Final Home Health Rule Issued for CY 2011
The Centers for Medicare & Medicaid Services (CMS) released the Home Health PPS final rule for calendar year (CY) 2011. The final rule addresses 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 will go into effect January 1, 2011.
In its proposed rule, CMS would have required that a professional therapist assess a patient on the 13th and 19th visits, making no distinction between therapy disciplines. In response to AOTA’s comments that the three therapy disciplines are distinct and one cannot make decisions about a patient for another therapy discipline, CMS agreed and clarified that the policy applies to each discipline separately:
The patient’s function must be initially assessed and periodically reassessed by a qualified therapist of the corresponding discipline for the type of therapy being provided (that is, PT, OT, and/or SLP). When more than one therapy discipline is being provided, the corresponding qualified therapist would perform the reassessment during the regularly scheduled visit associated with that discipline which was scheduled to occur as near as possible to the 13th and 19th visit, but no later than the 13th and 19th visit.
CMS adopted the proposed requirement for patient assessment by a qualified therapist by the 13th and 19th visits, and added provisions to allow flexibility for rural areas and extenuating circumstances. CMS also made clarifications to the provisions regarding maintenance therapy.
CMS Final Home Health PPS Rule (see pages 19-27 for therapy clarifications)
AOTA Comments on Proposed Home Health Rule
For AOTA's Analysis of the final rule, go to AOTA Analysis
Please continue to check this page for developments.