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Home Healthcare Crystal Ball for 2021: More Virtual Care & Bigger Reimbursements from CMS

CMS New Proposed Rule HHA The Centers for Medicare and Medicaid Services (CMS) is out with a new proposed rule when it comes to payment and reimbursement. The proposed rule brings some positive changes for home healthcare providers. It also makes permanent a change implemented to respond to the COVID-19 pandemic.

Telemedicine

CMS proposes allowing home health agencies (HHAs) to continue to use telemedicine to provide care to Medicare recipients, even after the COVID-19 public health emergency is over. But, video appointments wouldn’t take the place of the in-person home care that’s part of the patient’s plan of care. CMS does note that telehealth visits could change the number of in-person visits as part of the plan of care. Home health providers still would not receive payment for telehealth care. The proposed rule does however allow HHAs to still report costs associated with telemedicine technology as part of their administrative costs on their cost reports, even after the COVID-19 public health emergency.

GJM’s Jamie Dixon works with many HHAs on their cost reports. 

“These front-line workers need all the tools they can get,” he says. “Being able to monitor and be present with their clients is efficient, safe and could be lifesaving.”

Reimbursements Boost

Also included in the proposed rule is an increase in reimbursements for home health agencies. CMS has estimated that Medicare payments to HHAs in the 2021 calendar year (CY) will increase by 2.6% (about $540 million) compared to the current calendar year. Last year’s predicted bump in reimbursements called for half that, a 1.3% increase from CY 2019 to CY 2020.

Home Infusion Therapy

The proposed rule also calls for new policies for Medicare enrollment for home infusion therapy providers and updates the payment rates for such services. The new payment rates would follow the CY 2021 Physician Fee Schedule.

“COVID has hit the entire healthcare industry extremely hard. Home Health Agencies always rise to the crisis. The additional tools and resources outlined in this proposed rule will assist them in what they do best.”

CMS announced the proposed rule on June 25 and has compiled a fact sheet with more information. 

Jamie Dixon Gilmore Jasion MahlerJamie Dixon, CPA is a member of the Gilmore Jasion Mahler (GJM) Healthcare Specialist Team, with an expertise in long-term care, home healthcare and hospice. A member of the Ohio Council for Home Care and Hospice, he has been a member of the organization’s Financial related committees for close to 20 years. Jamie also serves as GJM firm administrator.

Established in 1996, Gilmore Jasion Mahler, LTD (GJM) is the largest public accounting firm in Northwest Ohio, with offices in Maumee and Findlay. Locally owned, GJM offers cloud-based accounting and provides comprehensive services including assurance, business advisory, tax, risk advisory, healthcare management and outsourced accounting. The Firm’s professionals specialize in industries including construction & real estate, healthcare, manufacturing & distribution and utilities.