Revisions to the Home Care Medicare Benefit Policy Manual

In the Calendar Year 2012 Home Health Prospective Payment System rule, CMS proposed their intent to provide clarification to the Benefit Policy Manual language regarding the definition of "confined to the home".   

The new language more accurately reflects the definition as articulated at Section 1835(a) of the Social Security Act. In addition, vague terms, such as "generally speaking," have been removed to ensure clear and specific requirements of the definition. These changes present the requirements first and more closely align the policy manual with the Act. According to CMS, this will prevent confusion, promote a clearer enforcement of the statute, and provide more definitive guidance to HHAs in order to foster compliance.

Please note this is in effect Nov. 19, 2013.

Contact: Cheryl Udell, cudell@leadingageny.org, 518-867-8383, ext. 151