CMS Issues Proposed Rule That Would Update Home Health Payments and Allow Home Health Agencies to Continue Telemedicine Beyond Pandemic

CMS issued a proposed rule that proposes routine updates to the home health payment rates for calendar year (CY) 2021 and includes a proposal to make permanent certain regulatory changes related to telehealth beyond the expiration of the public health emergency for the COVID-19 pandemic (the Proposed Rule).

Home Health Agency Use of Telehealth

The Proposed Rule would finalize, effective January 1, 2021, the amendment to the home health regulations outlined in the March 30, 2020 Policy and Regulatory Revisions in Response to the COVID–19 Public Health Emergency Interim Final Rule (85 FR 19230). Accordingly, home health agencies (HHAs) would be able to continue to use telecommunications technologies to provide care to Medicare beneficiaries beyond the duration of the COVID-19 pandemic. The telecommunications technology must be related to the skilled services being furnished, be outlined on the plan of care, and be tied to a specific goal indicating how such use would facilitate treatment outcomes. CMS cautions, however, that the use of telemedicine may not substitute for an in-person home visit on the plan of care, nor can telemedicine be considered a visit for the purpose of patient eligibility or payment. The Proposed Rule would also allow HHAs to continue reporting the costs of telecommunications technology as allowable administrative costs on the home health agency cost report beyond the COVID-19 pandemic.

Home Health Agency Payments

The Proposed Rule also proposes updates to the home health payment rates for CY 2021. Based on the proposed changes, CMS estimates that Medicare payments to HHAs in CY 2021 would increase by 2.6 percent, or $540 million. This change reflects a proposed 2.7 percent home health payment update and a 0.1 percent decrease in payments due to reductions made in the rural add-on percentages mandated by the Bipartisan Budget Act of 2018 for CY 2021. The Proposed Rule would also update the home health wage index including the adoption of revised Office of Management and Budget statistical area delineations and limiting any decreases in a geographic area’s wage index value to no more than 5 percent in CY 2021.

Home Infusion Therapy

Further, the Proposed Rule would implement Medicare enrollment policies and specific requirements for qualified home infusion therapy suppliers. CMS explained that given CMS’s responsibility in preventing waste and abuse in the Medicare program, the agency believes that the safeguards that Medicare enrollment furnishes are needed with respect to home infusion therapy suppliers. CMS also proposes updates to the CY 2021 home infusion therapy services payment rates, consistent with the requirements outlined in the 21st Century Cures Act.