Summary

GAO reviewed the Department of Health and Human Services, Centers for Medicare and Medicaid Services' (CMS) new rule on the Medicare Home Health Prospective Payment System. GAO found that (1) the final rule sets forth an update to the 60-day national episode rates and the national per-visit amounts under the Medicare prospective payment system for home health agencies, rebases and revises the home health market basket to ensure it continues to adequately reflect the price changes of efficiently providing home health services, and revises the fixed dollar loss ratio, which is used in the calculation of outlier payments; and (2) with the exception of the 60-day delay in its effective date, CMS complied with the applicable requirements in promulgating the rule.