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Home Health Changes in Federal Spending Bill

The recent spending bill passed by Congress and signed into law by the President on Fri., Feb. 9th will have both positive and negative impacts on home health care.

The biggest change shifts the current 60-day unit of payment to a 30-day model. The language was part of the proposed Home Health Groupings Model (HHGM) last year and was not finalized by the Centers for Medicare and Medicaid Services (CMS). This change is budget neutral.

Beyond this measure, the bill seeks to make several other changes. It includes rural add-on language supported by LeadingAge NY that ensures that providers can continue services to patients by covering the additional transportation and staffing costs required in remote areas. It also provides some relief from the face-to-face (F2F) requirement by removing the mandate that CMS look at both physician and Home Health Agency (HHA) records when determining coverage eligibility. We will see whether CMS follows through with this change in a proposed rule. 

The bill also extends Independence at Home, a program from CMS that incentivizes primary care at home. The program originally began as a three-year pilot, and it was floated to become permanent in 2016. The bill extends the program by seven years. It also expands telehealth coverage under Medicare. For 2020, Medicare Advantage plans can also provide additional telehealth benefits to enrollees. Similarly, accountable care organizations (ACOs) have an ability to expand the use of telehealth services under the bill, with a study by 2026 required by federal agencies.

Changes were also made to the Certified Home Health Agency (CHHA) Medicare reimbursement rate and the market basket rate for home health care. For a broader summary of the provisions in the spending bill, see LeadingAge National’s memo here.

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