Home Health CY 2023 Prospective Payment Rule Finalized
The Centers for Medicare and Medicaid Services (CMS) has released the Home Health Calendar Year (CY) 2023 Prospective Payment Rule, which is scheduled to be posted in the Federal Register on Nov. 4th. LeadingAge NY and member agencies have been concerned about the proposed rate cuts, and the sector has been lobbying Congress to address cuts if finalized as proposed.
CMS originally proposed a -7.69 percent permanent adjustment to the CY 2023 base payment rate in addition to a temporary adjustment of $2 billion to reconcile retrospective overpayments from the first two years of the Patient-Driven Groupings Model (PDGM). In the final rule, CMS is finalizing a -3.925 percent behavioral adjustment to the CY 2023 national standardized 30-day period payment. It will not seek to address $2 billion in overpayments in 2023.
CMS reviewed the updated forecast of prices and adjusted projections to a 4.1 percent market basket with a -0.1 percent productivity adjustment. CMS finalized a CY 2023 final home health payment update of 4 percent instead of the proposed 2.9 percent.
The final aggregate adjustment to home health payments in CY 2023 will be a 0.7 percent, or $125 million, increase compared to CY 2022.
LeadingAge National has provided a summary of the final rule here. CMS indicates in its commentary that it is planning on addressing the rest of the proposed behavioral cuts moving forward. Over the last several months, bipartisan support to scale back the CMS cuts to agencies has emerged, including a strong letter to CMS from the New York congressional delegation. LeadingAge NY will continue to work with LeadingAge National to advocate for these changes moving forward in the Preserving Access to Home Health Act of 2022 (S. 4605/H.R. 8581).
Contact: Meg Everett, meverett@leadingageny.org, 518-867-8871