06/23/2022

Home Health PPS Proposed Rule represents a big cut

Last Friday, the Centers for Medicare & Medicaid Services (CMS) issued the CY2023 Home Health Prospective Payment System Proposed Rule. CMS has proposed a -4.2% aggregate decrease to CY 2023 home health payments, or -$810 million compared to CY 2022. This decrease reflects the effects of the proposed 2.9% home health payment update percentage ($560 million increase), an estimated 6.9% decrease that reflects the effects of the proposed prospective, permanent behavioral assumption adjustment of -7.69% ($1.33 billion decrease), and an estimated 0.2% decrease that reflects the effects of a proposed update to the fixed-dollar loss ratio (FDL) used in determining outlier payments ($40 million decrease). LeadingAge will issue a comprehensive analysis for members this week and will review the proposals on the July 19 Home Health Member Network call. To register for this call, please click here.