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HHS/CMS

RIN: 0938-AS46

Publication ID: Fall 2015

Title: CY 2016 Home Health Prospective Payment System Refinements and Rate Update (CMS-1625-F)(Section 610 Review)
Abstract: This annual final rule updates the 60-day national episode rate based on the applicable home health market basket update and case-mix adjustment. It also updates the national per-visit rates used to calculate low utilization payment adjustments (LUPAs) and outlier payments under the Medicare prospective payment system for home health agencies. These changes apply to services furnished during home health episodes beginning on or after January 1, 2016. Additionally, this rule will implement a Home Health value-based purchasing model, beginning January 1, 2016, in which all Medicare-Certified Home Health Agencies in selected states will be required to participate.
Agency: Department of Health and Human Services(HHS)	Priority: Economically Significant
RIN Status: Previously published in the Unified Agenda	Agenda Stage of Rulemaking: Completed Actions
Major: Yes	Unfunded Mandates: No
RFA Section 610 Review: Section 610 Review
CFR Citation: 42 CFR 409 42 CFR 424 42 CFR 484
Legal Authority: 42 U.S.C. 1302 42 U.S.C. 1395(hh)

Legal Deadline:

Action	Source	Description	Date
Final	Statutory		11/01/2015

Timetable:

Action	Date	FR Cite
NPRM	07/10/2015	80 FR 39840
NPRM Comment Period End	09/04/2015
Final Action	11/05/2015	80 FR 68624
Final Rule Effective	01/01/2016

Regulatory Flexibility Analysis Required: Yes	Government Levels Affected: Federal, State
Small Entities Affected: Businesses	Federalism: No
Included in the Regulatory Plan: No
RIN Data Printed in the FR: Yes
Agency Contact: Hillary Loeffler Director, Division of Home Health and Hospice Department of Health and Human Services Centers for Medicare & Medicaid Services Center for Medicare, MS: C5-07-22, 7500 Security Boulevard, Baltimore, MD 21244 Phone:410 786-0456 Email: hillary.loeffler@cms.hhs.gov