Beginning calendar year 2010, CMS will cap home health outlier payments at 10% per HHA and target total aggregate outlier payments at 2.5% of all HH PPS payments. This is an agency level cap such that in any given calendar year, an individual HHA would receive no more than 10% of its total HH PPS payments in outlier payments.
In a 12/05/09 New York Times article, the impact of this legislation has been a topic of interest during the first week of Senate debate. Under Congress’s new legislation to insure more than 30 million Americans, home care would be hit disproportionately hard. Home care currently accounts for 3.7% of the Medicare budget but would take a 10.2% hit by the House bill and 9.4% hit by the Senate bill. This translates into a $55 billion reduction over 10 years in Medicare spending on home health services under the House bill and a $43 billion reduction under the Senate bill.
