Mary Madison, RN, RAC-CT, CDP
Clinical Consultant – Briggs Healthcare
Late in the afternoon (4:15pm ET) on Tuesday, November 2, 2021, CMS filed the public inspection copy of 2021-23993. (This document is scheduled to be published in the Federal Register on 11/09/2021 and available online at federalregister.gov/d/2021-23993, and on govinfo.gov.) At first blush, this Final Rule appears to be solely directed at the home health industry, but wait…
Here’s a synopsis of what’s included in this FR, effective January 1, 2022:
- updates the home health and home infusion therapy services payment rates for calendar year (CY) 2022 in accordance with existing statutory and regulatory requirements
- finalizes recalibration of the case-mix weights and updates the functional impairment levels, and comorbidity adjustment subgroups while maintaining the current low utilization payment adjustment (LUPA) thresholds for CY 2022
- finalizes a policy to utilize the physical therapy LUPA add-on factor to establish the occupational therapy add-on factor for the LUPA add-on payment amounts and makes conforming regulations text changes to reflect that allowed practitioners are able to establish and review the plan of care
- finalizes proposed changes to the Home Health Quality Reporting Program (QRP) including finalizing proposed measure removals and adoptions, public reporting, and modification of effective dates
- finalizes proposed modifications to the effective date for the reporting of measures and certain standardized patient assessment data in the Inpatient Rehabilitation Facility (IRF) QRP and Long-Term Care Hospital (LTCH) QRP
- codifies certain Medicare provider and supplier enrollment policies
- makes permanent selected regulatory blanket waivers related to home health aide supervision that were issued to Medicare participating home health agencies during the COVID-19 public health emergency (PHE), and updates the home health conditions of participation regarding occupational therapists’ assessment completion to implement provisions of the Consolidated Appropriations Act, 2021 (CAA 2021)
- finalizes proposals to expand the Home Health Value-Based Purchasing (HHVBP) Model and to end the original HHVBP Model one year early
- establishes survey and enforcement requirements for hospice programs as set forth in the CAA 2021
- finalizes revisions to the infection control requirements for long-term care (LTC) facilities (Medicaid nursing facilities and Medicare skilled nursing facilities, also collectively known as “nursing homes”) that will extend the mandatory COVID19 reporting requirements beyond the current COVID-19 PHE until December 31, 2024
The corresponding CMS Fact Sheet provides these statements:
“Today, the Centers for Medicare & Medicaid Services (CMS) acted to improve home health care for older adults and people with disabilities through a final rule that would accelerate the shift from paying for Medicare home health services based on volume to a system that pays for value. The rule finalizes a nationwide expansion of the successful Home Health Value- Based Purchasing (HHVBP) Model and makes updates to the Medicare Home Health Prospective Payment System (PPS) and the home infusion therapy services payment rates for Calendar Year (CY) 2022, in accordance with existing statutory and regulatory requirements.
This final rule makes permanent the changes to the home health Conditions of Participation (CoP) that were implemented during the COVID-19 public health emergency (PHE) and finalizes changes to the CoPs to implement a provision of the Consolidated Appropriations Act, 2021.
This rule also finalizes changes to the Home Health, Long -Term Care Hospital (LTCH), and Inpatient Rehabilitation Facility (IRF) Quality Reporting Programs (QRP); finalizes revisions to the infection control requirements for Long-Term Care Facilities (Medicaid nursing facilities and Medicare skilled nursing facilities, also collectively known as “nursing homes”) that will extend the mandatory COVID-19 reporting requirements beyond the current COVID-19 PHE until December 31, 2024; incorporates into regulation several existing Medicare provider enrollment policies; and finalizes survey and enforcement requirements for hospice programs to implement provisions of the Consolidated Appropriations Act, 2021.”
There’s a lot in this FR. Please take the time to read it thoroughly with your team so you’re prepared for January 1, 2022 and beyond. I’ve bolded the entities beyond Home Health providers in the bulleted synopsis, namely IRFs, LTCHs and LTCFs. If you’re a provider in one of those settings, you need to pay attention to those items as they will affect you in less than 60 days.