The Centers for Medicare & Medicaid Services have announced a temporary moratorium on the enrollment of new home health provider enrollments in Medicare, Medicaid and the Children’s Health Insurance Program (CHIP) in fraud “hot spot” areas of the country. The goal of the temporary moratorium is to fight fraud and safeguard taxpayer dollars, while ensuring patient access to care. Authority to impose such moratoria was included in the Affordable Care Act, and CMS is exercising this authority for the first time. (more…)
Posts Tagged ‘Federal Register’
The Centers for Medicare & Medicaid Services (CMS) today announced proposed changes to the Medicare home health prospective payment system (HH PPS) for calendar year (CY) 2014 that would foster greater efficiency, flexibility, payment accuracy, and improved quality. Based on the most recent data available, CMS estimates that approximately 3.5 million beneficiaries received home health services from nearly 12,000 home health agencies, costing Medicare approximately $18.2 billion in 2012.
In the rule, CMS projects that Medicare payments to home health agencies in calendar year (CY) 2014 will be reduced by 1.5 percent, or $290 million based on the proposed policies. The proposed decrease reflects the effects of the 2.4 percent home health payment update percentage ($460 million increase), the rebasing adjustments to the national, standardized 60-day episode payment rate, the national per-visit payment rates, and the non-routine medical supplies (NRS) conversion factor ($650 million decrease), and the effects of ICD-9-CM coding adjustments ($100 million decrease).
In addition, the rule proposes routine updates to the HH PPS payment rates such as updating the payment rates by the HH PPS payment update percentage and updating the home health wage index for 2014. (more…)
The Centers for Medicare & Medicaid Services issued a notice announcing proposed changes to the Outcome and Assessment Information Set (OASIS) in the Federal Register on June 21.
The proposed version – OASIS-C1 – reflects changes to accommodate the need to enable the coding of diagnoses using the ICD-10-CM coding set which goes into effect October 1, 2014; the need to address issues raised by stakeholders – such as updating clinical concepts and modifying item wording and response categories to improve item clarity – and to reduce burden associated with OASIS data collection by removing items not currently used by CMS for payment, quality, or risk adjustment.