Medicare Part A Home Health Requirements
CMS Issues Final 2012 Home Health PPS Rule
The Centers for Medicare & Medicaid Services (CMS) issued its final Home Health Prospective Payment System (PPS) regulation for calendar year (CY) 2012. Click here to read the final rule.
Rulemaking for CY 2012
AOTA submitted comments on the proposed rule on September 6, 2011 advising CMS to assess the impact of the recent new assessment schedule before making payment cuts based on perceived overutilization identified under the previous therapy requirements. We supported CMS’ clarification regarding when a continuing need for occupational therapy allows for a patient’s continued eligibility and urged CMS to add specific examples to the Medicare Benefit Policy Manual and to educate agencies about this policy to reduce confusion. In addition, we recommended that CMS continue to evaluate the effectiveness of the recent therapy assessment schedule in regards to patient access as well as administrative burden. We advocated that unfettered clinical reasoning and judgment of the therapist should determine a patient’s individual therapy needs.
CMS released its final Home Health Prospective Payment System (PPS) regulation for CY 2012 on November 4, 2011. CMS updated home health PPS rates for home health agencies effective January 1, 2012. Payments are estimated to decrease by approximately 2.31% or $430 million in CY 2012. CMS provided further clarification of the occupational therapy policy regarding when occupational therapy would be considered a dependent service versus when it would be considered a qualifying service under the Medicare home health benefit. Click here to read AOTA's analysis of the final rule.
Click here to access AOTA's Home Health PPS Podcast with Member Experts. (recorded 2/13/12)
Resources on Rulemaking for CY 2012
AOTA Home Health PPS Podcast with Member Experts (recorded 2/13/12)
AOTA Analysis: Final 2012 Home Health PPS Rule
CMS Issues Final Home Health PPS Rule for 2012
CMS Press Release: CMS Finalizes 2012 Medicare Home Health Payment Changes
CMS Final Home Health PPS Regulation for 2012
Medicare Part A Home Health Requirements
AOTA Comments on 2012 Proposed Home Health PPS Rule for 2012
AOTA Analysis: Proposed Home Health PPS Rule for CY 2012
CMS Issues Proposed Home Health PPS Rule for 2012
CMS Home Health PPS Proposed Rule for CY 2012
CMS Press Release: CMS Proposes 2012 Medicare Home Health Payment Changes
Rulemaking for CY 2011
CMS’ Home Health PPS final rule for CY 2011 addressed 2011 home health payment rates, as well as therapy coverage and documentation requirements. CMS delayed implementation of some therapy provisions to April 1, 2011. Rate changes and most other provisions went into effect January 1, 2011. The following resources provide information about the rule requirements for occupational therapy practitioners, specifically about reassessments and documentation.
AOTA Guidance for Completing Functional Reassessments and Documentation in Medicare Home Health
AOTA Home Health Documentation Guide
Additional Resources for CMS Home Health Rule
CMS Transmittal 144 – Revisions to Medicare Policy Manual – Home Health Therapy Services (replacing CMS Transmittal 142)
CMS Transmittal 142 - Revisions to Medicare Policy Manual- Home Health Services
CMS Therapy Requirements Fact Sheet
AOTA Analysis: Final 2011 Medicare Home Health PPS Rule
Final Home Health Rule Issued
CMS Final Home Health PPS Rule (see pages 19-27 for therapy clarifications)
AOTA Comments on Proposed Home Health Rule
CMS Home Health PPS Proposed Rule for CY 2011
Background on Proposed Rule
CMS Home Health Resources
CMS Therapy Questions & Answers
CMS Home Health Prospective Payment System Fact Sheet
CMS Home Health Agency Center
Medicare Benefit Policy Manual - Home Health Services
Medicare Benefit Policy Manual - Covered Medical and Other Health Services (See Sections 220 & 230 for Occupational Therapy)
CMS Home Health, Hospice, DME Open Door Forum
Additional Resources
OT/OTA Student Supervision & Medicare Requirements
AOTA Fact Sheet re. OT and Home Health Care
OASIS-C Announcement
Home Health Care Services Chapter in March 2012 MedPAC Report to Congress
MedPAC Comment Letter re. Proposed Home Health Rule for 2012
MedPAC Home Health Care Services Payment System
Home Health Services Chapter in March 2011 MedPAC Report to Congress
MedPAC Comment Letter re. Proposed Home Health Rule for 2011
Home Health Services Chapter in March 2010 MedPAC Report to Congress
