Home Health

Breaking news: CMS releases 2021 proposed payment rule: Telehealth is here to stay

CMS’ 2021 proposed PPS payment rule aims to make recently relaxed telecommunications requirements permanent beyond the public health emergency (PHE).

That means regardless of the PHE, beginning Jan. 1, 2021, home health agencies can continue to use telecommunications as long as it “is related to the skilled services being furnished, is outlined in the plan of care and is tied to specific goals indicating how such use would facilitate treatment outcomes,” CMS stated.

Technology can’t substitute for in-person visits on the plan of care “and cannot be considered a visit for the purpose of patient eligibility or payment,” CMS added. Agencies would continue to report telecommunications as allowable administrative expenses on the cost report.

“These proposed changes are one of the first flexibilities provided during the COVID-19 PHE that CMS is proposing to make a permanent part of the Medicare program,” CMS stated. The relaxed requirements for home health were first announced in the March 30, 2020 rule, “Policy and Regulatory Revisions in Response to the COVID–19 Public Health Emergency Interim Final Rule.”

Note: There are no proposed changed to the Patient-Driven Groupings Model (PDGM) in the rule.

Payment changes

Medicare home health payments would increase in aggregate by 2.6%, or $540M, according to the proposed rule. That reflects the proposed 2.7% home health payment update percentage and a 0.1% decrease in payments due to reductions made in the rural add-on percentages, CMS stated.

CMS also plans to update the home health wage index implementing statistical area delineations refined by the Office of Management and Budget and apply a 5% cap on wage-index decreases in 2021.

The proposed changes also include Medicare enrollment policies for qualified home infusion therapy suppliers and updates the home infusion therapy services payment rates for 2021.

Related link: View the proposed 2021 PPS payment rule at: https://tinyurl.com/y9annnhn.

Editor’s note: Watch for continued coverage of this rule in upcoming issues of Home Health Line.