CMS Home Health 2022 Final Rule: What Does It Mean For You Next Year?
shelly • November 10, 2021
On November 2nd 2021, the Centers for Medicare and Medicaid Services (CMS) released the final rule for home health PPS in calendar year 2022. Let's take a look at some of the bullet points included in these changes.
Final Rule for 2022:
As always, agencies are advised to review the full CMS final rule for specifics, but here are some of main items to consider:
- Conditions of Participation : Some of the blanket waivers put into place for COVID- 19 will become permanent. This will include certain uses of telecommunications for assessments and home health aide supervision. The rule includes the ability for the occupational therapist to complete the initial and comprehensive assessments for beneficiaries where either physical or speech therapy is on the plan of care and skilled nursing is not.
- Payment updates: CMS increased payment estimates the aggregate up by $570 million or 3.2 percent. The breakdowns can be seen in the final rule, but include a 2.6 percent increase included in the 2022 home health payment update, a 0.7 percent increase related to the updated fixed-dollar loss ratio, and the 0.1 decrease in the rural add-on percentages. There are changes to payments related directly to recalibrating the PDGM case mix weights, occupational therapy LUPA add-ons, and the home health infusion therapy benefit.
- Quality Reporting: The reporting updates are more aligned with desired patient outcomes as opposed to being based upon certain Oasis-based measures that are not able to show demonstrable differences in performance.
- Survey processes for hospice: The goal of these changes are to drive the quality of care for hospice programs. CMS wants a multi-disciplinary survey team approach. We will see more focus related to prohibiting surveyor conflict of interest, expansion of surveyor training from accrediting bodies and establishment of a hospice program complaint hotline. Accrediting bodies with CMS approved hospice programs will use Form CMS-2567. It also changes the role of enforcement within the survey process to potentially terminate participation in the Medicare program for those who are noncompliant.
- Medicare provider enrollment: The regulatory changes are related to deactivations, rejection and return of provider enrollment applications, and establishment of effective dates for provider enrollment transactions.
- Value-Based Purchasing Expansion: If you follow this blog, you have seen the proposed expansion parameters. VBP is expanding nationwide with the quality performance data to be collected beginning in 2023. This data will determine payment adjustments based upon performance. CMS will assist agencies in calendar year 2022 to understand how to everything will be assessed.
At Kenyon Homecare Consulting , we help agencies to provide high-quality, patient-centered care that is in compliance with state and federal regulations. Should you need assistance with your agency start-up, operations, or compliance, please call us at 206-721-5091 or contact us online to see how we can help you today!
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