News Roundup December 7th, 2020

In a year where many areas in the health industry received an unexpected jolt, home health agencies across the US have been rolling with the punches as the pandemic continues to tax the system. The Centers for Medicare and Medical Services (CMS) continues to guide home health providers with direction on how services are rendered and issued back in late October the 2021 Medicare Home Health Final Rule [CMS-1730-F]

Key takeaways see changes in payment rates for calendar year 2021. Additionally, rules around technologies related to telecommunication were finalized to address needs beyond the expiration of the Coronavirus Disease 2019 (COVID-19) public health emergency (PHE). 

Of the most salient and significant changes in Home Health payment rates for calendar year 2021 surround the payment part of the Request for Anticipated Payment (RAP). At the new year, home health agencies will be required to submit RAPs even though there will not be upfront payments that many home health providers have in the past received. No-pay RAPs are required within five calendar days of the start of care. 

Home Health News provides more details:

“Under the Prospective Payment System (PPS), agencies could receive 50% to 60% of their payment up front. This year, that was lowered to 20% for existing agencies, with new agencies being shut out from RAPs.

In 2021, there will be no payment tied to the RAPs for anybody. Once RAPs are fully phased out in 2022, the Notice of Admission (NOA) will take its place.” 

From CMS’s own newsstands, another main focus of the final rule is to promote efficiency. In areas of telecommunications technology, telehealth, which has seen a rise in usage and popularity due to pandemic, practices are now being brought to the forefront to help enhance delivery of care.

Though CMS states “the use of technology may not substitute for an in-person home visit that is ordered on the plan of care and cannot be considered a visit for the purpose of patient eligibility or payment” the movement towards incorporating technology into routine processes in care delivery shows an increased openness to adopt and innovate according to the landscape. 

Lastly, from the same news release issued by CMS their notes on updates to the Home Health Prospective Payment System rates for CY 2021 states that:

“[the] rule finalizes routine, statutorily required updates to the home health payment rates for CY 2021. CMS estimates that Medicare payments to HHAs in CY 2021 will increase in the aggregate by 1.9 percent, or $390 million, based on the finalized policies.”

While an increase in medicare payments will be seen Home Health Care News points out that “the figures are less than the $540 million boost […] initially floated in CMS’s proposed rule”