Home Care Regulatory Issues

Patient Rights Notice
Patient Rights Notice: PDF Document pdfthumb
Conditions of Participation
Medicare and Medicaid Program: Conditions of Participation for Home Health Agencies- Final rule pdfthumb
Comparison of the current and final revisions to the Home Health Conditions of Participation pdfthumb
Emergency Preparedness
The final rule pdfthumb
The Interpretive Guidelines for Emergency Preparedness (all providers) pdfthumb
Emergency Preparedness Interpretive Guidelines for Home Health Agencies pdfthumb
Final Regulations
Medicare and Medicaid Programs; CY 2017 Home Health Prospective Payment System Rate Update; Home
Health Value-Based Purchasing Model; and Home Health Quality Reporting Requirements
pdfthumb
Proposed Regulations and Comments
Proposed regulations have a thirty to ninety day comment period where by all interested persons may submit written comments on the proposed rules prior to a final action.
Home Health Statute and Regulations
After comments to a proposed rule are analyzed by the respective government agency, a final regulation is published in the Federal Register. These final regulations are what govern the implementation of Federal programs.

Home Health Regulations

Medicare Policy

Definition of Home Health
Confined to the Home Definition pdfthumb
Jimmo v. Sebelius Settlement Agreement pdfthumb

Local Coverage Determinations

Decisions by a fiscal intermediary or carrier whether to cover a particular service
Beneficiary Notices
Home health agencies are required to provide notice of Medicare non-coverage of services to beneficiaries.
CMS Beneficiary Notice Initiative web site
Home Health PPS
Emergency Preparedness Resources
The packet was developed by the NAHC Emergency Preparedness Workgroup and provides tools to assist agencies, patients and their families, and agency staff develop emergency preparedness plans. The guide has been updated to include the OASIS-C.
Emergency Preparedness Packet for Home Health Agencies-2010 pdfthumb
PECOS
NAHC PECOS LookUp Tool Kit
Welcome to the National Association for Home Care & Hospice’s (NAHC) PECOS LookUp Tool. This tool contains the latest PECOS dataset along with the latest PECOS Pending dataset available to NAHC as supplied by CMS and will allow you to check your physician’s existence in the PECOS database.
NAHC PECOS LookUp Tool Kit
Medicare Home Health Prospective Payment System (PPS)
Home health agencies are paid prospectively, based on a case-mix system, for their services. The Centers for Medicare & Medicaid Services (CMS) offers detailed information about the PPS methodology and payment calculations on its web site.
CMS Home Health Center
OASIS-C
The Centers for Medicare & Medicaid Services (CMS) requires home health agencies to use a standardized assessment tool for all Medicare and Medicaid patients. OASIS-C is being replaced with OASIS-C2 effective for all assessments completed on or after January 1, 2017. The following document has been provided by CMS.
OASIS-C2 Guidance Manual
Consumer Assessment of Health Providers and Systems (CAHPS)
The term CAHPS refers to a comprehensive and evolving family of surveys that ask consumers and patients to evaluate the interpersonal aspects of health care. CMS and AHRQ have developed a Home Health CAHPS tool for surveying home health patients. Results of these surveys will be publicly reported on Home Health Compare in late 2010 or early 2011. Participation is voluntary, but Medicare payments may be reduced for agencies that do not participate.
Detailed information about the HH CAHPS