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CMS Issues Home Health Prospective Payment System Proposed Rule

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The Centers for Medicare & Medicaid Services (CMS) has issued the proposed rule for the home health (HH) prospective payment system for calendar year (CY) 2023.   

CMS estimates that overall Medicare payments to HH agencies in CY 2023 will decrease by 4.8% (-$810 million) as compared to CY 2022. The decrease reflects the application of a proposed prospective permanent behavioral assumption adjustment of -7.69% (- $1.33 billion) to a 2.9% proposed payment update and a 0.2% decrease due to a proposed update to the fixed-dollar loss ratio.   

Additionally, the rule includes proposals that would:  

  • Update payment rates for home infusion therapy services  
  • Require HH agencies to submit data to the HH Quality Reporting Program (QRP) for all payers, beginning in CY 2025  
  • Change the baseline year for the expanded HH Value-Based Purchasing (VBP) Model   
  • Make permanent selected regulatory waivers related to HH aide supervision and the use of telecommunication that were issued during the COVID-19 public health emergency  

Finally,  CMS seeks stakeholder impact on current efforts related to health equity measure development for the HH QRP and the expanded HH VBP Model.