The
CY2023 home health proposed rule just posted to the Federal Register preview site. NAHC staff are reviewing the provisions and will provide a detailed summary soon. Until then, below is the summary from the posting.
This proposed rule would set forth routine updates to the Medicare home health
and home infusion therapy services payment rates for calendar year (CY) 2023 in accordance
with existing statutory and regulatory requirements. This proposed rule discusses home health
utilization; proposes a methodology for determining the difference between assumed versus
actual behavior change on estimated aggregate expenditures for home health payments as result
of the change in the unit of payment to 30 days and the implementation of the Patient Driven
Groupings Model (PDGM) case-mix adjustment methodology; and proposes a temporary
retrospective and permanent prospective adjustment to the CY 2023 home health payment rates.
This rule proposes reassignment of certain diagnosis codes under the PDGM. and proposes to
establish a permanent mitigation policy to smooth the impact of year-to-year changes in home
health payments related to changes in the home health wage index. This rule also proposes
recalibration of the PDGM case-mix weights and updates the low utilization payment adjustment
(LUPA) thresholds, functional impairment levels, comorbidity adjustment subgroups for CY
2023 and the fixed-dollar loss ratio (FDL) used for outlier payments. Additionally, this rule
discusses the future collection of data regarding the use of telecommunications technology
during a 30-day home health period of care on home health claims. In addition, this rule proposes
changes to the Home Health Quality Reporting Program (HH QRP) requirements; changes to the
expanded Home Health Value-Based Purchasing (HHVBP) Model; and updates to the home
infusion therapy services payment rates for CY 2023