Tuesday, October 4, 2022
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CMS Released Home Health Proposed Rules

Recently, the Centers for Medicare and Medicaid Services (CMS) released their proposed rules for the Home Health (HH) Prospective Payment System (PPS). SDAHO home health members will receive individual analyses to show the impact the rules will have on their specific facility.
Among the proposed updates are:
  • Recalibration of the Patient-Driven Grouping Model (PDGM) case-mix weights, LUPA thresholds, functional levels, and comorbidity adjustment subgroups;
  • Payment adjustments to reflect the impact of differences between assumed behavior changes and actual behavior changes on estimated aggregate payment expenditures under the HH PPS;
  • Creation of a permanent 5% cap on wage index decreases;
  • Updates to the expanded HH value-based purchasing (VBP) program;
  • Updates to the HH quality reporting program (QRP); and
  • Updates to home infusion therapy rates.

Comments on the rules are due August 16 and can be made here. For more information, contact Jacob Parsons, SDAHO’s Director of Fiscal Policy.

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