An Analysis and Commentary on Federal Health Care Issues by Larry Goldberg

CMS Releasing Final Calendar Year 2021 PPS Updates – Home Health Issued

The Centers for Medicare and Medicaid Services (CMS) have issued their final calendar year (CY) 2021 update to the home health prospective payment system (HH PPS). The rule is effective January 1, 2021. 

The rule will update the payment rates and the wage index for home health agencies (HHAs); set forth the case-mix weights for 2021; and specify the CY 2021 fixed-dollar loss ratio (FDL) for outlier payments. The rule also will adopt revised Office of Management and Budget (OMB) statistical area delineations described in a September 14, 2018 OMB Bulletin No. 18-04 effective beginning in CY 2021. This rule includes a cap on wage index decreases in excess of 5.0 percent for CY 2021. The rule also includes changes to the home health regulations regarding the use of telecommunications technology; implements the permanent home infusion therapy services benefit and supplier enrollment requirements for CY 2021; finalizes a policy to align the Home Health Value-Based Purchasing (HHVBP) Model data submission requirements with any exceptions or extensions granted for purposes of the Home Health Quality Reporting Program (HH QRP) during the COVID-19 Public Health Emergency (PHE). 

The 190-page rule is currently on display at the Federal Register. A copy is available at: https://public-inspection.federalregister.gov/2020-24146.pdf. Publication is slated for November 4.

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