Medicare Home Health PPS Rules for 2013 July 12

July 12 - Medicare Home Health PPS Rules for 2013

More detail on the proposed Medicare Home Health Rules for 2013. CMS has proposed drastic changes to survey and enforcement requirements for home health agencies. They have added a new subpart to provide survey and certification guidance that outlines the basis for enforcement of compliance standards. They have added new definitions for requirement of survey and frequency of the survey. The items defined include standard, abbreviated standard, extended, partial extended and complaint survey. They also are proposing new definitions for condition - level deficiency, deficiency, noncompliance, standard-level deficiency, and substandard compliance. They are proposing and Informal Dispute Resolution to allow home health agencies an informal opportunity to resolve disputes in the survey findings.

CMS is also proposing alternative sanctions for home health agencies with deficiencies. They have defined new terms for directed plan of correction, immediate jeopardy, new admission, per instance, plan of correction, repeat deficiency, and temporary management.   They have listed a set of factors to be considered in selecting sanctions. The available sanctions include civil money penalties, suspension of payment for new admissions, temporary management and termination. Civil money penalties can be applied per instance with a range of $1,000 to $10,000.

They can also be applied per day with a range of $500 to $10,000.

We encourage you to carefully read these sections as they are very detailed.