Manual Updates for Home Health

The Medicare Benefit Policy Manual and Medicare Program Integrity Manual have been updated in relation to home health recertification and plan of care requirements for payment. The changes stem from provisions in the 2019 Home Health Prospective Payment System (HH PPS) final rule and the 2017 Home Health Conditions of Participation (HH CoPs).

The Centers for Medicare and Medicaid Services (CMS) finalized a change eliminating the requirement that a physician estimate how much longer a patient will require skilled care when recertifying a patient for home health care. This affects recertifications on and after Jan. 1, 2019.

The 2017 HH CoPs finalized content requirements for home health plans of care. According to CMS, "for HHA services to be covered, the individualized plan of care must specify the services necessary to meet the patient-specific needs identified in the comprehensive assessment. In addition, the plan of care must include the identification of the responsible discipline(s) and the frequency and duration of all visits as well as those items listed in 42 CFR 484.60(a) that establish the need for such services. All care provided must be in accordance with the plan of care."

For new excerpts of the manuals, a summary of the changes, and additional information, click here.

Contact: Meg Everett, meverett@leadingageny.org, 518-867-8871