Sharon Hamilton RN, MS
Briggs Healthcare Clinical Consultant
The Centers for Medicare & Medicaid Services (CMS) issued a final rule (CMS-1689-FC) that updates the Medicare Home Health Prospective Payment System (HH PPS) rates and wage index for calendar year (CY) 2019. The final rule results in a 2.2 percent increase ($420 million) in payments to HHAs in CY 2019 and finalizes the methodology used to determine the rural add-on payment for CYs 2019 through 2022 as well as regulations text changes regarding certifying and recertifying patient eligibility for Medicare home health services and remote patient monitoring. This rule also finalizes the removal of seven measures from the Home Health Quality Reporting Program, a regulatory text change regarding OASIS data, and refinements the Home Health Value-Based Purchasing model. For CY 2020, this rule finalizes the implementation of an alternative case-mix adjustment methodology, the Patient Driven Groupings Model (PDGM). The PDGM will be implemented in a budget neutral manner on January 1, 2020. A Home Health Claims-OASIS Limited Data Set (LDS) file will be made available, upon request, to accompany the CY 2019 HH PPS final rule (click here). Lastly, this rule finalizes the definition of a “infusion drug administration calendar day” for the implementation of temporary transitional payments for home infusion therapy services for CYs 2019 and 2020, finalizes health and safety standards for home infusion therapy, and finalizes an accreditation and oversight process for home infusion therapy suppliers.
For more information go to https://s3.amazonaws.com/public-inspection.federalregister.gov/2018-24145.pdf