August 6, 2009

Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2010

On August 6, 2009, the Centers for Medicare and Medicaid Services (CMS) proposed payment changes for home health services that will cap outlier payments and reward home health agencies that submit quality data for 2010. Outlier payments will be capped at 10% per agency and will target total aggregate outlier payments at 2.5% of the home health prospective payment system. The proposed outlier policy is intended to address potential fraud and abuse of the current outlier policy. The proposed rule also links submission of quality data to reimbursement. Home health agencies that submit the data will receive the full update; those that do not, will receive less than the full update.