CMS Issues Home Health Prospective Payment System Rate Update Proposed Rule
The proposed rule would update Medicare payment policies and rates for home health agencies
By: Catie Hillard
July 12, 2022 – The Centers for Medicare & Medicaid Services (CMS) issued the calendar year (CY) 2023 Home Health Prospective Payment System (HH PPS) Rate Update proposed rule. This rule would update Medicare payment policies and rates for home health agencies (HHAs).
Beginning in October 2000, home health agencies were paid under the HH PPS for 60-day episodes of care. This included all home health services. The Balanced Budget Act of 2018 (BBA of 2018) included requirements for home health payment reform. One of the requirements was to change the 60-day period to a 30-day period payment rate. Since then, CMS has been required to post proposed rule changes annually for the next calendar year of the program.
Updates to the Home Health PPS for Calendar Year 2023
The rule proposes routine, statutorily updates to the home health payment rates for HHAs in 2023.
In addition, CMS is proposing to add a provision to apply a permanent prospective payment adjustment to the home health 30-day period payment rate. This would account for increases or decreases in aggregate expenditures. CMS predicts that the change would result in a decrease in Medicare payments to HHAs by 4.2% or $810 million in 2023 when compared to 2022.
Through the proposed rule, CMS is also requesting comments on the best way to collect telehealth data for home health claims so better analysis can be done on the characteristics of beneficiaries receiving remote services.
Overall, the goal of the proposed changes is to help improve patient care while also protecting Medicare’s sustainability for future generations by acting prudently with public funds.
To view the complete Home Health Prospective Payment System Rate Update Proposed Rule, click here.
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