CMS Issues Proposed Payment Update and Telemedicine Extension for Home Health Care

July 24, 2020

The Centers for Medicare & Medicaid Services (CMS) in late June 2020 announced proposed changes in the home health care sector, including a small payment increase to home health agencies for 2021. In addition, the proposed rule, according to CMS, includes making permanent the regulatory changes related to telemedicine in providing care under the Medicare home health benefit, beyond the expiration of the public health emergency (PHE) for the Coronavirus Disease 2019 (COVID-19) pandemic.

For 2021, the CMS proposal would increase Medicare payments to home health agencies by 2.6%, which equates to about $540 million for the industry. Last year, the proposed rule for 2020 included an increase of 1.3%. The CMS said its proposed slight payment change is due to the minimal data available to date from its transition to this year’s Patient-Driven Groupings Model (PDGM), which overhauled the home health payment system effective January 1, 2020. 

Telemedicine Services Extended 

Amid the coronavirus pandemic, at the end of March 2020, the CMS added more than 80 new telemedicine servicesto the list of services covered by Medicare. In its latest proposed ruling, the CMS is stating that “home health agencies can continue to utilize telecommunications technologies in providing care to beneficiaries under the Medicare home health benefit beyond the COVID-19 PHE, as long as the telecommunications technology is related to the skilled services being furnished, is outlined in the plan of care, and is tied to a specific goal indicating how such use would facilitate treatment outcomes.”

The use of telemedicine technology may not substitute, the CMS underscores, for an in-person home visit that is ordered on the plan of care and cannot be considered a visit for the purpose of patient eligibility or payment. The use, however, of telehealth may result in changes to the frequency and types of in-person visits as ordered on the plan of care. The CMS proposed ruling also allows home health care providers to continue to report the costs of telecommunications technology as allowable administrative costs on the home health agency cost report beyond the PHE for the COVID-19 pandemic.

In addition, the new rule proposes Medicare enrollment policies for qualified home infusion therapy suppliers and updates the home infusion therapy services payment rates for 2021.

Comments to the CMS on the new rulings must be received by August 31, 2020. 

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