BriggsNetNews

CY2024 Home Health Proposed Rule

Mary Madison, RN, RAC- CT, CDP
Clinical Consultant – Briggs Healthcare

Friday, June 30, 2023, CMS posted the public inspection copy of the Calendar Year 2024 Home Health PPS Proposed Rule.  This 392-page document is scheduled to be published in the Federal Register on 07/10/2023 and available online at federalregister.gov/d/2023-14044, and on govinfo.gov.

This proposed rule would set forth routine updates to the Medicare home health payment rates for calendar year (CY) 2024 in accordance with existing statutory and regulatory requirements. This rule would:

• provide information on home health utilization trends and solicits comments regarding access to home health aide services;
• implement home health payment-related changes;
• rebase and revise the home health market basket and revise the labor-related share;
• codify statutory requirements for disposable negative pressure wound therapy (dNPWT) and
• implement the new items and services payment for the home intravenous immune globulin (IVIG) benefit.

In addition, it proposes:

• changes to the Home Health Quality Reporting Program (HH QRP) requirements and the expanded Home Health Value-Based Purchasing (HHVBP) Model;
• to implement the new Part B benefit for lymphedema compression treatment items;
• codify the Medicare definition of brace and make other codification changes based on recent legislation;
• to add an informal dispute resolution (IDR) and special focus program (SFP) for hospice programs;
• to codify DMEPOS refill policy and
• to revise Medicare provider and supplier enrollment requirements.

To be assured consideration, comments must be received at one of the addresses provided in the ADDRESSES section, no later than 5 p.m. EDT on August 29, 2023.

Table of Contents

I. Executive Summary
A. Purpose and Legal Authority
B. Summary of the Provisions of this Proposed Rule
C. Summary of Costs, Transfers, and Benefits

II. Home Health Prospective Payment System
A. Overview of the Home Health Prospective Payment System
B. Monitoring the Effects of the Implementation of PDGM
C. Proposed Provisions for CY 2024 Payment Under the HH PPS

III. Home Health Quality Reporting Program (HH QRP)

A. Background and Statutory Authority
B. General Considerations Used for the Selection of Quality Measures for the HH QRP
C. Quality Measures Currently Adopted for the CY 2024 HH QRP
D. HH QRP Quality Measure Proposals Beginning with the CY 2025 HH QRP
E. Form, Manner, and Timing of Data Submission under the HH QRP
F. Policies Regarding Public Display of Measure Data for the HH QRP
G. Health Equity Update
H. Proposal to Codify HH QRP Data Completion Thresholds
I. Principles for Selecting and Prioritizing HH QRP Quality Measures and Concepts under Consideration for Future Years: Request for Information (RFI)

IV. Proposed Changes to the Expanded Home Health Value-Based Purchasing (HHVBP) Model

A. Background
B. Proposed Changes to the Applicable Measure Set
C. Proposed Changes to the Appeals Process
D. Public Reporting Reminder Health Equity Update

V. Medicare Home Intravenous Immune Globulin (IVIG) Items and Services

A. General Background
B. Proposed Scope of Expanded IVIG Benefit
C. Proposed IVIG Administration Items and Services Payment
D. Proposed Home IVIG Items and Services Payment Rate
E. Billing Procedures for Home IVIG Items and Services

VI. Hospice Informal Dispute Resolution and Special Focus Program

A. Background and Statutory Authority
B. Proposed Regulatory Provisions

VII. Proposed Changes Regarding Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS)

A. Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program (CBP)
B. Scope of the Benefit and Payment for Lymphedema Compression Treatment Items
C. Definition of Brace
D. Documentation Requirements for Durable Medical Equipment, Prosthetics, Orthotics
and Supplies Products Supplied as Refills to the Original Order

VIII. Proposed Changes to the Provider and Supplier Enrollment Requirements

A. Background
B. Proposed Provisions

IX. Collection of Information Requirements

A. Statutory Requirement for Solicitation of Comments                                                                                        B. Information Collection Requirements (ICRs)                                                                                                          C. Submission of PRA-Related Comments

X. Regulatory Impact Analysis

A. Statement of Need
B. Overall Impact
C. Detailed Economic Analysis
D. Regulatory Review Cost Estimation
E. Alternatives Considered
F. Accounting Statements and Tables
G. Regulatory Flexibility Act (RFA)
H. Unfunded Mandates Reform Act (UMRA)
I. Federalism
J. Conclusion