Federal Home Health Updates
(Nov. 12, 2024) Please see the following updates from LeadingAge National:
CMS Finalizes Home Health Payment and Conditions of Participation Changes. In the Calendar Year (CY) 2025 Home Health Payment Rule released on Nov. 1st, the Centers for Medicare and Medicaid Services (CMS) finalized an aggregate .5 percent increase for home health providers in CY 2025. While the final rule does not cut as deeply as was proposed thanks to LeadingAge advocacy, the impact of this year’s rule, on top of two prior years’ cuts, will be harmful. In addition to payment updates, CMS is making changes to the collection of Outcome and Assessment Information Set (OASIS) data for all patients as well as finalizing the addition of new OASIS items. Finally, CMS will be requiring a new condition of participation on Jan. 1, 2025, requiring agencies to create an acceptance-to-service policy.
An in-depth analysis of the final rule is available here.
Final HHVBP APR Errors and Recalculation Request. During the Nov. 6th Home Health and Hospice Open Door Forum, CMS shared that there were errors in calculating two claims-based measures for the Home Health Value-Based Purchasing (HHVBP) Model’s Annual Performance Reports (APRs). CMS is planning to issue the final APRs to home health providers on the Internet Quality Improvement and Evaluation System (iQIES) the week of Nov. 4th. Due to the error, CMS is offering agencies a final opportunity to submit a recalculation request within 15 calendar days of receiving their report (excluding the federal holiday on Nov. 11th). Providers can only submit a recalculation request for the two claims-based measures in the report: Acute Care Hospitalization and Emergency Department Use. To review how to submit a recalculation request, click here.
Home Health Agency Quality Program Non-Compliance Letters Issued for CY 2025. CMS issued notifications to home health agencies that were determined to be out of compliance with the Home Health Quality Reporting Program (HHQRP) requirements for the CY 2025 Annual Payment Update (APU). Non-compliance notifications are distributed by the Medicare Administrative Contractors (MACs) and were placed into home health agencies' My Reports folders in iQIES on Oct. 21, 2024. Agencies that receive a letter of non-compliance may submit a request for reconsideration to CMS via email no later than 11:59 p.m. on Nov. 27, 2024. Instructions on submitting a request for reconsideration can be found on the Home Health Quality Reporting Reconsideration and Exception & Extension webpage. All personal health information must be removed in order for the reconsideration request to be reviewed.
Contact: Meg Everett, meverett@leadingageny.org, 518-867-8871