Home Health Final Rule contains ‘significant change’ for agencies, expert warns

The 2020 Home Health Final Rule has a “significant change” that home healthcare agencies “should be paying close attention,” according to Aaron Tripp, vice president for reimbursements and financing policy at LeadingAge.

During a LeadingAge Coronavirus Update call this week, Tripp noted that although the payment part of the Request for Anticipate Payment will go away next year, home care providers are still required to submit a “slimmed-down RAP” within five days or face a fine that is equivalent to one day of the 30-day period for each day the agency is late with its submission. 

Tripp also noted that the rule finalizes expected changes from the proposed rule released last summer. Case-mix rates and low utilization payment adjustment thresholds related to the Patient-Driven Groupings Model are the same as 2020 levels, he noted. There also will be an expected 2% payment update and updates to wage-index levels. Regarding telehealth, plans of care must include a provision of remote patient monitoring or other services furnished via technology or telecommunications. 

“Our members have been working hard throughout this healthcare crisis to serve older adults in need of home healthcare while at the same time shouldering significant pandemic-related expenses for [personal protective equipment], staffing and other needs,” Tripp told the McKnight’s Home Care Daily. “They’ve cared for older adults both in person and via telehealth, despite shortcomings in Medicare reimbursement policies that keep providers from being paid for delivering telehealth services.”

Those realities, coupled with CMS’ decision to not address “faulty” behavior assumption adjustments, nor take into account providers’ additional pandemic-related supply expenses, particularly related to PPE and testing, in the rule for calendar year 2021 put home health agencies in an “untenable position,” Tripp said.

“Our members deserve to be paid fully for the care they provide to ensure older adults’ well-being,” he said.