Health Reform WK-EDGE 2021 home health rule finalizes permanent telehealth use provisions
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Friday, November 6, 2020

2021 home health rule finalizes permanent telehealth use provisions

By Kayla R. Bryant, J.D.

The rule ultimately increases payments to home health agencies by 2 percent from last year and implements policies for home infusion therapy supplier enrollment.

CMS has finalized the home health (HH) prospective payment system (PPS) update percentage for calendar year (CY) 2021 at 2 percent. The increase is lower than the proposed 2.6 percent increase due to changes in economic projections based on the impact of COVID-19. The final rule also makes permanent provisions for increased used of telecommunications for HH care that were created in light of COVID-19 (Final rule, 85 FR 70298, November 4, 2020).

HHS PPS. The HH market basket update percentage increase was originally proposed to be 3.1 percent based on economic forecasting available at that time (85 FR 39408, June 30, 2020). More recent forecasting projects slower anticipated compensation growth in labor markets through the recovery following the economic depression that started early in 2020. The market basket percentage increase for the final rule lowered to 2.3 percent. This figure is then lowered by a multifactor productivity (MFP) adjustment as mandated by section 3401 of the Patient Protection and Affordable Care Act (ACA) (P.L. 111-148), of 0.3 percentage points. For home health agencies (HHAs) that fail to submit the required data under the quality reporting program, (QRP), the payment update is reduced by 2 percentage points.

The CY 2021 national, standardized 30-day payment amount for HHAs that report under the QRP is $1,901.12. The amount for HHAs that fail to report QRP data is $1,863.84.

The national per-visit payment rates for various disciplines for HHAs that submit the required quality data are:

  • Home health aides: $69.11
  • Medical social services: $244.64
  • Occupational therapy: $167.98
  • Physical therapy: $166.83
  • Skilled nursing: $152.63
  • Speech-language pathology: $181.34.

The rates for disciplines for HHAs that fail to submit quality data are:

  • Home health aides: $67.76
  • Medical social services: $239.85
  • Occupational therapy: $164.69
  • Physical therapy: $163.56
  • Skilled nursing: $149.64
  • Speech-language pathology: $177.79.

Telehealth. The Coronavirus Aid, Relief, and Economic Security Act (CARES Act) (P.L. 116-136) required HHS to consider ways to encourage the use of telecommunications systems for home health. CMS previously revised plan of care requirements under 42 C.F.R. §409.43(a) during the COVID-19 public health emergency to require that plans include the provision of remote patient monitoring and other telehealth services with a description of how the use of technology will help achieve the goals on the plan of care and is tied to the patient’s needs. The use of these services cannot substitute for a home visit. CMS finalized these provisions in the current final rule, but will not require the plan of care to include a description of how technology will help achieve the plan’s goals.

MainStory: TopStory FinalRules AgencyNews HealthInformationTechnologyNews HomeBasedServicesNews QualityNews VBPNews NewsFeed

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