[Code of Federal Regulations]

[Title 42, Volume 3]

[Revised as of October 1, 2005]

From the U.S. Government Printing Office via GPO Access

[CITE: 42CFR484.1]



[Page 574-575]

 

                         TITLE 42--PUBLIC HEALTH

 

  CHAPTER IV--CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF 

                  HEALTH AND HUMAN SERVICES (CONTINUED)

 

PART 484_HOME HEALTH SERVICES--Table of Contents

 

                      Subpart A_General Provisions

 

Sec. 484.1  Basis and scope.









                      Subpart A_General Provisions



Sec.

484.1 Basis and scope.

484.2 Definitions.

484.4 Personnel qualifications.



                        Subpart B_Administration



484.10 Condition of participation: Patient rights.

484.11 Condition of participation: Release of patient identifiable OASIS 

          information.

484.12 Condition of participation: Compliance with Federal, State, and 

          local laws, disclosure and ownership information, and accepted 

          professional standards and principles.

484.14 Condition of participation: Organization, services, and 

          administration.

484.16 Condition of participation: Group of professional personnel.



[[Page 575]]



484.18 Condition of participation: Acceptance of patients, plan of care, 

          and medical supervision.

484.20 Condition of participation: Reporting OASIS information.



                    Subpart C_Furnishing of Services



484.30 Condition of participation: Skilled nursing services.

484.32 Condition of participation: Therapy services.

484.34 Condition of participation: Medical social services.

484.36 Condition of participation: Home health aide services.

484.38 Condition of participation: Qualifying to furnish outpatient 

          physical therapy or speech pathology services.

484.48 Condition of participation: Clinical records.

484.52 Condition of participation: Evaluation of the agency's program.

484.55 Condition of participation: Comprehensive assessment of patients.



Subpart D [Reserved]



      Subpart E_Prospective Payment System for Home Health Agencies



484.200 Basis and scope.

484.202 Definitions.

484.205 Basis of payment.

484.210 Data used for the calculation of the national prospective 60-day 

          episode payment.

484.215 Initial establishment of the calculation of the national 60-day 

          episode payment.

484.220 Calculation of the national adjusted prospective 60-day episode 

          payment rate for case-mix and area wage levels.

484.225 Annual update of the national adjusted prospective 60-day 

          episode payment rate.

484.230 Methodology used for the calculation of the low-utilization 

          payment adjustment.

484.235 Methodology used for the calculation of the partial episode 

          payment adjustment.

484.237 Methodology used for the calculation of the significant change 

          in condition payment adjustment.

484.240 Methodology used for the calculation of the outlier payment.

484.245 Accelerated payments for home health agencies.

484.250 Patient assessment data.

484.260 Limitation on review.

484.265 Additional payment.



    Authority: Secs. 1102 and 1871 of the Social Security Act (42 U.S.C. 

1302 and 1395(hh)) unless otherwise indicated.



    Source: 54 FR 33367, Aug. 14, 1989, unless otherwise noted.







    (a) Basis and scope. This part is based on the indicated provisions 

of the following sections of the Act:

    (1) Sections 1861(o) and 1891 establish the conditions that an HHA 

must meet in order to participate in Medicare.

    (2) Section 1861(z) specifies the Institutional planning standards 

that HHAs must meet.

    (3) Section 1895 provides for the establishment of a prospective 

payment system for home health services covered under Medicare.

    (b) This part also sets forth additional requirements that are 

considered necessary to ensure the health and safety of patients.



[60 FR 50443, Sept. 29, 1995, as amended at 65 FR 41211, July 3, 2000]