{"id":27987,"date":"2020-07-02T18:29:42","date_gmt":"2020-07-02T18:29:42","guid":{"rendered":"https:\/\/dev.mtelehealth.com\/?p=27987"},"modified":"2020-07-02T18:29:42","modified_gmt":"2020-07-02T18:29:42","slug":"nach-analyzes-latest-proposed-rule-for-home-health","status":"publish","type":"post","link":"https:\/\/drmiltie.com\/at-home-testing\/nach-analyzes-latest-proposed-rule-for-home-health\/","title":{"rendered":"NACH Analyzes Latest Proposed Rule for Home Health"},"content":{"rendered":"\n

Friday, June 26th, 2020<\/p>\n\n\n\n

WASHINGTON, D.C. (June 26, 2020)\u2014The preview of the CY 2021 home health proposed rule<\/a>, Medicare and Medicaid Programs; CY 2021 Home Health Prospective Payment System Rate Update; Home Health Quality Reporting Requirements; and Home Infusion Therapy Services Requirements, has been posted. The proposal is light compared to recent years\u2019 proposed rules, but does contain meaningful updates and changes.<\/p>\n\n\n\n

\u201cCMS has issued the proposed Medicare home health services payment rule in June for the first time in several years,\u201d noted Bill Dombi, President of the National Association for Home Care & Hospice. \u201cIt is evident from the rule that its early release was made possible by the limited changes that CMS proposes. NAHC appreciates CMS\u2019s recognition that any significant changes during the infancy of the PDGM system would be premature given the limited data available from 2020, combined with the chaos created by the Covid-19 pandemic. This proposal should help home health agencies achieve some semblance of stability during these difficult times.\u201d<\/p>\n\n\n\n

Below is a summary of each of the areas addressed by the Centers for Medicare & Medicaid Services (CMS) \u2013 payment rates, telehealth, quality program and home infusion therapy.<\/p>\n\n\n\n

Payment Rates<\/strong>
The 2021 proposed Medicare home health rates represent a simple inflation rate update, a significant change in wage index area designations, no change in the structure of the Patient Driven Groupings Model (PDGM) payment model, a scheduled phasing-out of the rural add-on, and a continuation of outlier payment standards. Overall, this proposal would bring a rare year of relative stabilization in Medicare payments for most home health agencies. However, it is noteworthy that the wage index changes will have a significant impact on HHAs that serve certain geographic areas. This reimbursement factor does not get the headlines, but it can be very meaningful for some providers.<\/p>\n\n\n\n

Generally, CMS explains that it is doing very little to change the payment model and the payment rates because it has only limited data from the new PDGM model. That limitation is compounded by the chaotic impacts on patient case mix, service modalities, and patient volume triggered by the COVID-19 pandemic. Earlier this year, NAHC advocated for CMS to roll back the 2020 behavioral adjustment that was set at 4.36% due to these changes. CMS later responded that it felt that is was premature to do so given the data limitations even though there were strong signs pointing to a significant increase in LUPAs. Here are some of the details on the 2021 reimbursement proposals.<\/p>\n\n\n\n