The Centers for Medicare and Medicaid Services issued a proposed rule on Tuesday, July 1, 2014 that will redefine how home health agencies are reimbursed by Medicare for skilled intermittent home health services.  Some of the highlights include:

• eliminate the requirement that physicians provide a narrative explaining the patient's home bound status and need for skilled care
• continue the 4-year phase-in of rate re-basing that started in 2014
• implement proposed base episode rate for 2015  at $2922.76, compared to the 2014 base rate is $2869.27. While that looks like a $53.49 increase, the reality is that payment rates are actually decreased as CMS also recalibrates the case mix adjustment weights that effectively reduce those weights in the aggregate by 2.37%
• the recalibration results in some weights increasing while others decrease, primarily therapy related episodes.