Home Health Proposed Rule issued for CY2018, but the big news is what’s in store for 2019

 In Home Health, Industry News, News, Regulatory

Proposed Rule Issued for 2018, But 2019 Would Bring Big Changes for Home Health Payment Model

The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would update payment rates and the wage index for home health agencies (HHAs) serving Medicare beneficiaries with home health episodes of care ending on or after January, 2018 and (more importantly) proposes a redesign of the payment system in 2019. The Home Health Prospective Payment System (HH PPS) proposed rule is one of several proposed rules that would be effective for calendar year 2018, reflecting major changes for providers.

The proposed rule may be viewed here.

As is normally the case with the annually-published document, this proposed rule updates the Home Health Prospective Payment Systems payment rates for the standard 60-day episode, the national per-visit rates, and the non-routine medical supply (NRS) conversion factor. The overall payment rate for home health care are expected to be reduced 0.4%, resulting in $80 million less in payments to home health agencies for calendar year 2018.

These changes are in addition to the recently postponed Home Health Conditions of Participation, which go into effect in January, 2018.

Under the proposed rule, the home health payment update agencies that submit quality data for the Home Health Quality Reporting Program would be one percent in 2018. The proposed rule also includes proposals to refine the case-mix adjustment methodology, including a change in the unit of payment from 60-day episodes of care to 30-day periods of care, to be implemented for periods of care beginning on or after January 1, 2019. Additionally, the proposed rule includes proposals for the Home Health Value-Based Purchasing Model and the Home Health Quality Reporting Program.

More information will be published as it becomes available. Netsmart/DeVero will also offer a free webinar for home health providers once the rule becomes final.

For a summary of the proposed rule, please visit: https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2017-Fact-Sheet-items/2017-07-25.html.

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