0.2 percent for CY 2010 for those HHAs that do not submit the quality data.
The proposed rule will be published in the Aug. 6 Federal Register with comments accepted through Sept. 28.
