tci Medicare Compliance & Reimbursement - 2014 Issue 15

Home Health Prospective Payment System: Case Mix Recalibration Could Take A Big Bite Out Of Your Budget

CMS tries to align payments with current utilization data. The Centers for Medicare & Medicaid Services (CMS) has bad news for home health agencies. In its 2015 home health prospective payment system proposed rule, CMS outlines its plan to cull about 200 diagnosis codes from the case mix system and drop two OASIS items as well. CMS is “adjusting the weights relative to one another using more current data and aligning payments with current utilization data in a budget neutral manner,” the agency explains in the rule published in the July 7 Federal Register. Warning: While the...

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