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Regulatory Blueprint |
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2013 Regulatory Blueprint for Action |
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Face to Face Encounter Templates |
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Inpatient Physician Template |
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Community Physician Template |
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Proposed Regulations |
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Proposed regulations are preliminary federal rules that are established by the various government agencies and published in the Federal Register. |
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Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2013, Hospice Quality Reporting Requirements, and Survey and Enforcement Requirements for Home Health Agencies |
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Comments on Proposed Regulations |
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Proposed regulations have a thirty to ninety day comment period where by all interested persons may submit written comments on the proposed rules prior to a final action. |
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2013 Home Health PPS NPRM Comments |
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Appendix A: Wage Index 2012-2013 Comparison |
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Appendix B: Rebasing White Paper |
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Appendix C: Face to Face Question |
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Appendix D: Diagnosis Code Changes |
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Appendix E: Affected Case-Mix Diagnoses |
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Home Health Statute and Regulations |
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After comments to a proposed rule are analyzed by the respective government agency, a final regulation is published in the Federal Register. These final regulations are what govern the implementation of Federal programs. |
Home Health Regulations
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Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2012; Final Rule |
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Medicare Program: Home Health Prospective Payment System Refinement and rate Update for Calendar Year 2008 |
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Medicare Statute
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Definition of Home Health |
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Conditions and Limitations of Payment for Services (Provides skilled nursing, therapies, plan of care, and homebound requirements interspersed with other provider requirements) |
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Limitation on Liability When Claims are Denied |
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Waiver of Recovery of Payment |
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Exclusions from Coverage |
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Local Coverage Determinations
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Decisions by a fiscal intermediary or carrier whether to cover a particular service |
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Beneficiary Notices |
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Home health agencies are required to provide notice of Medicare non-coverage of services to beneficiaries. |
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CMS Beneficiary Notice Initiative web site |
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Home Health PPS |
Emergency Preparedness Resources
The packet was developed by the NAHC Emergency Preparedness Workgroup and provides tools to assist agencies, patients and their families, and agency staff develop emergency preparedness plans. The guide has been updated to include the OASIS-C. |
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Emergency Preparedness Packet for Home Health Agencies-2010 |
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PECOS |
NAHC PECOS LookUp Tool Kit
Welcome to the National Association for Home Care & Hospice’s (NAHC) PECOS LookUp Tool. This tool contains the latest PECOS dataset along with the latest PECOS Pending dataset available to NAHC as supplied by CMS and will allow you to check your physician’s existence in the PECOS database. |
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NAHC PECOS LookUp Tool Kit |
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Medicare Home Health Prospective Payment System (PPS) |
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Home health agencies are paid prospectively, based on a case-mix system, for their services. The Centers for Medicare & Medicaid Services (CMS) offers detailed information about the PPS methodology and payment calculations on its web site. |
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CMS Home Health Center |
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OASIS-C |
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The Centers for Medicare & Medicaid Services (CMS) requires home health agencies to use a standardized assessment tool for all Medicare and Medicaid patients. OASIS-B1 is being replaced wiith OASIS-C effective for all assessments completed on or after January 1, 2010. The following document has been provided by CMS. |
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OASIS-C Guidance Manual |
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Consumer Assessment of Health Providers and Systems (CAHPS) |
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The term CAHPS refers to a comprehensive and evolving family of surveys that ask consumers and patients to evaluate the interpersonal aspects of health care. CMS and AHRQ have developed a Home Health CAHPS tool for surveying home health patients. Results of these surveys will be publicly reported on Home Health Compare in late 2010 or early 2011. Participation is voluntary, but Medicare payments may be reduced for agencies that do not participate. |
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Detailed information about the HH CAHPS |
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