On July 2, 2018, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule [CMS-1689-P] outlining proposed Calendar Year (CY) 2019 Medicare payment updates and proposed quality reporting changes for home health agencies (HHAs), and proposed case-mix methodology refinements and a change in the home health unit of payment from 60 days to 30 days for CY 2020.
In addition, this rule proposes implementing temporary transitional payments for home infusion therapy services to begin on January 1, 2019, with full implementation of the new home infusion therapy benefit occurring in 2021. Per CMS, the new Proposed Rule is based on three pillars: empowering patients, increasing competition, and fostering innovation. CMS would continue a commitment to shift Medicare payments from volume to value, with continued implementation of the Home Health Value-Based Purchasing Model and the Home Health Quality Reporting Program, as well as a new case-mix adjustment methodology for the Home Health Prospective Payment System (HH PPS) that focuses on the patient’s condition and resulting care needs rather than on the amount of care provided in order to determine Medicare payment. The proposed rule would also modernize Medicare through innovations in home health and the new home infusion therapy benefit, meaningful quality measure reporting, reduced paperwork, and reduced administrative costs.
It is projected that by 2019, Medicare payments to HHAs will increase by 2.1 percent ($400 million). CMS encourages comments, questions, or thoughts on this proposed rule and will accept comments until August 31, 2018. The proposed rule can be downloaded from the Federal Register at: https://www.federalregister.gov/public-inspection .
To understand the impact of these changes on your medical technology reimbursement or for support in commenting, contact us.