Home health firms to lose $810M in Medicare payments: 6 home health CMS updates

Home health agencies would lose $810 million in Medicaid payments in 2023 under a CMS proposal released June 17. 

Six things to know:

1. The cuts represent an aggregate 4.2 percent decrease in funding from 2022, according to CMS. 

2. Under the proposal, agencies would see a $560 million increase in funding from the proposed home health payment update percentage; a $1.33 billion decrease from the proposed prospective, permanent behavioral assumption adjustment; and a $40 million decrease from the proposed update to the fixed-dollar loss ratio used in determining outlier payments. 

3. The rule also proposes a permanent 5 percent cap on negative wage index changes for home health agencies, regardless of the underlying reason for the decrease. 

4. CMS is also seeking comment on the use of services furnished via telecommunications systems in a 2021 final rule. The collection of data under that rule is limited to a broad category of telecommunications technology costs on an administrative level. This proposed rule is seeking comments on the collection of data on the use of these services at a beneficiary level. CMS said collecting this data will allow the agency to analyze the characteristics of the beneficiaries utilizing services furnished remotely and could give it a broader understanding of the social determinants that affect who benefits most from these services, including what barriers may potentially exist for certain subsets of beneficiaries.

5. CMS is also proposing to end the suspension of non-Medicare/non-Medicaid data for home health agency patients. Agencies would be required to submit all payer OASIS data for purposes of the home health quality reporting program beginning in the 2025 program year. 

6. CMS is updating the home infusion therapy services payment rates for 2023. The law requires annual updates to be equal to the percent increase in the consumer price index for all urban consumers for the 12-month period ending with June of the preceding year, reduced by the productivity adjustment for 2023. The consumer price index for June 2022 was not yet available at the time of this proposed rule, however.  

Read the full proposed rule here

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