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CMS Finalizes Home Health Prospective Payment Rule

On Oct. 31, 2018, the Centers for Medicare and Medicaid Services (CMS) released the CY 2019 Home Health Prospective Payment System Rate Update and CY 2020 Case-Mix Adjustment Methodology Refinements. You can access the rule here. It will be published in the Federal Register on Nov. 13th.

CMS projects that Medicare payments to home health agencies in CY 2019 will be increased by 2.2 percent, which is slightly higher than what was announced in the proposed rule. It also finalizes the Patient-Driven Groupings Model (PDGM). There is a key language shift regarding the start date as “on or after January 1, 2020,” indicating the possibility for a later start date. However, we encourage home health providers to begin planning for a Jan. 1, 2020 start date. An initial summary of the proposed rule written by LeadingAge is available here.

LeadingAge NY will be analyzing the rule and providing an analysis in the near future.

Contact: Meg Carr Everett, meverett@leadingageny.org, 518-867-8871