Fed Regist. 2010 Nov 17;75(221):70371-486.
This final rule sets forth an update to the Home Health Prospective Payment System (HH PPS) rates, including: the national standardized 60-day episode rates, the national per-visit rates, the nonroutine medical supply (NRS) conversion factors, and the low utilization payment amount (LUPA) add-on payment amounts, under the Medicare prospective payment system for HHAs effective January 1, 2011. This rule also updates the wage index used under the HH PPS and, in accordance with the Patient Protection and Affordable Care Act of 2010 (Affordable Care Act), updates the HH PPS outlier policy. In addition, this rule revises the home health agency (HHA) capitalization requirements. This rule further adds clarifying language to the "skilled services" section. The rule finalizes a 3.79 percent reduction to rates for CY 2011 to account for changes in case-mix, which are unrelated to real changes in patient acuity. Finally, this rule incorporates new legislative requirements regarding face-to-face encounters with providers related to home health and hospice care.
本最终规则规定了家庭健康预期支付系统（HH PPS）费率的更新内容，包括：自2011年1月1日起生效的医疗保险预期支付系统下，适用于家庭健康机构（HHA）的全国标准化60天疗程费率、全国每次访视费率、非常规医疗用品（NRS）换算因子以及低利用率支付金额（LUPA）附加支付金额。本规则还更新了HH PPS下使用的工资指数，并根据2010年《患者保护与平价医疗法案》（《平价医疗法案》）更新了HH PPS的异常值政策。此外，本规则修订了家庭健康机构（HHA）的资本化要求。本规则进一步在“熟练服务”部分添加了澄清性语言。该规则最终确定将2011财年的费率降低3.79%，以考虑病例组合的变化，这些变化与患者病情的实际变化无关。最后，本规则纳入了关于与家庭健康和临终关怀护理相关的提供者进行面对面接触的新立法要求。
