NAHC: CMS Bases Payments on Therapy Utilization Despite Law

In response to a requirement of the Consolidated Appropriations Act (CAA), 2023, the Centers for Medicare & Medicaid Services (CMS) presented data used to determine Medicare home health payment rates for calendar year (CY) 2023, including the permanent and temporary rate adjustments calculated under the Patient Driven Groupings Model (PDGM) “budget neutrality” requirements. Also required…

You Need to Register for this CMS Webinar on PDGM

Wednesday, March 29, 2023 1:30 PM – 3:00 PM EDT REGISTER Free to all Medicare Home Health Prospective Payment System (HH PPS) Calendar Year (CY) 2023 Behavior Change Recap, 60-Day Episode Construction Overview, and Payment Rate Development Webinar ATTENTION all NAHC members! It is critical that you, and, if possible, multiple people in your organization, register…

You Need to Register for this CMS Webinar on PDGM

Wednesday, March 29, 2023 1:30 PM – 3:00 PM EDT REGISTER Free to all Medicare Home Health Prospective Payment System (HH PPS) Calendar Year (CY) 2023 Behavior Change Recap, 60-Day Episode Construction Overview, and Payment Rate Development Webinar ATTENTION all NAHC members! It is critical that you, and, if possible, multiple people in your organization,…

Summary of the Recent CMS Open Door Forum

The Centers for Medicare and Medicaid Services (CMS) held a Home Health, Hospice, and DME Open Door Forum on February 23, 2023.  The summary of the Forum applicable to home health and hospice providers is below. HOME HEALTH CMS PDGM Data Transparency and Stakeholder Feedback  CMS officials announced a webinar scheduled for Wednesday, March 29…

CMS Final CY2023 Home Health Rule: Slightly Modified But Home Health Access Risks Remain

The Centers for Medicare and Medicaid Services (CMS) issued the Final Rule regarding Medicare home health services payment rates for CY 2023. As usual, the rule also includes a hodgepodge of non-rate related proposals as well. This article provides a summary of the Final Rule. NAHC will be providing more detail over the next week…

Fight for Home Health Care & Hospice in DC!

Wednesday, September 14 REGISTER (required) Today is the last day to sign up (registration above) to join NAHC and your fellow home care and hospice professionals who will be on Capitol Hill on Wednesday, September 14th, to advocate to Congress for some of the biggest issues facing the industry right now. Home health providers are facing…

Key Home Health Legislation Builds Support in Congress

Send a message to Congress now! Help us build even more support The Preserving Access to Home Health Act of 2022 (S. 4605/H.R. 8581), a top NAHC Advocacy priority, is building momentum and adding supporters from both parties in both houses of Congress over the past week. As you probably know, this legislation would prevent the…

Private Duty Should Care About CMS Rate Cuts

  • GO HERE to tell your members of Congress to support this critical legislation!
  • Big win for NAHC Advocacy & home health providers & patients!

In June the Centers for Medicare & Medicaid Services (CMS) released their proposed rule for home health services for CY2023. As part of their proposal they called for a 7.69 percent reduction to the base payment rate in order to meet a budget neutrality requirement as part of the transition to the Patient Driven Groupings Model (PDGM). In the Balanced Budget Act of 2018 Congress set parameters for the creation of PDGM with a 30-day payment episode, removal of therapy utilization in payment determinations, and a new case-mix methodology.

That large of a payment reduction would negatively impact all provider types, as seniors would ultimately have less access to care in the home.

“We estimate that 44 percent of all home health agencies would operate at a financial loss next year of the 7.69 percent rate cut takes effect, triggering a loss a care access for the millions of people relying on home health care,” said NAHC President William A. Dombi.

“This legislation should secure continued access to care,” added Dombi. “It will also provide an extended opportunity for CMS to rethink its approach to the budget neutrality adjustment. We firmly believe that CMS has much better options to consider that do not devastate the care that millions depend on.”

The Preserving Access to Home Health Act of 2022, S. 4605/H.R. 8581, introduced in the Senate and House of Representatives in the last week of July, would freeze CMS’ proposed 7.69 percent payment rate cut for CY2023. The swift movement of this legislation is a direct result of NAHC’s advocacy efforts on behalf of the entire industry and warrants attention from the private home care industry as well.

We ask every provider, regardless of service type, to urge your Senators to sign on to it. You can send a pre-drafted message by clicking here, though calls and/or personal messages are best.

Please reach out to NAHC with any questions, comments or thoughts.

Thank you for your assistance in this effort!

Legislation to Stop Home Health Rate Cuts Introduced in House of Reps

GO HERE to tell your members of Congress to support this critical legislation! Big win for NAHC Advocacy & home health providers & patients! Legislation has been introduced in the House of Representatives to prevent cuts to the Medicare Home Health payment rate as proposed by the Centers for Medicare and Medicaid Services (CMS) in their…

NAHC Advocacy: Legislation to Stop Home Health Rate Cuts Introduced

GO HERE to tell your members of Congress to support this critical legislation! Big win for NAHC Advocacy & home health providers & patients! Legislation has been introduced in the Senate designed to prevent cuts to the Medicare Home Health payment rate as proposed by the Centers for Medicare and Medicaid Services (CMS) in their…