CMS releases rule proposal for home health payment system

July 17, 2019

The Centers for Medicare & Medicaid Services released its home health prospective payment system proposed rule for calendar year 2020, reports the American Hospital Association (AHA). This would increase payments by a net 1.3 percent ($250 million) in CY 2020.

In addition, it continues with last year's finalization of a new home health payment system, known as the "patient-driven groupings model," which will begin in CY 2020. As such, the rule proposes a cut of 8.01 percent, which CMS says is necessary to ensure budget neutrality when moving to the new system.

In addition, the agency proposes to allow therapist assistants, rather than only therapists, to perform maintenance therapy. CMS states that this would allow them to practice at the top of their state licensure, give flexibility to home health providers and improve beneficiary access to these services.

Regarding quality, the rule proposes to remove one quality measure and one question from the Home Health Consumer Assessment of Healthcare Providers and Systems related to pain from the Home Health Quality Reporting Program as part of the agency's response to the opioid crisis. CMS also proposes to adopt two new quality measures regarding the transfer of patient information, as well as several standardized patient assessment data elements.

CMS will accept comments on the proposed rule through Sept. 9.