AHA urges CMS to reverse home health 4.36% behavioral offset for CY 2020

The AHA today urged the Centers for Medicare & Medicaid Services to reverse its calendar year 2021 Home Health Prospective Payment System Rate Update of 4.36% behavioral offset for the remainder of CY 2020 and beyond until all CY 2020 data are available for analysis.

“While we continue to support the [Patient Driven Grouping Model] objective of increasing HH PPS payment accuracy, we remain concerned that CY 2020’s large behavioral offset, 4.36%, was implemented on a prospective basis,” AHA said in a letter to CMS Administrator Seema Verma. “This concern remains based on the historic difficulty CMS has had in aligning prospective adjustments with actual provider behavior.”

AHA also commented on the HH quality reporting requirements and on the home infusion therapy services requirements. “We urge CMS to provide further clarity on certain enrollment requirements, such as what supplier type to select on enrollment form CMS-855B and licensure requirements for suppliers that operate in multiple jurisdictions or who work with subcontractors,” the association wrote.