CMS finalizes CY 2020 home health rule with new payment model

The Centers for Medicare & Medicaid Services today released its home health prospective payment system final rule with comment period for calendar year 2020, which increases payments by a net 1.3% ($250 million) relative to 2019. In addition, it continues the rulemaking initiated last year to implement a new home health payment model, known as the “patient-driven groupings model,” which has a new 30-day unit of payment. To attempt to implement the model in a budget-neutral manner in CY 2020, CMS included a behavioral offset of -4.36%. rather than the proposed amount of -8.01%.
 
In addition, as proposed, the rule allows 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.
 
With respect to quality, the rule removed one and added two quality measures regarding the transfer of patient information. In addition, CMS added several standardized patient assessment data elements. However, CMS did not finalize its proposal to remove one question related to pain from the Home Health Consumer Assessment of Healthcare Providers and Systems survey, which is part of the Home Health Quality Reporting Program.
 
While this final rule with comment period takes effect on Jan. 1, CMS will take comments through Dec. 30 on certain policies.