Medicare Home Health Proposed Rule Available for Comment

Posted on July 18, 2019

The Centers for Medicare & Medicaid Services (CMS) recently released a proposed rule to update the Medicare home health (HH) prospective payment system effective Jan. 1, 2020. Highlights of the proposed rule include:

  • Providing a net 2.1% rate increase for HHs that submit quality data.
  • Implementing a new HH payment system, the patient-driven groupings model (PDGM), as finalized in the 2019 rule. As part of moving to the new system, the CMS proposes an 8% cut to ensure budget neutrality. The PDGM removes therapy thresholds for payment and changes the unit of HH payment from 60-day episodes of care to 30-day periods of care.
  • Allowing therapy assistants, rather than only therapists, to perform maintenance therapy. This will allow therapy assistants to practice at the top of their state licensure, while giving flexibility to HH providers and improving access to services.
  • Removing one quality measure and one question related to pain from the HH quality reporting program’s consumer assessment of healthcare providers and systems as part of the CMS’ response to the opioid crisis.
  • Adopting a new quality measure regarding the transfer of patient information and standardizing patient assessment data elements.

In the coming weeks, the MHA will provide members with an estimated impact analysis. The MHA will also make its draft comments available prior to the due date and encourages members to submit comments to the CMS by Sept. 9. The CMS is expected to release a final rule by Nov. 1 for the Jan. 1, 2020, effective date. Members with questions should contact Vickie Kunz at the MHA.

Tags: Medicare, home health, PPS, Medicare fee-for-services

Posted in: Member News

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