The Centers for Medicare & Medicaid
Services (CMS) released proposed rules and the wage index for calendar year
2015. Significant proposals relevant to speech-language pathologists include
- The standardized 60-day episode is increased by the
proposed wage index to $2,922.76, up from FY2014 $2,869.27. The per-visit
payment for episodes with four or fewer total visits for speech-language
pathologists is $151.85, up from $143.88.
- The therapy reassessment
timeframe requirement will be changed from the current "close to 13th and 19th
visits" to at least once every 14 calendar days. A qualified therapist from
each discipline providing services must reassess the patient at least once
every 14 calendar days regardless of the number of therapy visits provided.
This change is meant to simplify the process.
- The HHA provider
qualification regulations will be updated to be consistent with the CMS statute
and regulations, revising the SLP qualifications to an individual who has a
master's or doctoral degree in speech-language pathology and who is licensed by
the state. At this time all states require licensure for SLPs.
Other proposals include elimination of the need for a physician's separate
narrative based on the required physician face-to-face visit, implementation of
a benchmark of 70% compliance for quality reporting through OASIS, and the
consideration of a demonstration value-based purchasing model.
submit comments on the proposed rule, which are due early September.
Home health services have been paid by a prospective
payment system (PPS) since the enactment of the Balanced Budget Act of 1997. In
order to ensure services are paid at a reasonable rate, the computation must
include amounts based on the most recent audited cost report and adjusted to
account for the effects of case mix and wage levels. Subsequent legislation has
required quality reporting and physician face-to-face encounters. Final rules
are anticipated in November and will take effect on January 1, 2015.
and Medicaid Programs: CY 2015 Home Health Prospective Payment System Rate
Update; Home Health Quality Reporting Requirements; and Survey and Enforcement
Requirements for Home Health Agencies
For more information, or to
share your thoughts on the HHA proposed rules, please contact Lisa Satterfield,
ASHA's director of health care regulatory advocacy, at email@example.com.