CMS still may eliminate the PPS payment option entirely. Home health agencies smarting at the looming 10 percent cap on home health PPS outlier payments may face even bigger woes ahead. If abusive billing of the outlier option continues even under the 10 percent cap that begins Jan. 1, the Centers for Medicare & Medicaid Services may cut outlier payments from the prospective payment system altogether. So says CMS in a new question and answer about the outlier payment changes. "If CMS finds that the new CY 2010 outlier policy is not effective and/or achieving our goals, an alternative ... would be to eliminate the outlier policy altogether (in future rulemaking)," the agency warns in the Q&A. Plus: In a separate Q&A, CMS clarifies that claims are subject to the new outlier cap if they are paid at the 2010 rate. A link to the Q&As is online at
