Home Health

Proposed rule: CMS moving forward with PDGM in 2020

CMS is staying true to plans to implement a new payment model.

The 2020 PPS proposed rule, which was posted to the Federal Register July 11, reinforces the plan to implement the Patient-Driven Groupings Model (PDGM) beginning on or after Jan. 1, 2020.

The model will move from 60-day episodes to 30-day payment periods.

While the PDGM is still designed to be budget-neutral, the proposed rule outlines a total 8.01% decrease due to changes CMS anticipates agencies will make in response to the new model.

The proposed rule also seeks to:

  • Allow physical therapy assistants to furnish maintenance therapy.
  • Set routine updates to the home infusion therapy payment rates for CY2020 and propose payment provisions for these services in CY2021 and future years.
  • Modify payment regulations related to the content of the home health plan of care.
  • Make changes to the value-based purchasing model.
  • Change, add and remove measures in the Home Health Quality Reporting Program.

Related links: View a PDF of the proposed rule at http://bit.ly/2GaJ6dQ. View a CMS release on the proposed rule at https://go.cms.gov/2Y46HXM.