The Center for Medicare and Medicaid Services (CMS) released its proposed home health payment rule for CY 2022 on June 28, 2021. We’ve outlined the must-know details for home health providers to stay informed. The comment period is open until Aug. 27, 2021 at 5 pm ET.

What’s proposed for Calendar Year (CY) 2022?

  • On Jan. 1, 2022, the Home Health Value-Based Purchasing (HHVBP) Model will expand to all 50 states, the District of Columbia and U.S. territories. The first performance year of the expanded HHVBP Model would be CY 2022, with quality performance data from that year used to calculate payment adjustments under the expanded model in CY 2024. Proposed adjustments in the first payment year (CY 2024) are a maximum 5% increase or decrease in payment.
  • Payment highlights in the proposed rule include no Adjustments to PDGM 4.36 behavioral adjustment for CY 2022. CMS proposed a 1.7% increase in Medicare payments next year. CY 2022 National Standardized 30-day period payment is $2,013.43. CY 2022 rate for those not submitting quality data is $1,973.88. In addition, CMS plans to recalibrate case-mix weights, functional levels and comorbidity adjustment subgroups using CY 2020 data. For comorbidity adjustments, the number of low comorbidity adjustments increases to 20 groups and more than doubles the number of high interaction pairs to 85.
  • LUPA thresholds will be maintained for CY2022. Additionally, this rulemaking proposes to utilize the physical therapy LUPA add-on factor to establish the occupational therapy add-on factor for the LUPA add-on payment. This is due to a proposed expansion allowing OT to do initial assessment visits and complete comprehensive assessment when OT is on point-of-care (POC) and when SN not initially on POC. More information regarding the LUPA add-on will be published to the Federal Register on July 7, 2021 and online at federalregister.gov/d/2021-13763.
  • Regulatory blanket waiver home health aide supervision § 484.80(h)(1) and § 484.80(h)(2) will allow a maximum of two virtual supervision visits in 60-day period. CMS stated in its news release that: “While we are proposing to allow this telecommunications flexibility, we expect that in most instances, the HHAs would plan to conduct the 14-day supervisory assessment during an on-site, in person visit, and that the HHA would use interactive telecommunications systems option only for unplanned occurrences that would otherwise interrupt scheduled in-person visits.”

Reminders for CY 2022

  • Notice of Admission (NOA) will go into effect Jan. 1, 2022
  • OASIS-E is set to roll out on Jan. 1, 2023. A draft of OASIS-E will be released early CY2022.

Additional Resources

McBee is committed to helping home health organizations adapt, innovate and thrive in the future of value-based care. Want to learn more about how McBee can help your organization prepare for HHVBP roll-out? Get in touch to learn about our OASIS accuracy, coding, and episode management services to improve quality measures while achieving financial success and ensuring compliance in order to thrive under new CMS updates.

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